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Objective: Obesity is a common epidemic issue in all over the world. In order to prevent obesity it is essential to know about obesity and its detrimental consequences. This study aimed to evaluate children's awareness about obesity and to determine the associations between level of awareness, healthy lifestyle, dietary habits and risk factors for metabolic syndrome.Methods: Two hundred and thirty-six overweight children (119 boys and 117 girls) aged 10-14 years were enrolled to the study. Anthropometric and biochemical measurements were taken and metabolic syndrome (MetS) definition were done according to the International Diabetes Federation (IDF) consensus and divided into two groups as MetS (+) and MetS (-). Obesity awareness scale (OBA) and Adapted Healthy Lifestyle-Diet Index for Turkey (HLD-TR) were performed.Results: Among children, the prevalence of having MetS was found as 26.3%. Obesity awareness and HLD-TR index sores were lower in MetS (+) group than MetS (-) group. Metabolic syndrome related biochemical parameters and anthropometric measurements were associated with obesity awareness level of the children. The binary logistic regression model shows that a one-unit increase in the OBA index score increases the odd of not having MetS for 1.12 times after adjustments for age, gender, body mass index, and HLD-TR index score.Conclusions: Increased awareness about obesity among children will help to reduce the risk of metabolic syndrome, type 2 diabetes and atherosclerotic cardiovascular diseases in the future.
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Dieta Saudável/psicologia , Estilo de Vida Saudável , Síndrome Metabólica/prevenção & controle , Cooperação do Paciente , Obesidade Infantil/psicologia , Adolescente , Antropometria , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólica/etiologia , Obesidade Infantil/complicações , Comportamento de Redução do Risco , TurquiaRESUMO
Single nucleotide polymorphisms (SNPs), the most common genetic variations in human genome, can manage the predisposition of certain complex diseases or situations such as obesity. Genetic polymorphisms also play an important role as they can impact a population's susceptibility to being overweight or obese and developing related chronic complications such as hypertension, coronary heart disease, diabetes and cancer. The present study comprised of 193 unrelated healthy volunteers (120 females and 73 males) with Turkish origin. Only female adolescents (n = 110) were divided into 2 categories according to their BMI values as overweight (BMI ≥ 25) and normal (18.5 < BMI < 25) according to WHO classification. Genomic DNA was isolated from venous blood samples and genotyping of DENND1A rs10818854 and CYP19A1 rs2414096 variants was performed on Roche Light Cycler 2.0 Real-Time PCR platform. Serum hormone levels were analyzed by Electrochemiluminescent Immunoassay (ECLIA; Roche diagnostics). The genotype distributions were consistent with the Hardy-Weinberg equilibrium for both SNPs in the studied population (p > 0.05). The genotype distribution of DENND1A rs10818854 was determined for the first time in Turkish population and the variant allele frequency was found as 0.095. According to reduced sex hormone-binding globulin levels and increased free androgen index in the present study, obesity was linked with hyperandrogenism in female subjects. Both polymorphisms were investigated as potential genetic susceptibility markers for obesity and neither DENND1A nor CYP19A1 showed any associations.
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Aromatase/genética , Proteínas Adaptadoras de Sinalização de Receptores de Domínio de Morte/genética , Fatores de Troca do Nucleotídeo Guanina/genética , Obesidade/genética , Adolescente , Adulto , Alelos , Aromatase/metabolismo , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Proteínas Adaptadoras de Sinalização de Receptores de Domínio de Morte/fisiologia , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Variação Genética/genética , Genótipo , Fatores de Troca do Nucleotídeo Guanina/fisiologia , Humanos , Masculino , Sobrepeso , Polimorfismo de Nucleotídeo Único/genética , Dados Preliminares , Turquia , Adulto JovemRESUMO
BACKGROUND: Vitamin D, an important factor in calcium-phosphate homeostasis, has recently been suggested to play an important role in the pathogenesis of numerous chronic conditions such as hyperandrogenism. The aim of this study was to investigate the relationship between vitamin D status and premature adrenarche (PA). METHODS: A total of 71 girls with PA and 52 healthy girls, as the control group, were recruited. Axillary and/or pubic hair development before the age of 8 years was defined as PA. Bone age and anthropometric measures including height, weight, and body mass index (BMI) were obtained. 25-Hydroxyvitamin D (25(OH)D), fasting plasma glucose and insulin were measured. Vitamin D insufficiency was defined as <20 ng/mL. RESULTS: The PA patients had older bone age, higher BMI standard deviation score, homeostasis model of assessment-insulin resistance (HOMA-IR), and androgen but lower 25(OH)D than the control group. HOMA-IR and dehydroepiandrosterone sulfate were also higher in PA patients with vitamin D insufficiency compared with those with normal vitamin D. There was a negative correlation between 25(OH)D and HOMA-IR. CONCLUSION: Low vitamin D is associated with PA; and insulin resistance may be a factor in this association.
