Ozhirenie v detskom vozraste:vozmozhnosti primeneniya amerikanskogokonsensusa v rossiyskoy praktike

Cover Page


We have analyzed the opportunity to use in Russian practice An Endocrine Society Clinical Practice Guideline: Prevention
and Treatment of Pediatric Obesity. The document contains exact statements on diagnostic criteria of obesity and overweight, clarification
of basic principles of investigation, detailed therapeutic recommendations, considerations on obesity prophylaxis problem. All recommendations
are given according to the evidence database existing to the moment of guideline development. The guidelines are found
to be comfortable to use by clinicians taking in consideration a few limitations. Clarifications in international pediatric percentile body
mass index charts usage, nomenclature specifications, and pharmacotherapy with drugs non-approved for children are necessary.

About the authors

Email: org@endocrincentr.ru


  1. Дедов И.И., Мельниченко Г.А., Бутрова С.А., Савельева Л.В. и соавт. Ожирение у подростков России // Ожирение и метаболизм №4, 2006 г., с. 30-34.
  2. Prevention and Treatment of Pediatric Obesity: An Endocrine Society Clinical Practice Guideline Based on Expert Opinion // JCEM. 2008; 93(12): 4576-99.
  3. Evaluation and Treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline // JCEM. 2006; 91: 1621-34.
  4. Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline // JCEM. 2008; 91(6): 1995-2010.
  5. Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline // JCEM. 2006; 91(10): 3697-716.
  6. Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline // JCEM. 2007; 92(8): S. 1-47.
  7. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline // JCEM. 2008; 93(4): 1105-20.
  8. The Diagnosis of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline // JCEM. 2008, 93(5): 1526-40.
  9. Case Detection, Diagnosis, and Treatment of Patients with Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline // JCEM. 2008; 93(9): 3266-81.
  10. Primary Prevention of Cardiovascular Disease and Type 2 Diabetes in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline // JCEM. 2008; 93(10): 3671-89.
  11. Himes J.H., Dietz W.H. Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services // Am. J. Clin. Nutr. 1994; 59(2): 307-16.
  12. Barlow S.E., Dietz W.H. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services // Pediatrics. 1998; 102(3): E29.
  13. Assessment of Childhood and Adolescent Obesity. Results from an International Obesity Task Force workshop. Dublin, June 16, 1997 // Am. J. Clin. Nutr. 1999; 70(1): 117S-175S.
  14. Hedley A.A., Ogden C.L., Johnson C.L., Carroll M.D., Curtin L.R., Flegal K.M. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002 // JAMA. 2004; 291(23): 2847-5.
  15. Петеркова В.А., Ремизов О.В. Ожирение в детском возрасте. В кн.: Ожирение: этиология, патогенез, клинические аспекты. Под ред. Дедова И.И., Мельниченко Г.А. - М.: Медицинское информационное агентство, 2004. С. 312-329.
  16. Whitaker R.C., Wright J.A., Pepe M.S., Seidel K.D., Dietz W.H. Predicting obesity in young adulthood from childhood and parental obesity // N. Engl. J. Med. 1997; 337(13): 869-73.
  17. Freedman D.S., Mei Z., Srinivasan S.R., Berenson G.S., Dietz W.H. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study // J. Pediatr. 2007; 150(1): 12-17.
  18. Liese A.D., D'Agostino R.B. Jr., Hamman R.F, Kilgo P.D., Lawrence J.M., Liu L.L., Loots B., Linder B., Marcovina S., Rodriguez B., Standiford D., Williams D.E. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study // Pediatrics. 2006; 118(4): 1510-8.
