• Journal of mucopolysaccharidosis and rare diseases
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• v.4 no.2
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• pp.42-44
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• 2018

Prader-Willi syndrome (PWS) is a multisystemic complex disorder characterized by hyperphagia and impaired satiety which lead to severe and early obesity. In infancy, hypotonia and poor suck are main problems, and a child goes through Failure-to-thrive. During childhood, clinical manifestations change to food seeking as well as excessive weight gain, short stature, developmental delay, cognitive disability and behavioral problems. Also, growth hormone insufficiency is frequent. Most patients receive the recombinant growth hormone (rGH) therapy that provides improvement in growth, body composition, and physical attributes. The clinical care guideline for rGH therapy in PWS had been noticed in 2013. The rGH therapy helps in body fat, lean body mass, height SDS and head circumference. Also, the rGH therapy helps motor function, psychomotor development and cognition and behavioral issues.In Samsung medical center, there are clinical care guidelines for rGH therapy in PWS and an useful application for the patients. 'Living with PWS', the name of an moblie application for PWS patients, was introduced in the lecture. The application revised to version 2. It was made more convenient to users than in version 1. It helps caregivers to schedule the rGH therapy and to monitor height and weight.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.150-159
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• 2008

Purpose: To assess the relationship between lifestyle and metabolic syndrome in obese children and adolescents. Methods: We retrospectively reviewed the medical records and laboratory results of 109 subjects (7~15 years of age) who visited our pediatric obesity clinic between January 2004 and December 2007. They completed the parent- and self-report questionnaire developed by the Committee on Nutrition of the Korean Pediatric Society to assess lifestyle. The metabolic syndrome was defined as having 3 or more of the following metabolic risk factors: obesity, hypertension, serum triglycerides ${\geq}$110 mg/dL, HDL-cholesterol ${\leq}$40 mg/dL, fasting glucose ${\geq}$110 mg/dL, and insulin ${\geq}20{\mu}IU/mL$. Results: All subjects had at least 1 risk factor (obesity). Sixty-three percent of subjects had 2 or more risk factors, 32% of subjects had 3 or more risk factors, and 10% had 4 or more metabolic risk factors. Hypertriglyceridemia (36%), hypertension (32%), hyperinsulinemia (24%), and HDL-hypocholesterolemia (20%) were observed. Fasting blood glucose levels were normal in all subjects. Hypertension was significantly associated with an unbalanced diet and hyperinsulinemia was significantly associated with parental obesity (p<0.05). Those who ate after 8 PM were at a risk of hypertension (odds ratio, 2.5; 95% CI, 1.0~6.1). Those who did not have a preference for exercise were at a risk of hyperinsulinemia (odds ratio, 10.4; 95% CI, 2~54.1). Those who watched TV for ${\geq}$3 hours/day were at a risk of metabolic syndrome (odds ratio, 4.8; 95% CI, 1.2∼18.8). Conclusion: Lifestyle, such as eating late, no preference for exercise, and TV watching ${\geq}$3 hours/day, were related to metabolic syndrome in obese children and adolescents.

• Nutrition Research and Practice
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• v.17 no.4
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• pp.780-788
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• 2023

BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively. CONCLUSIONS: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.576-583
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• 2008

Purpose : The identification of specific behaviors conducive to overeating or inactivity is the cornerstone of obesity management. The Committee on Nutrition of the Korean Pediatric Society developed parent and self-reporting questionnaires about eating behavior and physical activity in 2006. The aim of this study was to evaluate the usefulness of the questionnaires in assessing modifiable lifestyle factors related to obesity. Methods : A retrospective chart review was performed for 177 children (6-11 years old) and 134 adolescents (12-16 years old) from 10 hospitals between May 2006 and January 2007 who had completed parent or self-reporting questionnaires. Cases were divided into normal and overweight groups at or above the age-gender-specific 85th percentile based on 2007 Korean national growth charts. Results : Compared to children, the adolescents tended to have a significantly more sedentary lifestvle and inappropriate dietary behaviors significantly (P<.05). Overweight mothers were significantly associated with overweight children and adolescents (P<.05). Being overweight was significantly associated with a family history of adult diseases for children and adolescents (P<.05). Inappropriate eating behaviors (strong appetite, eating fast, eating until they were full, binge eating, favoring greasy foods) were associated with being overweight in children and adolescents. Sedentary activity such as TV viewing and using a computer were significantly associated with overweight in children and adolescents (P<.05). Conclusion : Intervention to modify obesity-related lifestyle factors is needed before adolescence. These questionnaires are useful in identifying modifiable lifestyle factors and in individual counseling for overweight children and adolescents in pediatric clinics.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.368-374
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• 2006