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Adrenarca , Hiperandrogenismo/etiologia , Resistência à Insulina , Puberdade Precoce/etiologia , Deficiência de Vitamina D/complicações , Estudos de Casos e Controles , Criança , Estudos Transversais , Feminino , Humanos , Hiperandrogenismo/diagnóstico , Modelos Logísticos , Fatores de Risco , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/fisiopatologiaRESUMO
BACKGROUND: The association between thyroid autoimmunity (TA) and idiopathic isolated angioedema (or angioedema without urticaria) has not been evaluated in either children or in adults up until now. We, therefore, aimed to investigate underlying or concomitant TA and/or autoimmune thyroid disease in children diagnosed with recurrent idiopathic angioedema. METHODS: Children who were consecutively diagnosed with recurrent idiopathic histaminergic acquired angioedema (IH-AAE) between January 2011 and January 2014 constituted the case group. A standard diagnostic and therapeutic algorithm was applied to all the patients with recurrent IH-AAE. Thyroid autoantibodies and thyroid function tests were measured in all the patients with recurrent IH-AAE and in healthy control groups. Prophylaxis with an antihistamine was started for patients with frequently recurrent IH-AAE. RESULTS: Eighty consecutive children with recurrent IH-AAE (49 boys; median age, 8.3 years) and 80 healthy children (39 boys; median, 8 years) were enrolled in this prospective, case-control study (p > 0.05 for age and sex). The IH-AAE group was significantly different than the control group with respect to TA (13.7% versus 2.5%, respectively; p = 0.009) but was similar with respect to autoimmune thyroid disease (3.7% versus 0%, respectively; p = 0.2). The median follow-up of the recurrent IH-AAE group was 34 months (range, 12-45 months). Patients with recurrent IH-AAE with and those without TA were not different with respect to either the need or the duration of antihistamine prophylaxis (p > 0.05 for both). CONCLUSIONS: Recurrent IH-AAE may be related to or associated with TA and/or autoimmune thyroid diseases in some children. However, exploring to see whether this association is a causal link or just an epiphenomenon deserves further investigation and longer follow-ups.
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Angioedema/epidemiologia , Angioedema/etiologia , Autoimunidade , Glândula Tireoide/imunologia , Adolescente , Fatores Etários , Angioedema/diagnóstico , Autoanticorpos/sangue , Autoanticorpos/imunologia , Criança , Pré-Escolar , Comorbidade , Gerenciamento Clínico , Feminino , Seguimentos , Humanos , Lactente , Masculino , Estudos Prospectivos , RecidivaRESUMO
Prevalence, risk factors and metabolic complications of overweight/obesity (OW/OB) are not well described in the childhood survivors of acute lymphoblastic leukemia (ALL). Longitudinal changes in body mass index-z score (BMIz) from diagnosis to the last follow-up visit after the end of treatment were evaluated in 73 children at first complete remission. Of them, 40 were tested for adipokine profiles at visit. The mean BMIz increased gradually from diagnosis (0.07 ± 1.68) to the end of dexamethasone containing reinduction therapy (0.70 ± 1.48, P:0.007), followed by a fall at the end of treatment (0.15 ± 1.24) and a rise again at visit (0.40 ± 1.23, P:0.007). OW/OB percentage of 15% at diagnosis, increased to 35% at visit (p < 0.05). Post-treatment OW/OB in survivors was related with being OW/OB at diagnosis (OR 5.4, 95% CI [0.94-31.7]; P = 0.02) and after dexamethasone containing reinduction therapy (OR 5.1, 95% CI [1.1-21.4]; P = 0.05), but not with age at diagnosis, gender, treatment intensity and cranial irradiation. Metabolic syndrome (MetS) was more prevalent in survivors (13%) than in Turkish children (2%). As compared with controls, survivors had higher leptin level (8.1 ± 8.6 vs 3.2 ± 2.2 ng/ml, P = 0.01) and leptin/adiponectin ratio (2.1 ± 3.5 vs 0.6 ± 0.5, P = 0.03). Leptin/adiponectin ratio was correlated with HOMA-IR (r: 0.57, P = 0.001). The prevalence of OW/OB and MetS are elevated in the childhood survivors of ALL. Post-treatment OW/OB in survivors is related with OW/OB at diagnosis and dexamethasone containing therapy. Elevated leptin level and leptin: adiponectin ratio may serve as an early sign of metabolic derangement increasing the risk for early cardiovascular disease.
