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European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity

R. Pasquali, F. Casanueva, M. Haluzik, L. van Hulsteijn, S. Ledoux, MP. Monteiro, J. Salvador, F. Santini, H. Toplak, OM. Dekkers,

. 2020 ; 182 (1) : G1-G32. [pub] -

Language English Country Great Britain

Document type Journal Article, Practice Guideline

Persistent link   https://www.medvik.cz/link/bmc19044448

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.

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$a Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.
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$a Casanueva, F $u Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS), CIBER de Fisiopatologia Obesidad y Nutricion (CIBERobn ), Instituto Salud Carlos III, Santiago de Compostela, Spain.
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$a Haluzik, M $u Diabetes Centre and Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine and Institute of Endocrinology, Prague, Czech Republic.
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$a van Hulsteijn, L $u Department of Clinical Endocrinology and Metabolism, University Medical Centre Groningen, Groningen, the Netherlands.
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$a Ledoux, S $u Department of Physiology, Obesity Center, Louis Mourier Hospital (APHP), Colombes and Paris Diderot University, Paris, France.
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$a Monteiro, M P $u Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Oporto, Porto, Portugal. University College of London, London, UK.
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$a Salvador, J $u Department of Endocrinology and Nutrition, University Clinic of Navarra, Pamplona, Spain. CIBEROBN, Instituto Carlos III, Madrid, Spain.
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$a Santini, F $u Obesity and Lipodystrophy Center, University Hospital of Pisa, Pisa, Italy.
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$a Dekkers, O M $u Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands. Department of Clinical Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, the Netherlands. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
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