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 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.
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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.
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