• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.604-609
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• 2008

Purpose : Obesity in children and adolescence is highly correlated with adult obesity, which can provoke hypertension. Therefore, it is important to evaluate the blood pressure of obese children regularly. In this study, the results of ambulatory blood pressure monitoring (ABPM) in obese children and adolescents were evaluated. Methods : ABPM was conducted for selected patients who visited Handong University Sunlin Hospital from Feb. 1, 2006 to Dec. 1, 2007. The patients were classified into 3 groups: group 1 was normal, group 2 had normal casual blood pressure and a body mass index over the 95th percentile, and group 3 had high casual blood pressure over 120/80 mm Hg and a body mass index over the 95th percentile. Systolic and diastolic 24-hour blood pressure was measured, including both day and night. Results : There were 49 patients in the study. The results showed a significant difference for average systolic blood pressure between the three groups ($105.1{\pm}4.7$, $111.0{\pm}7.1$, $117.8{\pm}6.6mmHg$, P<0.001), but for average diastolic blood pressure only between groups 1 and 3 ($69.1{\pm}5.3$, $77.9{\pm}6.3mmHg$, P=0.001). In the daytime, only groups 1 and 3 showed a statistically significant difference for systolic and diastolic blood pressure. During the night the systolic pressure of group 3 was significantly higher than the other groups, but the diastolic pressure of group 3 was only higher than that group 1. No statistical difference was found in night dips among the groups. Conclusion : Ambulatory blood pressure monitoring in children and adolescents showed statistically higher blood pressure in obese patients with high casual blood pressure.

• Journal of radiological science and technology
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• v.36 no.4
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• pp.263-271
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• 2013

The decrease of bone mineral density gives rise to the outbreak of osteopenia and makes the possibility of a bone fracture. It makes health problems in society. It's very important to prevent osteopenia in advance. Also it's critical to prevent and take care of it in adolescent because it's the most developing period comparing to middle ages because that bone mineral density decreases. There are genetic, physical and enviromental factors that affect bone mineral density. Recently, a lifestyle and eating habits are also changing as the society atmosphere is gradually doing. This study have shown that 134 women and 75 men was chosen and responded to the survey of measuring bone mineral density and investigating a lifestyle. The measure of bone mineral density is to use Dual energy X-ray absorptiometry(DEXA) and check femoral neck and lumbar spine. Also questionaries was required to pre-made survey about their lifestyles. Analysis of data was done with SPSS program. Multiple regression analysis was used for the relation of bone mineral density, the heigths and BMI. The sample of Groups are checked for drinking, smoking or excercising about differences by t-test. The results of the experiments were; first, there is statistically significant differences in the comparisons between BMD and BMD. But there isn't any special correlation between drinking, smoking and BMD. Secondly, bone mineral density becomes low related to an intake of caffeine. Particularly, this is statically significant on women. Also there is statically significant correlation between femoral neck and quantity of motion for both men and women. Third, there is significant relation between eating habits and bone mineral density on women's lumbar spine. However, there is no significant relation between men's lumbar spine and women's one. Therefore, to prevent osteopenia, it's good to abstain from intaking caffeine within an hour after a meal. In addition, it's helpful to walk or run regularly and have a balanced meal.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.745-752
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• 2005

Purpose : Adolescent obesity is known to be associated with complications such as hypertension, coronary artery disease and insulin resistance. We measured the common carotid artery by ultrasound as a predictor of atherosclerosis, and investigated the relationship between carotid artery parameters and serum cytokines in obese adolescents. Methods : Twenty-nine obese adolescents(16-17 years old, obesity index>130 percent) and twentyseven normal controls were included. Obesity index and body mass index were calculated from their height and weight. Skin fold thickness was measured at the triceps, and fat mass and fat distribution by bioelectrical impedence analysis. Blood pressure was measured at resting state and serum lipid, insulin, and homocysteine levels after a 12-hour fasting period. Intimal wall thickness, systolic and diastolic diameters of the common carotid artery were measured by ultrasound, and compliance and distensibility calculated by equation. Results : Systolic and diastolic diameters of the carotid artery significantly correlated with arm circumference, body mass index, fat distribution and fat mass. The higher systolic blood pressure was, the larger systolic and diastolic diameter. The higher diastolic blood pressure was, the larger carotid intimal thickness. Insulin levels had positive correlations with systolic, diastolic diameters and serum homocysteine level with intimal thickness. Conclusion : The carotid artery diameter significantly increased with the degree of obesity and blood pressure. The carotid intimal wall thickness significantly correlated with diastolic blood pressure. Measurement of carotid artery thickness, insulin and homocysteine levels might be useful to predict the development of coronary artery disease.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.754-763
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• 2002

Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1037-1041
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• 2006