  19. Кураева Т.Л., Дубинина И.А., Васюкова О.В., Дианов О.А., Петряйкина Е.Е., Малиевский О.А., Волков И.Э., Петеркова В.А. Клиническая характеристика сахарного диабета 2 типа у детей и подростков // VII Всероссийская научно- практическая конференция «Приоритетный национальный проект «Здоровье». Задачи детской эндокринологии в его реализации». Материалы конференции. 1-2 июня 2009 г. Санкт-Петербург, с. 48-49
  20. Cook S., Weitzman M., Auinger P., Nguyen M., Dietz W.H. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994 // Arch. Pediatr. Adolesc. Med. 2003; 157(8): 821-7.
  21. Витебская А.В., Васюкова О.В. Диагностика инсулинорезистентности у детей и подростков // Проблемы эндокринологии. №6, 2006. С. 39-41.
  22. Kaplowitz P.B., Slora E.J., Wasserman R.C., Pedlow S.E., Herman-Giddens M.E. Earlier onset of puberty in girls: relation to increased body mass index and race // Pediatrics. 2001;108(2): 347-53.
  23. Дедов И.И., Мельниченко Г.А., Чеботникова Т.В. и соавт. Ожирение и половое развитие: эпидемиологическое исследование детей и подростков Московского региона // Ожирение и метаболизм», №3, 2006 г., с. 14-20.
  24. Dietz W.H., Bellizzi M.C. Introduction: the use of body mass index to assess obesity in children // Am. J. Clin. Nutr. 1999; 70(1): S. 123-5.
  25. Flegal K.M., Ogden C.L., Wei R., Kuczmarski R.L., Johnson C.L. Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index // American Journal of Clinical Nutrition, 2001; 73(6),1086-93.
  26. Cole T.J., Bellizzi M.C., Flegal K.M., Dietz W.H. Establishing a standard definition for child overweight and obesity worldwide: international survey // BMJ. 2000; 320(7244): 1240-3.
  27. Must A., Dallal G.E., Dietz W.H. Reference data for obesity: 85th and 95th percentiles of body mass index and triceps skinfold thickness // Am. J. Clin. Nutr. 1991 Apr.; 53(4): 839-46.
  28. Fernбndez J.R., Redden D.T., Pietrobelli A., Allison D.B. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents // J. Pediatr. 2004; 145(4): 439- 44.
  29. Reinehr T., Hinney A., de Sousa G., Austrup F., Hebebrand J., Andler W. Definable somatic disorders in overweight children and adolescents // J. Pediatr. 2007; 150(6): 618-22.
  30. Schwimmer J.B., Deutsch R., Kahen T., Lavine J.E., Stanley C., Behling C. Prevalence of fatty liver in children and adolescents // Pediatrics. 2006; 118(4): 1388-93.
  31. Lee J.M., Okumura M.J., Davis M.M., Herman W.H., Gurney J.G. Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study // Diabetes Care. 2006; 29(11): 2427-32.
  32. Savoye M., Berry D., Dziura J., Shaw M., Serrecchia J.B., Barbetta G., Rose P., Lavietes S., Caprio S. Anthropometric and psychosocial changes in obese adolescents enrolled in a Weight Management Program // J. Am. Diet. Assoc. 2005; 105(3): 364-70.
  33. Wilfley D.E., Stein R.I., Saelens B.E., Mockus D.S., Matt G.E., Hayden-Wade H.A., Welch R.R., Schechtman K.B., Thompson P.A., Epstein L.H. Efficacy of maintenance treatment approaches for childhood overweight: a randomized controlled trial // JAMA. 2007; 298(14): 1661-73.
  34. Anderson J.W., Konz E.C., Frederich R.C., Wood C.L. Long-term weight-loss maintenance: a meta-analysis of US studies // Am. J. Clin. Nutr. 2001; 74(5): 579-84.
  35. Knowler W.C., Barrett-Connor E., Fowler S.E., Hamman R.F., Lachin J.M., Walker E.A., Nathan D.M. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin // N. Engl. J. Med. 2002; 346(6): 393-403.
  36. American Dietetic Association (ADA). Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight // J. Am. Diet. Assoc. 2006; 106(6): 925-45.
  37. Spear B.A., Barlow S.E., Ervin C., Ludwig D.S., Saelens B.E., Schetzina K.E., Taveras E.M. Recommendations for treatment of child and adolescent overweight and obesity // Pediatrics. 2007; 120(4): S254-88.
  38. Popkin B.M., Siega-Riz A.M., Haines P.S., Jahns L. Where's the fat? Trends in U.S. diets 1965-1996 // Prev. Med. 2001; 32(3): 245-54.
  39. James J., Thomas P., Cavan D., Kerr D. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial // BMJ. 2004; 328(7450): 1237.