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OBJECTIVES: Children with obesity have a high cardiovascular risk and an impaired oxidant-antioxidant status, which may lead to endothelial dysfunction and increased carotid intima media thickness (IMT) even in childhood. The aim of this study was to investigate the circulating oxidized low-density lipoprotein (LDL) concentrations and the IMT of carotid arteries in prepubertal obese children, and also to search for its possible association with carotid atherosclerosis. METHODS: Twenty-seven prepubertal obese children (age, 7.48±2.05 years; boys, 59%) and 30 healthy children (age, 7.80±2.19 years; boys, 55%) were included in the study. Serum concentrations of oxidized LDL, total cholesterol, triglyceride, high-density lipoprotein, LDL, and glucose were measured, and carotid IMT was determined by ultrasound. RESULTS: Serum oxidized LDL levels were significantly higher in prepubertal obese children than in healthy children (p<0.01). No significant correlation was observed between oxidized LDL levels and carotid IMT measurements. However, a significant positive correlation was found between oxidized LDL levels and body mass index, total cholesterol, and LDL-cholesterol. CONCLUSION: Our findings revealed that the oxidation of LDL starts early in obese children but the carotid IMT is not significantly affected. Also, oxidized LDL levels are more strongly associated with obesity and dyslipidemia than the carotid IMT in prepubertal children.
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Aterosclerose/diagnóstico , Espessura Intima-Media Carotídea , Lipoproteínas LDL/sangue , Obesidade/sangue , Aterosclerose/sangue , Aterosclerose/patologia , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
INTRODUCTION: The optimal dietary strategy to improve the metabolic and reproductive endocrine profile in adolescents with obesity and polycystic ovary syndrome is undefined. This study was conducted to evaluate the efficacy of the MEtabolic Syndrome REduction in NAvarra (RESMENA) diet versus a control diet based on American Heart Association (AHA) recommendations for the treatment of PCOS in adolescents with PCOS. METHODS: A total of 40 adolescents diagnosed with PCOS between the ages of 13-18 years were randomized to either a RESMENA or control diet for 6 months. Dietary status, anthropometry, body composition, biochemical parameters, and reproductive endocrine hormones were compared between the 2 groups before and after the intervention. RESULTS: Both diet groups showed significant decreases in anthropometric parameters whereas the RESMENA diet provided a greater decrease in all these parameters except neck circumference and fat percentage (p<0.05). At the end of the study fasting insulin, ALT, and total cholesterol levels decreased in both control and RESMENA group, HbA1c, HOMA-IR, and hsCRP levels decreased and QUICKI score increased in the RESMENA group (p<0.05). There was no statistical difference in the androgen levels of the control group compared to the baseline. In the RESMENA group, there was a significant decrease in total testosterone, free testosterone, 17-OH progesterone, androstenedione, LH levels and LH/FSH ratio and free androgen index and a significant increase in SHGB levels (p<0.05). CONCLUSIONS: Both dietary patterns resulted in significant improvement in anthropometric measurements and body composition, but the RESMENA diet showed beneficial effects on insulin resistance parameters and androgen levels.
