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Body Mass Index Standard Deviation Score (body + mass_index_standard_deviation_score)
Selected AbstractsInsulin sensitivity, VO2max and body composition in severely obese Swedish children and adolescentsACTA PAEDIATRICA, Issue 1 2009Gunilla Morinder Abstract Aim: The aim of this study was to identify relationships between insulin sensitivity (SI), cardiorespiratory fitness and body composition in severely obese Swedish children and adolescents. Methods: Two hundred and twenty-eight obese children (119 girls, 8,16 years, body mass index (BMI) 23.2,57.0 kg/m2) performed a frequently sampled intravenous glucose tolerance test (FSIVGTT), a submaximal bicycle ergometry test and a dual-energy X-ray absorptiometry (DEXA). Results: Mean SI (SD) was 0.38 (0.32) (×10,5/min/pM). SI correlated positively with relative body mass (BM) VO2max (r = 0.42) (p < 0.001), relative fat-free mass (FFM) VO2max (r = 0.36) (p < 0.001) and negatively with body mass index standard deviation score (BMI SDS) (r =,0.22) (p = 0.001). SI did not correlate with percent body fat (r =,0.01) and absolute VO2max (r = 0.01). In multiple regression analyses with SI as dependent variable, VO2max and body composition, together with gender, age and Tanner stage, explained 20,26% of the variance. Conclusion: Relative (BM) VO2max and relative (FFM) VO2max were stronger predictors of SI than percent body fat in severely obese children and adolescents. The study confirms that cardiorespiratory fitness is of importance for the metabolic syndrome in the studied population. Efforts to improve SI should include physical activity targeting cardiorespiratory fitness also in severely obese children and adolescents. [source] Kisspeptin serum levels in girls with central precocious pubertyCLINICAL ENDOCRINOLOGY, Issue 4 2009L. De Vries Summary Objective, Central precocious puberty (CPP) causes early epiphyseal maturation, and early initiation of treatment improves final height. Unfortunately, there is no one parameter that can distinguish CPP from premature thelarche (PT), which is self-limited and requires no therapy. In animal models, kisspeptin, the ligand for the G-protein coupled receptor GPR54, was found to induce precocious activation of the gonadotrophic axis. Data on kisspeptin levels in girls with precocious puberty or in healthy prepubertal girls are lacking. We measured blood kisspeptin levels in girls with CPP and evaluated its potential as a clinical marker for CPP. Design, This was a case,control study. Patients, Thirty-one girls clinically diagnosed with CPP and 14 prepubertal age-matched healthy controls. Measurements, Kisspeptin blood levels. Results, Kisspeptin levels were significantly higher in the girls with CPP than in the controls: 14·62 ± 10·2 pmol/l vs. 8·35 ± 2·98 pmol/l, P < 0·05. Within the CPP group, there were no significant differences between the girls with a peak LH >5·0 IU/l and those with a peak LH ,5·0 IU/l regarding kisspeptin or any of the clinical, laboratory or ultrasound parameters, or in Tanner stage. No correlation was found between kisspeptin and body mass index standard deviation score (BMI-SDS) or height-SDS (Ht-SDS) for the entire cohort, or when analysed separately for the CPP group and the control group. Conclusions, Although kisspeptin is significantly higher in girls with true CPP than in age-matched prepubertal controls, the evident overlap limits its use as a single diagnostic tool until further data obtained in larger studies should prove otherwise. [source] The addition of rosiglitazone to insulin in adolescents with type 1 diabetes and poor glycaemic control: a randomized-controlled trialPEDIATRIC DIABETES, Issue 4pt1 2008Monique L Stone Objective:, To evaluate the effect of rosiglitazone, an insulin sensitizer, on glycaemic control and insulin resistance in adolescents with type 1 diabetes mellitus (T1DM) Research design and methods:, Randomized, double-blind, placebo-controlled crossover trial of rosiglitazone (4 mg twice daily) vs. placebo (24 wk each, with a 4 wk washout period). Entry criteria were diabetes duration >1 yr, age 10,18 yr, puberty (,Tanner breast stage 2 or testicular volume >4 mL), insulin dose ,1.1 units/kg/day, and haemoglobin A1c (HbA1c) >8%. Responses to rosiglitazone were compared with placebo using paired t -tests. Results:, Of 36 adolescents recruited (17 males), 28 completed the trial. At baseline, age was 13.6 ± 1.8 yr, HbA1c 8.9 ± 0.96%, body mass index standard deviation scores (BMI-SDS) 0.94 ± 0.74 and insulin dose 1.5 ± 0.3 units/kg/day. Compared with placebo, rosiglitazone resulted in decreased insulin dose (5.8% decrease vs. 9.4% increase, p = 0.02), increased serum adiponectin (84.8% increase vs. 26.0% decrease, p < 0.01), increased cholesterol (+0.5 mmol/L vs. no change, p = 0.02), but no significant change in HbA1c (,0.3 vs. ,0.1, p = 0.57) or BMI-SDS (0.08 vs. 0.04, p = 0.31). Insulin sensitivity was highly variable in the seven subjects who consented to euglycaemic hyperinsulinaemic clamps. There were no major adverse effects attributable to rosiglitazone. Conclusion:, The addition of rosiglitazone to insulin did not improve HbA1c in this group of normal weight adolescents with T1DM. [source] Cost-effectiveness of routine and group programs for treatment of obese childrenPEDIATRICS INTERNATIONAL, Issue 5 2009Marja Kalavainen Abstract Background:, Cost-effectiveness analyses facilitate the allocation of health care resources. The aim of the study was to compare the cost-effectiveness of group treatment, already known to be more effective, with routine counseling in obese children. Method:, A prospective 6-month intervention assessed family-based group treatment (15 separate sessions for parents and children) and routine counseling (two appointments for children). Children's weights and heights were measured at baseline, at the end of the intervention and at follow up 6 months later, and the changes in weight for height and body mass index standard deviations scores (BMI-SDS) were calculated and used as main outcome measures. The mean costs and effects of the programs were analyzed to produce the incremental cost-effectiveness ratio, which is an estimate of the additional costs per 1% decrease in weight for height or 0.1 decrease in BMI-SDS. Cost-effectiveness analysis was performed from the perspective of the service provider. Results:, At the end of the intervention, group treatment costs were 1.4-fold (non-calculable 6 months later) when counted per 1% weight for height decrease, and 3.5-fold (2.8-fold 6 months later) when counted per 0.1 BMI-SDS decrease. Incremental cost-effectiveness ratio estimates were ,53 when calculated for 1% weight for height decrease, and ,266 (,275 6 months later) when calculated for 0.1 BMI-SDS decrease. Conclusions:, Family-based group treatment is more costly compared with individual routine counseling. Salaries form most of the total costs. [source] | ||||||||||