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BMI SDS (bmi + sd)

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Medical Sciences	100%

Selected Abstracts

Risk factors for obesity in childhood survivors of suprasellar brain tumours: a retrospective study

ACTA PAEDIATRICA, Issue 10 2010
Ngee Lek
Abstract Aim:, To characterize postdiagnosis changes in body mass index (BMI) among childhood survivors of suprasellar brain tumours, and to determine the risk factors associated with obesity. Methods:, We conducted a retrospective analysis of 46 children (16 boys and 30 girls) with median (IQR) age of 7.49 (3.47,11.59) years at tumour diagnosis, and followed up for 3.93 (1.68,7.27) years. Survival analyses were used to identify risks of developing obesity. Results:, There were no sex differences in age at tumour diagnosis, duration of follow-up, tumour types, endocrinopathies, treatment modalities or baseline BMI SDS. In the first year after tumour diagnosis, ,BMI SDS (median; IQR) was greater in girls (1.32; 0.07,2.08) than in boys (0.48; ,0.40 to 0.89) (p = 0.01). At diagnosis, 3/46 children (6%) were obese; this increased to 20/46 (43%) by last follow-up (p < 0.001) and was more common in girls (17/30; 57%) than in boys (3/16; 19%). Female gender (hazard ratio 5.0, 95% CI 1.2,21.7; p = 0.04) and greater than average baseline BMI (hazard ratio 4.7, 95% CI 1.1,20.8; p = 0.02) were risk factors for subsequent obesity. Conclusion:, Accurate prediction of obesity risk is important and would allow early targeted intervention in high-risk patients. [source]

Adiponectin levels are high in children with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency

ACTA PAEDIATRICA, Issue 5 2009
Thomas MK Völkl
Abstract Objective: It has been shown that adiponectin serves as an insulin-sensitizing adipokine. Serum concentrations of adiponectin are low in children with obesity, and increase with fat mass loss, indicating that adiponectin can serve as a biomarker. Since the prevalence of overweight and obesity is increased in children with congenital adrenal hyperplasia (CAH), our study aimed to evaluate serum levels of adiponectin in a cohort of CAH children and adolescents, and their associations with clinical parameters such as chronological age (CA), body mass index (BMI), Tanner stage (TS), medication and metabolic control. Patients and methods: We studied 51 patients, aged between 5.6 and 19.6 years (median 11.8; 30 females, 21 males), cross-sectionally. All patients had genetically confirmed CAH and received standard steroid substitution therapy. Adiponectin was measured by an enzyme linked immunoassay. Since BMI SDS of the CAH cohort were significantly higher compared to the reference population, we built matched pairs with healthy Caucasian subjects from a normal representative cohort for sex, Tanner stage, chronologic age and BMI. Results: Adiponectin concentrations were significantly higher in CAH patients (median 11 ,g/L) compared to the matched controls (6.7 ,g/L, p < 0.0001). Correlation analyses in CAH patients revealed a significant inverse relationship between adiponectin and CA, TS, BMI, serum DHEAS and serum testosterone, but no correlation with hydrocortisone and fludrocortisone dosage. Conclusion: Currently, the importance of the elevated adiponectin concentrations in CAH children for risk assessment is not clear. However, our data imply that besides adequate metabolic control of glucocorticoid substitution, a long-term follow-up of other metabolic markers of insulin resistance should be conducted in CAH patients. [source]

Insulin requirement in preschoolers treated with insulin pumps at the onset of type 1 diabetes mellitus

ACTA PAEDIATRICA, Issue 3 2009
Agnieszka Szypowska
Abstract The aim: The aim of this study is to analyze changes in the basal insulin requirement in preschoolers treated with insulin pump at the onset of T1DM, using system to calculate meal time insulin. Methods: 58 children (31 girls) under 6 years (mean age 3.3 ± 1.5 years) initiated on insulin pump therapy within 2 months after recognition of T1DM and treated at least for 1 year were analyzed during a follow-up period of 165 patient-years. Data was collected every 6 months: HbA1c, BMI SDS, diabetic ketoacidosis, severe hypoglycaemia, total daily insulin dose (TDD) and basal insulin. Results: Basal insulin rose from 10% in the third month and did not exceed 30% of TDD after 12 months (p<0.0001). In the third month, 46% of children were without basal insulin; this group included significantly older children (3.7 ± 1.4 vs. 2.8 ± 1.4 years; p = 0.01), which had lower TDD (0.33 ± 0.18 vs. 0.54 ± 0.23u/kg/d; p = 0.0007) than children with basal insulin. HbA1c persisted ,7.3%. Conclusion: In preschool children initiated on CSII therapy at the time of T1DM diagnosis the first year of treatment is critical for altering the basal insulin dose. Preschoolers with TDD lower than 0.5U/kg/d may not require basal insulin. Moreover, basal insulin did not exceed 30% of TDD in the first years after T1DM onset. [source]