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OBJECTIVES: Alexithymia and low health literacy are the barriers of self-management. This study aims to examine the relationship between alexithymia, health literacy and diet quality in obese adolescents, and their effects on anthropometric and biochemical markers. METHODS: The 20-item Toronto alexithymia scale (TAS-20) was used to determine the alexithymic traits of the adolescents, and "The Newest Vital Sign" (NVS) scales were used to determine their health literacy levels. Diet quality was evaluated with the Healthy Eating Index-2010 (HEI-2010). RESULTS: 39.7% of the obese adolescents were alexithymic, and 69.4% of alexithymics and 35.1% of non-alexithymics had metabolic syndrome. Alexithymic adolescents were lack of adequate health literacy. There were positive correlations between alexithymia scores and insulin, triglyceride, systolic and diastolic blood pressure levels, and all anthropometric values except height (p<0.05). There was a negative correlation between alexithymia scores and health literacy scores (p<0.05). There were negative correlations between health literacy and alexithymia scores, insulin, total cholesterol, triglyceride, ALT, systolic, diastolic blood pressure levels and all anthropometric values except height, and positive correlation was observed between health literacy scores and diet quality (p<0.05). Total HEI score was negatively correlated with waist circumference, neck circumference, body weight, BMI, triglyceride, AST, ALT, systolic and diastolic blood pressure, and positively correlated with health literacy and HDL levels (p<0.05). CONCLUSIONS: As alexithymia severity increased in obese adolescents, the degree of obesity and the incidence of metabolic syndrome increased while the level of health literacy decreased. The increase in health literacy levels, on the other hand, decreased the level of alexithymia and increased the quality of the diet.
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Letramento em Saúde , Síndrome Metabólica , Obesidade Infantil , Humanos , Adolescente , Síndrome Metabólica/epidemiologia , Sintomas Afetivos/epidemiologia , Sintomas Afetivos/etiologia , Obesidade Infantil/epidemiologia , Dieta , Insulina , TriglicerídeosRESUMO
Objective: This study was designed to examine the effect of blue light exposure and exposure time on puberty in an animal model. Methods: Eighteen 21-day-old female Sprague Dawley rats were divided into three equal groups which were: control group (CG); blue light-6 hours (BL-6); and blue light-12 hours (BL-12). CG rats were maintained with 12/12-hour light-dark cycles. The animals in BL-6 and BL-12 were exposed to blue light of wavelength 450-470 nm and intensity of 0.03 uW/cm2 for 6 and 12 hours, respectively. Exposure to blue light continued until the first signs of puberty. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, dehydroepiandrosterone sulfate (DHEA-S), leptin and melatonin were measured. Subsequently the ovaries and uterus were examined histomorphologically. Results: The median day of puberty start was 38, 32 and 30 for the CG, BL-6, and BL-12 groups, respectively (p=0.001). FSH, testosterone, DHEA-S, and leptin concentrations of all groups were similar. However, LH and estradiol concentrations in BL-6 were higher compared to CG (p=0.02). There was a negative correlation between blue light exposure, exposure time, and melatonin concentrations (r=-0.537, p=0.048). Ovarian tissue was compatible with puberty in all groups. As blue light exposure time increased, capillary dilatation and edema in the ovarian tissue increased. Prolonged exposure was associated with polycystic ovary-like (PCO) morphological changes and apoptosis in granulosa cells. Conclusion: These results suggest that exposure to blue light and the duration of exposure induced earlier puberty in female rats. As the duration of blue light exposure increased, PCO-like inflammation, and apoptosis were detected in the ovaries.
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Melatonina , Síndrome do Ovário Policístico , Ratos , Feminino , Humanos , Animais , Leptina , Ratos Sprague-Dawley , Hormônio Luteinizante , Hormônio Foliculoestimulante , Estradiol , Puberdade , Testosterona , DesidroepiandrosteronaRESUMO
Purpose: Our study aimed to examine the effects of blue light exposure on prepubertal male rats' puberty and testis tissue. Methods: Eighteen 21-day-old male Sprague Dawley rats were divided into three groups consisting of six rats in each group: Control Group (CG), Blue Light-6 hours (BL-6), and Blue Light-12 hours (BL-12). CG rats were maintained with 12/12-hour light-dark cycles. The rats of BL-6 and BL-12 were exposed to blue light (450-470nm/irradiance level 0.03uW/cm2) for 6 hours and 12 hours, respectively. Rats were exposed to blue light until the first signs of puberty. The ELISA method was used to analyze the serum levels of FSH, LH, testosterone, DHEA-S, leptin, ghrelin, melatonin, glutathione, glutathione peroxidase, and malondialdehyde. Testes were dissected for histomorphological examination. Results: The medians of the pubertal entry days of the CG, BL-6, and BL-12 were 38th, 30th, and 28th days, respectively. (p:0.001) The FSH, LH, and testosterone concentrations of all groups were similar. The FSH concentration increased as the LH concentration increased (r: 0.82 p: 0.001). The serum LH concentration increased as serum testosterone, and DHEAS decreased, respectively (r: -0.561, p: 0.01) (r:-0.55 p:0.01). Testicular lengths and weights of the BL groups were smaller compared to CG (p: 0.03),(p: 0.04). GPx was higher for BL-6 and BL-12 than the CG (p:0.021, p:0.024). Testis tissue was compatible with the pubertal period in all groups. As the blue light exposure time increased, spermatogenesis was suppressed, and capillary dilatation and edema in the testis tissue increased. Conclusion: Our study is the first to show the effects of blue light exposure on male rats' puberty process. And we showed that exposure to blue light and the duration of exposure lead to precocious puberty in male rats. The blue light exposure suppressed spermatogenesis, marked vasodilatation in the interstitial area of the testis, and disrupted the integrity of the basement membrane. These findings intensified with increasing exposure time.