  40. AMERICAN ACADEMY OF PEDIATRICS: The Use and Misuse of Fruit Juice in Pediatrics. Committee on Nutrition // Pediatrics. 2001; 107(5): 1210-13.
  41. McConahy K.L., Smiciklas-Wright H., Mitchell D.C., Picciano M.F. Portion size of common foods predicts energy intake among preschool-aged children // J. Am. Diet. Assoc. 2004; 104(6): 975-9.
  42. Nordmann A.J., Nordmann A., Briel M., Keller U., Yancy W.S. Jr., Brehm B.J., Bucher H.C. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials // Arch. Intern. Med. 2006 Feb. 13; 166(3): 285-93.
  43. Сорвачева Т.Н., Петеркова В.А., Титова Л.Н., Витебская А.В., Пырьева Е.А. Эффективность низкоуглеводной диеты при лечении ожирения у детей- подростков // Вопросы питания, №3 2007 г. C. 29-34.
  44. Andersen L.B., Harro M., Sardinha L.B., Froberg K., Ekelund U., Brage S., Anderssen S.A. Physical activity and clustered cardiovascular risk in children: a cross-sectional study // Lancet. 2006; 368(9532): 299-304.
  45. Yin Z., Moore J.B., Johnson M.H., Barbeau P., Cavnar M., Thornburg J., Gutin B. The Medical College of Georgia Fitkid project: the relations between program attendance and changes in outcomes in year 1 // Int. J. Obes. (Lond.). 2005; 29(2): S40-5.
  46. Регистр лекарственных средств России. РЛС. Энциклопедия лекарств. - 17-й вып. / Гл. ред. Г.Л. Вышковский. - М.: «РЛС-2009», 2008. - 1440 с.
  47. McGovern L., Johnson J.N., Paulo R., Hettinger A., Singhal V., Kamath C., Erwin P.J., Montori V.M. Clinical review: treatment of pediatric obesity: a systematic review and meta-analysis of randomized trials // J. Clin. Endocrinol. Metab. 2008; 93(12): 4600-5.
  48. Lustig R.H., Greenway F., Velasquez-Mieyer P., Heimburger D., Schumacher D., Smith D., Smith W., Soler N., Warsi G., Berg W., Maloney J., Benedetto J., Zhu W., Hohneker J. A multicenter, randomized, double-blind, placebo-controlled, dose-finding trial of a long-acting formulation of octreotide in promoting weight loss in obese adults with insulin hypersecretion // Int. J. Obes. (Lond.). 2006; 30(2): 331-41.
  49. Farooqi I.S., Jebb S.A., Langmack G., Lawrence E., Cheetham C.H., Prentice A.M., Hughes I.A., McCamish M.A., O'Rahilly S. Effects of recombinant leptin therapy in a child with congenital leptin deficiency // N. Engl. J. Med. 1999; 341(12): 879-84.
  50. Levisohn P.M. Safety and tolerability of topiramate in children // J. Child. Neurol. 2000; 15(1): S. 22-6.
  51. Carrel A.L., Moerchen V., Myers S.E., Bekx M.T., Whitman B.Y., Allen D.B. Growth hormone improves mobility and body composition in infants and toddlers with Prader-Willi syndrome // J. Pediatr. 2004; 145(6): 744-9.
  52. Inge T.H., Krebs N.F., Garcia V.F., Skelton J.A., Guice K.S., Strauss R.S., Albanese C.T., Brandt M.L., Hammer L.D., Harmon C.M., Kane T.D., Klish W.J., Oldham K.T., Rudolph C.D., Helmrath M.A., Donovan E., Daniels S.R. Bariatric surgery for severely overweight adolescents: concerns and recommendations // Pediatrics. 2004; 114(1): 217-23.
  53. Harder T., Bergmann R., Kallischnigg G., Plagemann A. Duration of breastfeeding and risk of overweight: a meta-analysis // Am. J. Epidemiol. 2005 Sep. 1;162(5): 397-403.
  54. Kamath C.C., Vickers K.S., Ehrlich A., McGovern L., Johnson J., Singhal V., Paulo R., Hettinger A., Erwin P.J., Montori V.M. Clinical review: behavioral interventions to prevent childhood obesity: a systematic review and metaanalyses of randomized trials // J. Clin. Endocrinol. Metab. 2008; 93(12): 4606-15.
  55. O'Brien S.H., Holubkov R., Reis E.C. Identification, evaluation, and management of obesity in an academic primary care center // Pediatrics. 2004; 114(2): e154-9.



Abstract - 843

PDF (Russian) - 911



Copyright (c) 2009 Vitebskaya A.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies