Obesity Diagnostics

Laboratory Tests and Ancillaries

Laboratory tests are done to assess comorbidities associated with obesity and this includes lipid profile (eg low-density lipoprotein cholesterol [LDL-C], HDL-C, and TG), fasting glucose level, HbA1c, thyroid function tests (eg thyroid stimulating hormone [TSH], free T4), uric acid, liver function tests (hepatic enzymes), renal function tests, and urine free cortisol levels (performed in patients with signs of Cushing’s syndrome). Notably, adiposopathic or atherogenic dyslipidemia includes elevated levels of TG, non-HDL-C, apolipoprotein B, LDL particle number and small dense LDL particles, and reduced level of HDL-C.

Tests to rule out polycystic ovarian syndrome (only if symptomatic; Rotterdam criteria may be used for screening PCOS in reproductive-aged women), electrocardiogram (ECG) if >50 years old or with risk factors, chest X-ray (not routinely recommended), and polysomnography and other sleep studies in patients at risk for sleep apnea (eg suggestive signs and symptoms such as excessive daytime sleepiness, snoring, increased neck circumference or a high STOP-Bang [snoring, tiredness, observed apnea, high blood pressure, BMI of >35 kg/m², age >50 years, neck circumference >40 cm, male gender] score [≥3]) are also done.