Purpose : The prevalence of obesity and nonalcoholic steatohepatitis(NASH) was increased in adolescents. This study was performed to observe the prevalence of elevated aminotransferase levels in adolescents and to assess the correlations between aminotransferase levels and obesity related parameters(body mass index, waist circumference, hip circumference, waist to hip ratio and insulin level). Methods : We obtained weight, height, waist circumference and hip circumference from 2,417 male and 1,219 female adolescents. Mean age was $15.7{\pm}0.7$ years old. We measured fasting insulin, aspartate aminotransferase(AST) and alanine aminotransferase(ALT). Obese and overweight were defined as body mass indices(BMI) of more than the 95th, and 85th-94th percentiles, respectively, for age and sex. Results : The number of adolescents with obesity is 324(8.9 percent). 414(11.4 percent) subjects belonged to the overweight group. The average ALT level of obese, overweight and control groups were significantly different(obese : $32.1{\pm}34.3U/L$, overweight : $19.6{\pm}13.6U/L$, control : $12.7{\pm}6.7U/L$, P<0.001). The average AST level was also different according to group(obese : $27.8{\pm}16.5U/L$, overweight : $22.8{\pm}8.6U/L$, control : $20.8{\pm}8.5U/L$, P<0.001). AST and ALT were correlated with anthropometric parameters and insulin level. After multiple regression analysis, waist circumference was the significant predictive value for AST(r=0.234, P<0.001). Waist circumference, BMI and insulin levels were significant predictive values for ALT(r=0.435, P<0.001). Conclusion : The prevalence of abnormal aminotransferase was higher in the obese and overweight groups than control group. Waist circumference was useful to predict abnormal aminotransferase levels.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1174-1179
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• 2006

Purpose : Obesity and iron deficiency are common nutritional problems. Obese children are known to have iron deficiencies, but one presented opposite opinion in Korea. This study investigated the prevalence of obesity and iron deficiency in Incheon and the relationship between iron deficiency and obesity. Methods : Physical measurement and hematologic examinations were done a 764 healthy female students aged 14 to 15 years in May, 2005. Overweight was defined as a body mass index ${\geq}85th$ percentile. Iron deficiency was defined as serum ferritin <10 ng/mL. Iron deficiency anemia (IDA) was defined as serum Hb <12 g/dL and serum ferritin <10 ng/mL and/or transferrin saturation <16%. Results : 1) The prevalence of overweight was 24.4 percent (n=186), and that of obesity 16.5 percent (n=126). Ferritin and transferrin saturation was the lowest in the normal weight group. 2) The prevalence of iron deficiency and IDA was 18.7 percent (n=102) and 5.3 percent (n=41), respectively. 3) Iron deficiency was more common in the normal weight group compared with the overweight and underweight groups. Also, the non-obese had more iron deficiency and IDA than the obese. Conclusion : The prevalence of obesity in middle school girls could be higher in Incheon than in other regions, but there might be no difference in iron deficiency. However, iron deficiency was more prevalent in the normal weight group than in overweight group. The overweight group ate more food and gained more iron, so seemed to be less prevalent in iron deficiency than the normal weight group.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.362-369
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• 2002

Background : Anemia is still the most common nutrient deficiency worldwide, especially in adolescence because of an insufficient supply of iron, an increased iron requirement due to accelerated physical growth and blood loss due to menstruation in girls. This study was designed to assess the anemia and serum iron status of middle school girls. Methods : Hematologic examinations, physical examinations and questionnaires were performed for middle school girls in 1990, 1997, 1999 and 2000. Anemia was defined as a serum hemoglobin level of less than 11.5 g/dL. Iron deficiency was defined as a serum ferritin level of less than 10 ng/mL. Iron deficiency anemia was defined as anemia plus one of the following; MCV less than 78 fL, Ferritin level less than 10 ng/mL or Transferrin saturation rate less than 10%. Results : There was no significant difference in mean Hb between urban and rural areas and decreases in mean Hb as with age. The prevalence of anemia decreased by year; 13.5% in 1990, 6.9 % in 1997, 6.0% in 1999, and 5.7% in 2000. It was high in high school girls(10.1% in 1997 and 12.6% in 2000). The prevalence of iron deficiency decreased by year; 36.1% in 1990, 13.9% in 1997, 13.3% in 1999, and 23.2% in 2000. It was 21.3% in 1997 high school girls and 37.8% in 2000. The prevalence of iron deficiency anemia(IDA) decreased by year; 10.0% in 1990, 4.6% in 1997, 8.3% in 1999, and 6.1% in 2000. It was 11.6% in 1997 high school girls and 18.6% in 2000. Conclusion : Although the prevalence of iron deficiency decreased during this period, the prevalence of anemia in the elder adolescence girls was high. Two things are recommended; first, it is necessary to screen for anemia in middle school girls and high risk groups, second, it is important to evaluate the knowledge of nutrition and to enforce effective nutritional education, leading to subjects receiving adequate nutrition.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1109-1118
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• 2009

