Waist to height ratio as a screening tool for identifying childhood obesity and associated factors.

OBJECTIVE: To investigate the prevalence of obesity and associated factors during childhood in Southeastern Turkey. Another objective was to determine the cut-off points of Waist to Height Ratio (WHtR) values for defining obesity/abdominal obesity. METHODS: The community-based descriptive cross-sectional study was conducted in Gaziantep Turkey between November 2011 and December 2011 with 2718 primary school/high schools students aged 6-17 years. The SPSS 22.00 was used for the analysis of data. RESULTS: The prevalence of overweight, obesity, abdominal obesity, was 13.2%, 4.2% ,26.4%, respectively. There was a reverse relationship between BMI/WC values and sleep durations (p<0.05). The BMI/WC values were higher in students with computer usage time ≥1 hours in a day (p<0.05). Parental obesity status has an effective role on the WC/BMI values of children (p<0.05). The WHtR was a good predictor of diagnosis on obesity and abdominal obesity (AUC=0.928, p<0.0001; AUC=0.920, p<0.0001; respectively). The optimal cut-off values for obesity and abdominal obesity were detected as 0.5077, 0.4741, respectively. CONCLUSIONS: The WHtR can be used for diagnosis of obesity/abdominal obesity. Parental obesity, short sleep duration and computer use more than one hour per day are risk factors for the development of obesity in children and adolescents.

Uteroglobin gene polymorphism (G38A) may be a risk factor in childhood idiopathic nephrotic syndrome.

BACKGROUND: Uteroglobin (UG) is a multifunctional protein with anti-inflammatory properties. The aim of this study was to first evaluate the role of UG gene G38A polymorphism in childhood idiopathic nephrotic syndrome (INS), and determine whether this variation may be related to the occurrence of INS or a steroid response. METHODS: One hundred and thirty-six children diagnosed with INS in Gaziantep University, Department of Pediatric Nephrology, and 70 healthy volunteers were included. Children with INS were divided into two groups: steroid-sensitive (n = 84), and steroid-resistant (n = 52). Samples were examined using the polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) enzyme method. RESULTS: The distributions of AA, GG, and AG genotypes of UG gene G38A (G/A) were 16.9%, 44.9%, and 38.2% in the all-INS group, whereas they were 14.3%, 48.8%, and 36.9% in the steroid-sensitive INS (SSINS) group compared with 21.1%, 38.5%, and 40.4% in steroid-resistant INS (SRINS), and 5.7%, 41.4%, and 52.9% in controls. The risk of INS was increased almost 4-fold in children with the AA genotype (p = 0.016). The risk of having SSINS was increased 3.5-fold (p = 0.042) whereas the risk of SRINS was increased 4.8-fold in the same genotype (p = 0.014). CONCLUSIONS: The uteroglobin gene may play an important role in the development of INS, and the AA genotype of UG gene G38A polymorphism was found more frequently in those children. Further studies evaluating all polymorphisms in larger patient groups are needed to exactly determine the effect of UG gene on the development of INS and steroid response in children.

Prevalence of hypertension determined by ambulatory blood pressure monitoring (ABPM) and body composition in long-term survivors of childhood cancer.

AIM: In recent years, survival rates of childhood cancers have significantly increased, and occurrence of long-term adverse late effects (eg, insulin resistance, diabetes mellitus, metabolic syndrome, hypertension) has become increasingly important. Early diagnosis of obesity/hypertension in childhood is essential to avoid morbidity in the adulthood. Therefore, this study was aimed to determine the blood pressure (BP) profile by ambulatory BP monitoring (ABPM) method, and prevalence of hypertension, obesity, abdominal obesity among childhood cancer survivors. MATERIAL AND METHOD: The study was carried out with 52 cancer survivors. The ABPM measurement was performed during 24 hours. The anthropometric measurements of patients were performed using standardized protocols. The body composition analysis was performed with bioelectrical impedance analysis (BIA) method. Statistical significance was considered at p < 0.05. RESULTS: The mean age of patients was 12.84 ± 3.88 years. Time off therapy ranged 24-125 month. The prevalence of prehypertension and hypertension were 57.7% and 9.6%, respectively. There was no statistically significant relationship between diagnosis and BP status (p = 0.59). The prevalence of obesity, and abdominal obesity were 1.9% and 30.4%, respectively. There was a positive correlation between waist circumference (WC) and time off therapy (p = 0.046). The WC was found to be higher in patients who received cranial irradiation (p = 0.048). Weight/WC were higher in patients who used corticosteroids in the treatment (p = 0.019). CONCLUSION: Careful follow up of BP, weight and WC is necessary for long-term cancer survivors to prevent complications. Especially patients who receive cranial radiotherapy and use corticosteroid are at increased risk of abdominal obesity.

