Effects of maternal iodine supplementation during pregnancy and lactation on iodine status and neonatal thyroid-stimulating hormone.

OBJECTIVE: To determine the iodine status in pregnant and lactating women, as well as neonatal thyroid-stimulating hormone (TSH) concentration. STUDY DESIGN: Pregnant women cared at our hospital, the University Hospital in Bangkok, had routinely received 200 µg iodine tablet daily since October 2010. Urinary iodine concentrations (UICs) of 1508 pregnant and 87 lactating women and 76 offspring and breast milk iodine concentration (BMIC) (n=57) were measured. Cord serum TSH levels from hypothyroidism screening were analyzed. RESULT: Median UIC levels of pregnant and lactating women were 170.6 and 138.0 µg l(-1), respectively. Median BMIC and infants' UIC at 2-month postpartum in iodine-supplemented group were higher than the respective values of non-supplemented group. Median cord serum TSH level obtained before iodine supplementation (n=8332) was higher than that obtained after supplementation (n=5181; 7.3 vs 5.2 mU l(-1)). CONCLUSION: Maternal iodine supplementation improved iodine nutrition in their breast-fed offspring. A trend toward declining in cord serum TSH values after iodine supplementation indicates improvement of iodine status during pregnancy.

Vitamin D status and glucose homeostasis in obese children and adolescents living in the tropics.

BACKGROUND: Pediatric obesity continues to rise and has become a major health problem worldwide. Vitamin D deficiency has been increasing among obese non-Asian children and is associated with abnormal glucose homeostasis in obese adults. However, data on the vitamin D status and its association with glucose homeostasis in obese children residing in tropical Asian countries are unavailable. OBJECTIVE: To assess vitamin D status and glucose homeostasis in obese Thai children. PATIENTS AND METHODS: A total of 150 obese, and 29 healthy non-obese children and adolescents were enrolled. Weight, height, body mass index (BMI) and waist circumference were obtained. All obese children underwent an oral glucose tolerance test with glucose and insulin measurements. Plasma 25-hydroxyvitamin D (25-OHD) and calciotropic blood chemistries were measured in all participants. Insulin sensitivity indices were calculated from the measured glucose and insulin levels. RESULTS: Approximately 25% of the obese children and adolescents had impaired glucose tolerance, impaired fasting plasma glucose (FPG) and diabetes. Seventeen out of 150 (11.3%) obese children and 3 out of 29 (10.3%) non-obese children had vitamin D deficiency, which was defined as a 25-OHD level of <50 nmol l(-1). Glucose tolerance and insulin sensitivity indices were comparable between obese children with sufficient vitamin D and those with vitamin D deficiency. There were no relationships among serum 25-OHD; weight, height, and BMI standard deviation scores; insulin sensitivity indices; FPG and insulin; and 2-h plasma glucose and insulin levels. CONCLUSION: Vitamin D deficiency is not as prevalent in obese Thai children as in obese non-Asian children from high-latitude countries. Adiposity per se is unlikely to be a determinant of vitamin D status in these obese individuals. There was no association between vitamin D deficiency and abnormal glucose homeostasis.

Sexual maturation in Thai boys.

BACKGROUND: A worldwide secular trend towards earlier onset of puberty in girls has been noted during recent years. However, the data on sexual maturation of boys are relatively scarce and normative data of sexual maturation in Thai boys are still lacking. AIM: To determine the age of secondary sexual maturation in normal Thai boys. METHODS: Three hundred healthy urban boys aged 9-18 years were recruited during January 1997 to December 1999. Genital and pubic hair maturity staging was determined using the method of Marshall and Tanner. Testicular size was assessed by Prader orchidometer. Probit analysis was used to analyze the onset of puberty (gonadarche) and pubarche. RESULTS: Median (range) ages of the onset of puberty and pubarche were 10.8 (9.5-12) and 12.4 (10.9-13.9) years, respectively. CONCLUSION: The age of onset of genital development in boys living in Bangkok seems to be slightly earlier than that of boys in other countries. However, the onset of pubic hair development is comparable.

Pituitary function in paediatric survivors of severe traumatic brain injury.

BACKGROUND: Traumatic brain injury (TBI)-mediated hypopituitarism is an increasingly recognised problem. Paediatric survivors of TBI may be vulnerable to the possible effects of pituitary deficits as pituitary hormones control normal growth and development. Research concerning pituitary dysfunction following childhood TBI is limited. AIM: To identify pituitary dysfunction in paediatric survivors of severe TBI. METHODS: Of 1020 children who sustained a TBI and were admitted to the Royal Children's Hospital, Melbourne, Australia over 10 years, 117 were identified as survivors of severe TBI. 54 patients (31 males) were enrolled and administered questionnaires regarding quality of life and possible endocrine dysfunction. Where indicated, hormone testing was performed. RESULTS: 29 of the 54 patients underwent hormonal investigations, while 21 who had satisfactory questionnaires did not (four patients had already been diagnosed with pituitary deficiencies). In those 29 patients, TBI occurred at ages ranging from 0.25 to 16.80 years (median 9.7 years). Time from TBI to study ranged from 0.9 to 8.5 years (median 4.5 years). Of the 54 patients, nine had pituitary dysfunction, of whom four had multiple pituitary hormone deficiencies. CONCLUSIONS: Our study that confirms that paediatric survivors of severe TBI may develop pituitary dysfunction. Pituitary function should therefore be determined in these patients.