Purpose : Metabolic syndrome (MS), characterized by obesity and insulin resistance, elicits risk factors such as hyperlipidemia, hypertension, and glucose intolerance with additive effects on atherosclerosis, leading to cardiovascular diseases. The purposes of this study were to evaluate the prevalence of MS among overweight and obese adolescents and to investigate the impact of obesity on the cardiovascular system. Methods : In all, 684 adolescents were included in the study. Blood pressure, body mass index (BMI), fasting blood glucose, total cholesterol, triglyceride, low-density-lipoprotein (LDL)-cholesterol, high-density-lipoprotein (HDL)-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitive C-reactive protein (hs-CRP) were measured in the patients with a BMI of >85 percentile. Brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index were measured using Vascular Profiler (VP)-1000. Results : MS was confirmed in 19.5% of the overweight and obese adolescents and 50.8% of the obese adolescents. The systolic and diastolic blood pressure, height, weight, fat mass, %fat, BMI, obesity index, and waist circumference were higher in the overweight and obese adolescents with MS. Moreover, the triglyceride, AST, ALT, and hs-CRP levels were higher, whereas HDL-cholesterol level was significantly lower in this group. The overweight and obese adolescents with MS showed shorter diastolic and systolic times, higher heart rate and BaPWV, and longer E-wave deceleration time by echocardiography. Conclusion : Overweight and obese adolescents showed characteristic MS features such as hypertension and hyperlipidemia. Thus, obese adolescents predisposed to MS should be provided early treatment for obesity.

• Journal of Nutrition and Health
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• v.44 no.2
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• pp.131-139
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• 2011

The purpose of this study was to obtain information related to life style characteristics, school achievement and snacking behaviors among underweight and overweight adolescents in Ulsan area. The survey was carried out by self-questionnaires with 464 adolescents (333 underweight and 131 overweight). The results were as follows: Average BMI of the subjects was $19.81{\pm}3.10\;kg/m^2$ which was normal range, but average BMI of underweight and overweight were $16.90{\pm}1.19\;kg/m^2$ and $25.38{\pm}2.16\;kg/m^2$ respectively. The 49.5% of underweight and 94.7% of overweight students have correct perception about their body image. In the sleeping time, 58.9% of underweight and 66.4% of overweight students go to bed after PM 12 o'clock. In the regularity of eating breakfast, 68.5% of underweight and 67.9% of overweight students skipping breakfast at least 5 times per week. 32.6% of the subjects had snack once or more a day. Underweight students had more frequently ate snack than overweight students. The criteria of choosing snack were taste (77.4%), nutrition (9.3%), and price (6.3%). Food as snack they frequently had fruits, milk & milk products, cookies in order. Underweight students had more dodkboki & sundae, candy & chocolate and cake & bread than overweight students, although overweight students had more milk & yogurt than underweight students. The group who had a higher school record, they significantly had more fruits, milk & milk products (p < 0.01) and had not less nutritious foods (p < 0.001). This study may provide basic information on weight status, sleeping and snacking behaviors of adolescents. Therefore they should have nutrition education program to improve their life style and snacking patterns for underweight and overweight adolescents toward healthy weight.

• Journal of Oral Medicine and Pain
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• v.33 no.2
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• pp.121-132
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• 2008

To establish the diagnosis and treatment plan for skeletal Class II malocclusion, patient's skeletal morphology, prognosis as well as the treatment effect is one of the important factor to consider. Therefore, the present study classified analyzed the difference between initial(T1) and after use of activator(T2), and after finish of direct multi-bonding system treatment(T3) for Class II malocclusion during growth period according to the treatment result(effective body length) and morphology of vertical skeletal type. The experimental group was classified into two groups(1 group, 2 group) according to the effective body length change between before and after use of activator, showed good treatment effect of activator for patient with small mandible and large differential between maxilla and mandible, and short anterior facial height. And the difference between 1 and 2 group in the experimental group before treatment(T1) disappeared in the finished treatment(T3). But in contrast, the initial difference of T1 stage between a and b group in the control group did not disappear in the finished treatment(T3). In short, experimental group's treatment effect was much better than contrast group and the treatment effect was maintained and got stable results at comparison experimental group with contrast group. Through this study, we can find activator's treatment effect and stable retention of that in growing Class II malocclusion patients. By estimate of activator treatment effect through these results, we can establish the correct diagnosis and treatment plan for adolescent Class II malocclusion estimate of activator treatment effect and lead the ideal facial growth pattern.