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Hormônio Foliculoestimulante , Maturidade Sexual , Ratos , Masculino , Animais , Ratos Sprague-Dawley , Testículo , TestosteronaRESUMO
Objective: This study was planned to determine the effects of carob use on puberty because of the observation of early puberty or pubertal variants due to the long-term use of carob in our clinic. Methods: Forty-eight Wistar albino rats, on postnatal day 21, were assigned into two groups female (n=24) and male (n=24). Groups were divided into four groups Control, and Carob-150, Carob-300, and Carob-600. Ceratonia siliqua L. extract was given to rats in a 0.5% carboxymethylcellulose (CMC) solution. CMC (0.5%) was given to the control, Ceratonia siliqua L. extract was given 150 mg/kg/day to the Carob-150, 300 mg/kg/day to the Carob-300, 600 mg/kg/day to the Carob-600 by oral gavage. The treatments were performed once daily until the first sign of puberty. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, total testosterone, leptin, glutathione, glutathione peroxidase (GPx), and malondialdehyde were measured by commercial rat-specific ELISA kits. Testis, uterus and ovarian tissue were examined histologically. Results: The median time of preputial separation in male rats was 38th, 31st, 31st, and 31st days in the Control, Carob-150, Carob-300, and Carob-600 groups, respectively (p=0.004). The median day of vaginal opening day was the 39th, 31st, 34th, and 31st days in the Control, Carob-150, Carob-300, and Carob-600 groups, respectively (p=0.059). FSH, LH, testosterone (male), estradiol (female) and leptin levels of the groups were similar. However, GPx levels were higher in male and female animals given C. siliqua extract compared to the Control (male p=0.001 and female p=0.008). Testicular and ovarian tissues were concordant with the pubertal period in all groups. As the dose of Ceratonia siliqua extract increased, it induced spermatogenesis and spermiogenesis, causing abnormal changes, such as ondulation in the basement membrane, capillary dilatation, and increased congestion in males. In females, edema in the medulla gradually increased with increased dosage, and granulosa cell connections were separated in Carob-300 and Carob-600 groups. Conclusion: This study demonstrated that C. siliqua caused early puberty and increased spermiogenesis and folliculogenesis. Antioxidant mechanisms were impaired with increasing dose, possibly leading to tissue damage at high doses.
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Fabaceae , Frutas , Feminino , Animais , Ratos , Masculino , Humanos , Leptina , Ratos Wistar , Extratos Vegetais/farmacologia , PuberdadeRESUMO
Introduction: The mRNA-based BNT162b2 (Pfizer-BioNTech) vaccine has been shown to elicit robust systemic immune response and confer substantial protection against the severe coronavirus disease (COVID-19), with a favorable safety profile in adolescents. However, no data exist regarding immunogenicity, reactogenicity and clinical outcomes of COVID-19 vaccines in adolescents with type 1 diabetes (T1D). In this prospective observational cohort study, we examined the humoral immune responses and side effects induced by the BNT162b2 vaccine, as well as, the rate and symptomatology of laboratory-confirmed COVID-19 vaccine breakthrough infections after completion of dual-dose BNT162b2 vaccination in adolescents with T1D and compared their data with those of healthy control adolescents. The new data obtained after the vaccination of adolescents with T1D could guide their further COVID-19 vaccination schedule. Methods: A total of 132 adolescents with T1D and 71 controls were enrolled in the study, of whom 81 COVID-19 infection-naive adolescents with T1D (patient group) and 40 COVID-19 infection-naive controls (control group) were eligible for the final analysis. The response of participants to the BNT162b2 vaccine was assessed by measuring their serum IgG antibodies to the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 4-6 weeks after the receipt of first and second vaccine doses. Data about the adverse events of the vaccine was collected after the receipt of each vaccine dose. The rate of COVID-19 vaccine breakthrough infections was evaluated in the 6-month period following second vaccination. Results: After vaccinations, adolescents with T1D and controls exhibited similar, highly robust increments in anti-SARS-CoV-2 IgG titers. All the participants in the patient and control groups developed anti-SARS-CoV-2 IgG titers over 1,050â AU/ml after the second vaccine dose which is associated with a neutralizing effect. None of the participants experienced severe adverse events. The rate of breakthrough infections in the patient group was similar to that in the control group. Clinical symptomatology was mild in all cases. Conclusion: Our findings suggest that two-dose BNT162b2 vaccine administered to adolescents with T1D elicits robust humoral immune response, with a favorable safety profile and can provide protection against severe SARS-CoV-2 infection similar to that in healthy adolescents.
