By Carolyn Crist
(Reuters Health – In a small pilot study that screened 45 Ohio middle school students for cardiovascular risk factors, a third of the children had abnormal levels of cholesterol or blood sugar, and two kids were found to have undiagnosed diabetes.
Guidelines recommend that kids be screened at around age 10 for heart disease risk factors, but it often doesn’t happen, the study authors write in the Journal of Pediatrics.
Screenings at school could help doctors catch chronic conditions early and begin treatment as soon as possible, they suggest.
“These screenings aren’t happening as much as we’d like in traditional medical offices, and it may reach more students if it can be done practically and cheaply in a school setting,” said lead study author Dr. Robert Siegel of the Cincinnati Children’s Heart Institute in Ohio.
The American Academy of Pediatrics, the American Heart Association and the American Diabetes Association endorse screening children for weight, hypertension, cholesterol and diabetes, starting at ages 9 to 11. About 20 percent of children are screened nationwide, Siegel told Reuters Health by phone.
Siegel and colleagues recruited seventh and eighth graders in Norwood, Ohio, a town without a pediatrician within the city limits. With parental consent, researchers measured body mass index (BMI, a measure of weight relative to height), blood pressure, blood sugar, and cholesterol levels during two half-day sessions at the middle school. They also measured blood levels of hemoglobin A1c, which reflects blood sugar over the previous few months.
More than 40 percent of the students were overweight or obese, with a BMI above the 85th percentile for their age group, researchers found.
About a third of students had high blood sugar or cholesterol, and nearly half of students had high blood pressure on at least one of two blood pressure readings.
Importantly, two students had A1c readings well into the diabetes range. Neither girl had symptoms. One, who was in the low end of the weight range for her age, had type 1 diabetes, in which the pancreas does not make insulin, which helps the body use sugar to generate energy. The other, who was overweight, had type 2 diabetes, a condition usually associated with aging or obesity, in which the body has trouble using the insulin it makes.
“We didn’t expect in such a small group of students to find two children with diabetes who hadn’t been diagnosed,” Siegel said.
His team plans to expand the program at the middle school and other local schools to determine the long-term practicality of creating a consistent screening process. The researchers are also interested in seeing whether a full cardiovascular risk screening could remove the emphasis on weight and BMI screenings, which often create stigma and weight shame, he said.
“It’s always interesting to see that abnormal test results occur in children who do not have the traditional risk factors,” said Dr. Kyung Rhee of the University of California at San Diego School of Medicine, who wasn’t involved in the study.
“It’s also important to understand why parents do or do not want screening in the school setting,” Rhee told Reuters Health by email. “Parents have different values and concerns and do not really understand why it’s important to screen at such a young age when their children seem healthy on the outside.”
SOURCE: https://bit.ly/2ToRMky Journal of Pediatrics, online March 15, 2019.