Purpose : The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. Methods : Thirty-eight obese children(14-16 years old of age, male, body mass index $29.40{\pm}3.18kg/m^2$) and forty-five age and sex-matched healthy control children(body mass index $18.43{\pm}1.01kg/m^2$) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flowmediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. Results : The obese children had significantly increased IMT($0.52{\pm}0.09mm$ vs $0.40{\pm}0.07mm$, P< 0.001) and markedly impaired FMD($7.35{\pm}7.78$ percent vs $20.34{\pm}16.81$ percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P<0.001) and reduced FMD(r=-0.414, P<0.001). Conclusion : We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.665-676
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• 1994

The purpose of this study is to observe the longitudinal changes in BMI (Body Mass Index) of obese and non-obese 3rd. grade high school students in Seoul for 12 years and to see the trends of overt weight gain in obese adolescents. The results are as follows; 1. The average annual increasing rates of body mass Indices in male students were $1.14kg/m^2$ in obese group and $0.59kg/m^2$ in non-obese group. In female students, the average annual increasing rates of body mass indices were $0.93kg/m^2$ in obese group and $0.53kg/m^2$ in non-obese group. 2. The change rate of BMI for 12 years was significantly higher in obese group than non-obese group. 3. Puberty had less influence on the change rate of BMI in obese group compared to non-obese group. 4. In obese group, 71.8% of the variance in BMI at 17 can be predicted by BMI at 16 years in male students. In female students 44.4% can be predicted by BMI at age 16. 5. Among the 17-year-old obese students, 58.8% of the males and 56.2% of females were found not to have been obese at 7 years of age. 6. Among the 17-year-old obese students, those who were obese at 7 years of age were found to have higher BMI at later ages than those who were in the non-obese group. Obese adolescents were more likely to be obese in their childhood than non-obese group. There was no optimal age for the significant weight gain and the increasing rate of BMI was constantly higher in obese group than in non-obese group. Due to the fact that child obesity in early age contributes to obesity in adolescence, close observation is advised. On the other hand, a large proportion of obese adolescents can be preventable by early interventions, because about 50% of obese adolescents were not obese in early elementary school age.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.4
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• pp.377-383
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• 2021

Purpose: We investigated the association of effector memory (EM) CD8⁺ T cell and CD4⁺ T cell immunity with metabolic syndrome (MS). Methods: Surface and intracellular staining of peripheral blood mononuclear cells was performed. Anti-interleukin-7 receptor-alpha (IL-7Rα) and CX3CR1 antibodies were used to stain the subsets of EM CD8⁺ T cells, while anti-interferon-gamma (IFN-γ), interleukin-17 (IL-17), and forkhead box P3 (FOXP3) antibodies were used for CD4⁺ T cell subsets. Results: Of the 47 obese children, 11 were female. Children with MS had significantly higher levels of serum insulin (34.8±13.8 vs. 16.4±6.3 µU/mL, p<0.001) and homeostasis model assessment of insulin resistance (8.9±4.1 vs. 3.9±1.5, p<0.001) than children without MS. Children with MS revealed significantly higher frequencies of IL-7Rα^low CD8⁺ T cells (60.1±19.1% vs. 48.4±11.5%, p=0.047) and IL-7Rα^lowCX3CR1⁺ CD8⁺ T cells (53.8±20.1% vs. 41.5±11.9%, p=0.036) than children without MS. As the serum triglyceride levels increased, the frequency of IL-7Rα^lowCX3CR1⁺ and IL-7Rα^highCX3CR1^- CD8⁺ T cells increased and decreased, respectively (r=0.335, p=0.014 and r=-0.350, p=0.010, respectively), in 47 children. However, no CD4⁺ T cell subset parameters were significantly different between children with and without MS. Conclusion: In obese children with MS, the changes in immunity due to changes in EM CD8⁺ T cells might be related to the morbidity of obesity.