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AIM: The age-related values of penile length must be known to determine abnormal penis sizes and to follow the treatment of underlying diseases. The aim of this study is to evaluate abnormal penile length in Turkish children by establishing novel reference values for Turkish population and to compare the mean penile length and other parameters with alternates from different ethnic populations and geography. METHODS: This cross-sectional study was conducted on a voluntary basis between November 2008 and November 2009 from four centres in Turkey and comprised of 1278 healthy volunteered prepubertal children. Complete stretched penile length and penis circumference measurements were used for penile length and penis circumference evaluations, respectively. All measurements were taken twice by only one investigator, and mean values were recorded. RESULTS: Penile length and penis circumference for every age group were obtained, percentile curves were established and these findings were compared with the results of previous studies. Significant differences were found between penile length of Turkish children and recently used reference values. CONCLUSION: With this study, novel reference values for penile length in prepubertal children were presented to the literature.
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Pênis/anatomia & histologia , Fatores Etários , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Recém-Nascido , Masculino , Pênis/anormalidades , Valores de Referência , TurquiaRESUMO
OBJECTIVE: To investigate vitamin D status in children with Hashimoto thyroiditis. SUBJECTS AND METHODS: The study group consisted of 78 children recently diagnosed as Hashimoto thyroiditis and 74 subjects as the control group. Parameters of calcium metabolism, thyroid function tests, and 25-hydroxyvitamin D [25(OH)D] levels were measured. RESULTS: Vitamin D deficiency rate was significantly higher in the Hashimoto group compared with the control subjects (73.1% vs. 17.6%, p < 0.0001). In the Hashimoto group, mean 25(OH)D levels were significantly lower compared with the control group (31.2 +/- 11.5 versus 57.9 +/- 19.7 nmol/L, p < 0.001) and was inversely correlated with the anti-thyroid peroxidase (anti-TPO) levels (r = -0.30, p = 0.007). CONCLUSION: The higher vitamin D deficiency rates besides lower vitamin D levels in the Hashimoto group together with the inverse correlation between vitamin D and anti-TPO suggest that vitamin D deficiency may have a role in the autoimmune process in Hashimoto thyroiditis in children.
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Doença de Hashimoto/sangue , Doença de Hashimoto/epidemiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adolescente , Fosfatase Alcalina/sangue , Cálcio/sangue , Criança , Feminino , Humanos , Masculino , Hormônio Paratireóideo/sangue , Fósforo/sangue , Testes de Função Tireóidea , Tireotropina/sangue , Tiroxina/sangue , Vitamina D/sangueRESUMO
AIM: This study aimed to evaluate the effects of monotherapy with valproate or oxcarbazepine on the linear growth of children with idiopathic epilepsy. METHODS: Antiepileptic treatment with valproate or oxcarbazepine was initiated in 76 patients. These were evaluated at baseline and at 6 and 18 months after commencement of therapy to determine height standard deviations (height z-scores). Serum ghrelin, insulin-like growth factor-1, and insulin-like growth factor-binding protein-3 levels were measured. RESULTS: In prepubertal patients receiving oxcarbazepine, height z-scores were elevated after 6 and 18 months of therapy (p = 0.008 and p = 0.001, respectively); in pubertal patients, a significant increase was noted at the 18th month of therapy (p = 0.004). In prepubertal patients receiving oxcarbazepine, serum standardized insulin-like growth factor-1 and insulin-like growth factor-binding protein-3 levels were significantly higher at the 18th month of therapy compared with baseline (p = 0.005 and p = 0.004, respectively). In puber-tal patients receiving valproate, serum ghrelin levels were significantly decreased at the 18th month of therapy compared with baseline (p = 0.006). CONCLUSION: Exposure to oxcarbazepine stimulated linear growth in epileptic patients through mechanisms involving the release of insulin-like growth factor-1 and insulin-like growth factor-binding protein-3. In contrast, expo-sure to valproate did not affect linear growth, but did lead to a decrease in serum ghrelin levels.
