Which cardiometabolic risk factors should be screened in adolescents with obesity?

• A. Liver enzymes as indicated.
• B. Thyroid function tests alone.
• C. Vitamin D levels.
• D. Lipids, fasting glucose or HbA1c, and blood pressure.

Answer: (D)

Screening adolescents with obesity for cardiometabolic risk focuses on identifying lipid abnormalities, impaired glucose regulation, and elevated blood pressure. Lipids reveal dyslipidemia, which commonly accompanies obesity and tracks into adulthood, guiding lifestyle or treatment decisions to reduce future cardiovascular risk. Checking fasting glucose or HbA1c detects prediabetes or diabetes, an important early warning sign that prompts intensified lifestyle efforts and, if needed, medical management. Measuring blood pressure is crucial because obesity is a strong predictor of hypertension in youth, and repeated measurements are needed to confirm persistent elevation before taking further steps.

Liver enzymes, thyroid function tests, and vitamin D levels aren’t part of routine cardiometabolic risk screening in obesity. They may be ordered under specific clinical questions (such as suspected fatty liver, thyroid disorders, or vitamin D deficiency), but they do not provide the direct cardiometabolic risk profile used to guide obesity-related cardiovascular risk management.