Adolescent obesity and the role of the fat mass and obesity-associated gene polymorphism.

PURPOSE: The association between fat mass and obesity-associated (FTO) gene and obesity is unclear in both adults and adolescents. The aim of this study was to examine the role of the FTO gene variant rs9939609 as a candidate gene for obesity and the relationship between insulin resistance (IR), metabolic syndrome (MetS), estimated glomerular filtration rate (eGFR) and neutrophil-to-lymphocyte ratio (NLR). METHODS: Obese adolescents (n=100) and healthy controls (n=100) were included. Rs9939609 polymorphism in the FTO gene was genotyped by PCR-SNaPshot. RESULTS: The prevalence of insulin resistance (IR), metabolic syndrome (MetS) and hyperfiltration were 47%, 60% and 27%, respectively. There were no significant differences in genotype and allele frequencies between obese adolescents and controls; however, prevalence of MetS in female patients with A allele carriers was more frequent and prevalence of hyperfiltration was less frequent with T allele carriers (P.

The possible effects of maternal electronic media device usage during pregnancy on children's sleep patterns.

OBJECTIVE: In recent years, there has been increasing scientific evidence about potential health risks caused by electromagnetic fields because of electronic media devices. Therefore, this study aimed to examine the possible association between electronic media device usage during pregnancy and sleep patterns in children and the possible role of electronic media device presence in the sleeping environment on children's sleep disturbances. MATERIAL AND METHODS: The study was carried out with 400 healthy children aged between 1 month and 5 years whose parents agreed to complete the questionnaire form. The questionnaire form consisted of questions about the history of prenatal and postnatal electromagnetic field exposure caused by electronic media devices and the presence of sleep disturbances in children. Data were analyzed with SPSS for Windows program. P-values <0.05 were considered statistically significant. RESULTS: Sleep problems were more prevalent in children whose mothers lived near a base station during pregnancy (p<0.05). Sleep disorders were more frequent and sleep duration was shorter in children whose mothers used electronic devices (television, computer, mobile phone, wi-fi, microwave oven) during pregnancy (p<0.05). Sleep problems were also more common in children with electronic media devices in the sleeping environment during the night (p<0.05). Sleep disturbances were not associated with maternal consumption of tobacco or alcohol or history of disease during pregnancy (p>0.05). CONCLUSION: Our results highlight that exposure to electromagnetic fields caused by electronic media devices during the prenatal or postnatal period could be associated with sleep patterns in childhood. Considering the widespread use of electronic media devices, it may be an important public health problem given the long-term consequences of sleep disorders in childhood.

Increased potassium excretion in children with monosymptomatic nocturnal enuresis: could it be related to Kir 4.1- KCNJ10 gene polymorphism?