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Anticonvulsivantes/uso terapêutico , Estatura/efeitos dos fármacos , Carbamazepina/análogos & derivados , Epilepsia/tratamento farmacológico , Puberdade/efeitos dos fármacos , Ácido Valproico/uso terapêutico , Adolescente , Carbamazepina/uso terapêutico , Criança , Pré-Escolar , Feminino , Grelina/sangue , Humanos , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Fator de Crescimento Insulin-Like I/análise , Masculino , Oxcarbazepina , Puberdade/sangueRESUMO
The aim of the study was to investigate the relationship between leptin receptor gene (LEPR) Gln223Arg polymorphism and obesity in Turkish children. Ninety-two obese and 99 lean children (between 5-15 years) were included in the study. Twenty-three of the obese children were diagnosed with metabolic syndrome. Blood samples were collected for morning fasting blood glucose, insulin, leptin, and lipid level measurements. LEPR Gln223Arg polymorphism was analyzed by restriction fragment length polymorphism. Significant differences were observed in anthropometric measurements, fasting blood glucose, insulin, leptin, and lipid levels between obese and lean children. Serum leptin levels were markedly higher in obese children. No significant association was noted between Gln223Arg polymorphism and serum leptin, insulin and lipid levels. There were no differences in the genotype frequencies or allele distribution for Gln223Arg polymorphism among obese, obese with metabolic syndrome and lean children. Our findings suggest that there is no association between Gln223Arg polymorphism and obesity in Turkish children.
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Síndrome Metabólica/genética , Obesidade/genética , Receptores para Leptina/genética , Adolescente , Glicemia/análise , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Marcadores Genéticos , Humanos , Incidência , Leptina/sangue , Lipídeos/sangue , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etnologia , Obesidade/epidemiologia , Obesidade/etnologia , Polimorfismo Genético , Polimorfismo de Fragmento de Restrição , Estatísticas não Paramétricas , Turquia/epidemiologiaRESUMO
It is well-known that in children with type 1 diabetes (T1D), the frequency of Celiac disease (CD) is increased due to mechanisms which are not fully elucidated but include autoimmune injury as well as shared genetic predisposition. Although histopathologic examination is the gold standard for diagnosis, avoiding unnecessary endoscopy is crucial. Therefore, for both clinicians and patients' families, the diagnosis of CD remains challenging. In light of this, a joint working group, the Type 1 Diabetes and Celiac Disease Joint Working Group, was convened, with the aim of reporting institutional data and reviewing current international guidelines, in order to provide a framework for clinicians. Several controversial issues were discussed: For CD screening in children with T1D, regardless of age, it is recommended to measure tissue transglutaminase-immunoglobulin A (tTG-IgA) and/or endomysial-IgA antibody due to their high sensitivity and specificity. However, the decision-making process based on tTG-IgA titer in children with T1D is still debated, since tTG-IgA titers may fluctuate in children with T1D. Moreover, seronegativity may occur spontaneously. The authors' own data showed that most of the cases who have biopsy-proven CD had tTG-IgA levels 7-10 times above the upper limit. The decision for endoscopy based solely on tTG-IgA levels should be avoided, except in cases where tTG-IgA levels are seven times and above the upper limit. A closer collaboration should be built between divisions of pediatric endocrinology and gastroenterology in terms of screening, diagnosis and follow-up of children with T1D and suspicious CD.
