Early adiposity rebound (child BMI curve)

• The HAS guide provides for no laboratory test for an isolated early adiposity rebound, provided that the growth chart (no slowing), head circumference, clinical examination, eating behaviour and development have been checked. Any abnormality refers to the following tabs.

• Overweight with no clinical sign of complication and no indication for diabetes screening: no laboratory tests.

Fasting laboratory tests, depending on the context

• Fasting plasma glucose (screening for type 2 diabetes)if neededFrom age 10 or the onset of puberty, in overweight or obesity, with at least one risk factor: maternal or gestational diabetes, type 2 diabetes in a 1st- or 2nd-degree relative, signs or conditions of insulin resistance (acanthosis nigricans, hypertension, dyslipidaemia, PCOS, low birth weight for gestational age) ^[2]. Repeat at least every 3 years if normal ^[2]. If diabetes is confirmed, pancreatic tests must rule out autoimmune type 1 diabetes ^[2].
• Lipid profileif neededEstablished obesity (BMI ≥ IOTF 30 threshold) with a family history of dyslipidaemia ^[2].
• ASTif neededEstablished obesity (BMI ≥ IOTF 30 threshold), depending on family history, the trajectory of the BMI curve and the clinical history ^[2]. Recheck every 2 to 3 years if normal, especially in adolescence ^[2].
• ALTif neededEstablished obesity (BMI ≥ IOTF 30 threshold), depending on family history, the trajectory of the BMI curve and the clinical history ^[2]. Recheck every 2 to 3 years if normal, especially in adolescence ^[2].

• Headache, vomiting, visual disturbance, polyuria-polydipsia or drop in height: urgent hospital opinion and brain imaging.
• Specialist opinion (specialised obesity centre, PRADORT reference centre): do not wait for the tests before referring.

Tests to be organised with the centre consulted

• TSH (if rare cause suspected)if neededInitial assessment tests of the PNDS (French national protocol for diagnosis and care), to be coordinated with the centre consulted; hormone assays are guided by the clinical picture ^[4].
• Free T4 (if rare cause suspected)if neededInitial assessment tests of the PNDS (French national protocol for diagnosis and care), to be coordinated with the centre consulted; hormone assays are guided by the clinical picture ^[4].
• 8 am serum cortisol (if rare cause suspected)if neededInitial assessment tests of the PNDS (French national protocol for diagnosis and care), to be coordinated with the centre consulted; hormone assays are guided by the clinical picture ^[4].
• 8 am ACTH (if rare cause suspected)if neededInitial assessment tests of the PNDS (French national protocol for diagnosis and care), to be coordinated with the centre consulted; hormone assays are guided by the clinical picture ^[4].
• IGF-1 (if rare cause suspected)if neededInitial assessment tests of the PNDS (French national protocol for diagnosis and care), to be coordinated with the centre consulted; hormone assays are guided by the clinical picture ^[4].
• Fasting plasma glucose (if rare cause suspected)if neededInitial assessment tests of the PNDS, to be coordinated with the centre consulted; hormone assays are guided by the clinical picture ^[4]. In the young child, fasting is decided with the centre.
• Fasting insulin (if rare cause suspected)if neededInitial assessment tests of the PNDS, to be coordinated with the centre consulted; hormone assays are guided by the clinical picture ^[4]. In the young child, fasting is decided with the centre.