BACKGROUND AND OBJECTIVES: There are controversial results in the literature regarding urinary electrolytes, especially potassium, in enuretic children. KCNJ10 channel protein, a member of the Kir 4.1 family is expressed in renal distal tubules and has an important function in renal ion transport. We investigated whether KCNJ10 gene polymorphisms are associated with clinical and laboratory findings of a group of Turkish children with monosymptomatic primary nocturnal enuresis (MNE). METHOD: Ninety-seven MNE children and 100 healthy controls were tested for three single nucleotide polymorphisms (SNPs) in the KCNJ10 gene. The transversions in SNPs were G to A for intron 1(SNP1), G to A for exon 2 (SNP2), and T to C transition for promoter (SNP3). All SNPs were genotyped by PCR-restriction fragment length polymorphism. RESULTS: SNP3 in promoter of KCNJ10 gene showed strong association with MNE children for distribution of genotype and allele frequency, while SNP1 in intron 1 and SNP2 in exon 2 were noninformative. The distribution of TT, TC, and CC genotypes for SNP3 was 66%, 26.8% and 7.2% respectively in MNE compared with 38%, 59% and 3% respectively in controls (p < 0.0001). In enuretic children, TT genotype was higher and there was an increased potassium excretion in children with TT genotype (P < 0.05). CONCLUSION: We conclude that KCNJ10 gene promoter polymorphism may have a role on potassium excretion in Turkish MNE children. This is the first study in literature evaluating KCNJ10 gene polymorphism in this patient population. Future studies investigating the other SNPs, mutations or altered regulation of Kir4.1 in larger samples would help clarify the role (s) of KCNJ10 gene in enuresis.

Association of melatonin receptor 1 B gene (rs10830963 and rs9192552) polymorphism with adolescent obesity and related comorbidities in Turkey.

Objective To examine the role of rs10830963 and rs8192552 polymorphisms in melatonin receptor 1 B (MTNR1B) gene on the development of obesity and related comorbidities among adolescents in South-Eastern Turkey. Methods The present study included 200 unrelated adolescents (100 obese, 100 normal weight). The rs8192552 and rs10830963 polymorphisms in the MTNR1B gene were genotyped using a PCR SNaPshot assay. Results No statistically significant association was observed between MTNR1B gene rs8192552/rs10830963 polymorphisms and adolescent obesity. In adolescents with an rs8192552 E allele, homeostasis model assessment for insulin resistance (IR) level was lower and IR was less common. In morbidly obese adolescents with an rs8192552 E allele, total cholesterol level was lower. In obese adolescents with metabolic syndrome, plasma fasting glucose level was higher in rs10830963G allele carriers. In obese girls, body weight was lower in those with a rs10830963 C allele, whereas in obese boys, body weight and waist circumference were higher in those with a rs10830963 C allele. Conclusions The MTNR1B gene was not confirmed as an obesity susceptibility gene in adolescents. However, an association between the MTNR1B gene and IR/hypercholesterolemia/metabolic syndrome was observed in obese adolescents. A sex-specific effect on obesity was also identified.

Kidney Disease Profile of Syrian Refugee Children.

INTRODUCTION: Although preventative nephrology is the effective management of childhood kidney diseases, it is hard to provide it in this undesirable conditions. In this study, we aimed to document the kidney disease profile of Syrian refugee children admitted to our hospital. MATERIALS AND METHODS: One hundred and thirty Syrian refugee children were admitted to the Pediatric Nephrology Department of the University of Gaziantep from September 2012 to January 2015. Demographic data, history, symptoms, physical examination findings, laboratory investigations, diagnosis, disease outcome, and therapeutic procedures such as peritoneal dialysis and hemodialysis were obtained from patient files. RESULTS: Of the 130 admitted children, 74 were girls (59.6%). The average age was 6.97 ± 4.2 years (range, 1 month to 17 years). Congenital abnormalities of the kidney and urinary tract were found in 34 children (26.2%). Other morbidities were chronic kidney disease in 30 (23.1%), nephrotic syndrome in 24 (18.5%), urolithiasis in 9 (6.9%), acute kidney injury in 4 (3.1%), glomerulonephritis in 5 (3.8%), enuresis in 12 (9.2%), and others in 12 (9.2%). CONCLUSIONS: Congenital abnormalities of the kidney and urinary tract and chronic kidney disease were highly prevalent in Syrian refugee children. Although free health care have been provided to all of these children, the continuation of political crisis and instability would increase the number of admissions and affect the quality of life of those children in a different environment from the home country.