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Doença Celíaca , Diabetes Mellitus Tipo 1 , Autoanticorpos , Doença Celíaca/complicações , Doença Celíaca/diagnóstico , Criança , Tomada de Decisão Clínica , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico , Humanos , Imunoglobulina A , TransglutaminasesRESUMO
BACKGROUND: Fever is one of the leading causes of hospital admissions in children. Although there are many ways to measure body temperature, the optimal method and the anatomic site are still controversial. In this study, we aimed to evaluate the performance of new methods of measuring body temperature and to compare the accuracy, sensitivity and specificity of these methods. METHODS: The body temperatures of the patients who were hospitalized as inpatients or who presented to the emergency room as outpatients between November 2014- March 2015 were measured and recorded. Mercury and digital axillary measurements, tympanic, temporal artery and non-contact skin temperatures were measured. Measurements were compared with each other. RESULTS: According to our results temperature tends to increase over time for up to 8 minutes after placement when using axillary thermometers. Non-contact skin thermometers should be used only for follow-up of patients with fever, because of their low sensitivity and low negative predictivity. At the first examination, tympanic thermometers and axillary thermometers may be preferable for the diagnosis of fever. CONCLUSIONS: According to our results, using non-contact thermometers seems feasible and logical during the follow-up ofpatients with fever, but not in cases whose exact body temperature should be known. For the first examination of the patient to diagnose fever, tympanic thermometers and axillary thermometers may be preferable. Future studies are warranted to expose the optimum way of measuring body temperature in children.
Assuntos
Temperatura Corporal , Termômetros , Axila , Criança , Febre/diagnóstico , Humanos , Sensibilidade e Especificidade , Membrana TimpânicaRESUMO
To assess the incidence, risk factors and outcomes of PTDM, a total of 61 non-diabetic children (24 girls, 37 boys, age: 14.5 +/- 2.1 yr) were examined after their first kidney transplantation (37.3 +/- 21.6 months) with an OGTT. At baseline, 16 (26.2%) patients had IGT, 45 (73.8%) had NGT, and no patient had PTDM. No significant difference was shown between TAC- and CSA-treated patients in terms of IGT. Higher BMI z-scores (p = 0.011), LDL-cholesterol (p < 0.05) and triglyceride levels (p < 0.01), HOMA-IR (p = 0.013) and lower HOMA-%beta (p = 0.011) were significantly associated with IGT. Fifty-four patients were re-evaluated after six months; eight patients with baseline IGT (50%) improved to NGT, three (19%) developed PTDM requiring insulin therapy, five (31%) remained with IGT, and four patients progressed from NGT to either IGT (two) or PTDM (two). These 12 progressive patients had significantly higher total cholesterol (p < 0.05), triglycerides (p < 0.05), HOMA-IR (p < 0.01) and lower HOMA-%beta (p < 0.0) than non-progressive patients at baseline. We can conclude that post-transplantation glucose abnormalities are common in Turkish pediatric kidney recipients, and higher BMI z-scores and triglyceride concentrations are the main risk factors. Considering that the progressive patients are significantly more insulin resistant at baseline, we suggest that the utility of both HOMA-IR and HOMA-%beta in predicting future risk of PTDM and/or IGT should be evaluated in children.
Assuntos
Diabetes Mellitus/etiologia , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Adolescente , Glicemia , Criança , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Feminino , Humanos , Resistência à Insulina , Masculino , Estudos ProspectivosRESUMO
Objective To determine whether first-voided urinary LH (FV-ULH) - level measurement can adequately assess pubertal suppression as much as standard tests can. Subjects and methods The study group included patients with central precocious puberty and rapidly progressing early puberty who received up to 3 - 4 doses of GnRHa therapy monthly and did not have adequate hormonal suppression after GnRH stimulation (90-minute LH level > 4 IU/L). Design: All of the participants underwent an LHRH test just after admission to the study. According to the stimulated peak LH levels, the patients were divided into 2 groups and followed until the end of the first year of treatment. The concordance between FV-ULH and stimulated LH levels was assessed. Results The FV-ULH levels in patients with inadequate hormonal suppression were significantly high compared to patients with adequate hormonal suppression. FV-ULH levels were very strongly correlated with stimulated LH levels (r = 0.91). Its correlation with basal LH levels was significant (r = 0.65). However, this positive correlation was modestly weakened after the first year of treatment. The cutoff value for FV-ULH of 1.01 mIU/mL had the highest sensitivity (92.3%) and specificity (100%). Conclusion FV-ULH levels, using more reliable and sensitive assay methods, can be used to monitor the adequacy of GnRHa therapy.