• Korean Journal of Health Psychology
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• v.16 no.3
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• pp.537-555
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• 2011

The purpose of this study was two-fold. First, comparisons on the psychological and physical attributes of normal weight, overweight, and obese children were conducted. Second, the influence of BMI and physical fitness interaction on psychological adaptation in children with obesity was explored. Participants were 245 children between the ages of 9 and 13 years (64.5% males). Data on children considered overweight (n = 45) or obese (n = 78) were gathered from the Korean Obese Children's Physical Activity (KOCPA) projects. Normal weight children (n = 122) were recruited from two Seoul elementary schools. Psychological measurements included Weight Efficacy Life-style Questionnaire (WEL), Physical Self-efficacy Scale (PSES), Child Dietary Self-efficacy Scale (CDSS), Self-concept Inventory (SCI), and the Korean version of the Pediatric Quality of Life Intervention TM Version 4.0 Generic Core Scales (PedsQLTM4.0). BMI (kg/m2) and physical fitness (e.g., aerobic endurance, flexibility) were recorded by experts in exercise physiology. Results showed that children in the high BMI group reported poorer psychological adaption and demonstrated lower physical fitness when compared to the remaining groups. Compared to normal weight children, children considered overweight and obese were found to have lower physical self-efficacy, more negative self-concept, and poorer quality of life. Further, these children also had significantly lower physical fitness levels than their normal weight counterparts. Physical fitness was found to have a significant main effect on weight efficacy (WEL), physical self-efficacy (PSES), and quality of life (PedsQL) in children considered overweight or obese. A significant BMI-physical fitness interaction effect was found for self-concept (SCI) only. Children with higher BMI reported poorer self-concept regardless of fitness level whereas children with lower BMI and higher fitness reported more positive self-concept. Implications and limitations are discussed.

• Child Health Nursing Research
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• v.20 no.3
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• pp.205-214
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• 2014

Purpose: The purpose of the study was to develop and evaluate the effect of a metabolic syndrome prevention program using mobile application for university students. Methods: A pretest-posttest design with content analysis as a triangulation method was used. The participants were 49 university students. Data were analyzed using descriptive statistics, $x^2$-test, t-test and Fisher's exact test with the SPSS WIN 18.0 program. Results: The application consisted of six main menus as follows: 'basic education', 'nutrition education', 'exercise education', 'meal diary', 'exercise checkup', and 'tips'. The experimental group had higher recognition about metabolic syndrome prevention than the control group (F=7.919, p=.007). Understanding of metabolic syndrome among participants was mostly related to chronic diseases such as obesity, hypertension and diabetes in relation to the importance of eating habits and exercising. Conclusion: The results indicate that metabolic syndrome prevention education using mobile application is necessary and would be useful for university students.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1052-1057
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• 2008

Purpose : This study was to examine the relations of perception of physique with self-esteem, sociality and problematic behaviors in children. Methods: Four hundred sixty five (231 boys and 234 girls) children were divided into three groups according to their height or body mass index according to the physical growth standard table had been presented in 2007 by the Korean Pediatric Society. The group 1, 2, and 3 was short, borderline and normal or obese, overweight and normal, respectively. Their perception and satisfaction of height and weight were investigated, and their self esteem and behavior styles were examined with Self-Esteem Inventory (SEI) and Korean Child Behavior Checklist (K-CBCL). We compared the numbers of appropriate perception, satisfaction, self-esteem and problematic behaviors in each group, and analyzed the relationship among perception of physique, self-esteem, sociality, and behavioral characteristics. The collected data were analyzed with chi-square test, ANOVA and Pearson correlation coefficient used with SPSS (ver. 12.0). Results : There were significant mismatches among their real physique perception and satisfaction (P<0.05). There were no significant differences of their self-esteem, sociality, and problematic behaviors according to their actual height and weight. There were significant differences of their self-esteem according to their perception or satisfaction of their height and weight (P<0.01). Conclusion : The children who considered themselves have short stature or obesity had problematic behaviors or low self-esteem. Therefore, children should be educated to have the appropriate perception of their own body image.