Abnormal growth in mitochondrial disease

ACTA PAEDIATRICA, Issue 3 2009
S Wolny
Abstract Aim: To review the height and weight of children with mitochondrial disease attending our supra-regional service. Methods: This was a retrospective audit of cross-sectional data. Height and weight measurements were available in 24 children and adolescents (median 7.86 years; range 1.76,20.5 years) who all had a confirmed diagnosis of mitochondrial disease. Values were converted to SD scores using UK reference data. Results: Patients with mitochondrial disease were short with an overall SD score of ,1.97 (95% confidence intervals ,2.72 to ,1.23 SD). Patients were also thin with a relatively low BMI SDS of ,1.07 (95% confidence intervals ,1.69 to - 0.07 SD), which fell with advancing years (r =,0.7; p < 0.000). Conclusion: Short stature and a progressive reduction in body mass index (BMI) are features of mitochondrial disease in childhood. The mechanisms underlying the abnormal growth in these patients need to be studied in more detail. [source]

Insulin sensitivity, VO2max and body composition in severely obese Swedish children and adolescents

ACTA PAEDIATRICA, Issue 1 2009
Gunilla 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]

Adiponectin levels in adolescent girls with polycystic ovary syndrome (PCOS)

CLINICAL ENDOCRINOLOGY, Issue 6 2009
Orit Pinhas-Hamiel
Summary Objective, To determine serum adiponectin concentrations in adolescent girls with and without polycystic ovary syndrome (PCOS) and to assess possible correlations of adiponectin levels with insulin and androgen levels. Design, Prospective case,control study. Setting, Endocrine clinics in the community. Patients, Forty-four adolescent girls were grouped as follows: 14 were overweight [body mass index (BMI) standard deviation score >1·645] with PCOS; 16 were lean (BMI SDS <1·036) with PCOS; and 14 were lean (BMI SDS <1·036) without PCOS. Intervention, Blood samples were collected from all girls between 8 and 11 am, after an overnight fast. Main outcome measures, Serum levels of adiponectin, leptin, insulin, Müllerian-inhibiting substance, luteinizing hormone, follicle-stimulating hormone, testosterone, 17-alpha-hydroxyprogesterone, androstendione, dehydroepiandrosterone sulphate (DHEAS) and 17,-oestradiol. Results, Adiponectin concentrations were significantly decreased in obese adolescents with PCOS (10·5 ± 5·5 ,g/ml) compared with that in lean girls with or without PCOS (16·9 ± 8·64 and 18·0 ± 7·4 ,g/ml respectively). Leptin levels were significantly elevated in obese adolescents with PCOS compared with the levels in normal weight adolescents with PCOS, and compared with that in normal weight controls. Insulin levels were markedly higher in obese adolescents with PCOS compared with that in normal weight adolescents (12·3 ± 12·2 vs. 4·5 ± 2·9, P < 0·05), and compared with that in normal weight PCOS adolescents (7·4 ± 4·9); however, this difference was not statistically significant. Insulin levels did not differ between normal weight adolescents with PCOS and normal controls. Adiponectin concentrations correlated inversely with BMI, leptin and insulin. Conclusions, Hypoadiponectinaemia is evident only in obese adolescents with PCOS and therefore does not seem to be involved in the pathogenesis of PCOS in this age group. [source]

Insulin sensitivity in growth hormone-deficient children: influence of replacement treatment

CLINICAL ENDOCRINOLOGY, Issue 4 2004
Giorgio Radetti
Summary objective, In adults, excessive GH secretion may lead to secondary diabetes mellitus, while prolonged GH treatment may accelerate the onset of type 2 diabetes mellitus in predisposed children. The aim of the study was to evaluate insulin sensitivity (IS) and glucose tolerance (GT) in a group of GH-deficient children treated with GH for a period of 6 years. patients and design, One hundred and twenty-eight children (40 females, 88 males) were included in the study. At the beginning of treatment chronological age was 8·9 ± 3·2 years, height standard deviation score (SDS) ,2·43 ± 0·90 and body mass index (BMI) SDS 0·18 ± 1·60. At the end of the study chronological age was 13·0 ± 2·9 years, height SDS ,1·24 ± 1·27 and BMI SDS 0·23 ± 1·54. GH was administered at a mean weekly dosage of 0·3 mg/kg, injected subcutaneously over 6,7 days. GT was assessed according to the criteria of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. IS was evaluated with the quantitative insulin sensitivity check index (QUICKI). results, No cases of impaired GT or diabetes were recorded during the follow-up period. IS, already lower than in controls before starting treatment with GH, decreased significantly during the first year of therapy (QUICKI: 0·346 ± 0·033 vs. 0·355 ± 0·044, P < 0·05), with no further decrease in the following years. No correlation was found between QUICKI, BMI, years of treatment and onset of puberty. conclusions, GH treatment in GH-deficient children does not lead to an impaired GT or type 2 diabetes mellitus, although it does significantly decrease IS. [source]