• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.179-184
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• 2007

Purpose: Obesity has recently emerged as a significant health problem in the pediatric population, and the prevalence of non-alcoholic fatty liver disease is increasing in tandem with a significant rise in childhood obesity. Therefore, this study was conducted to clarify the risk factors of non-alcoholic steatohepatitis in obese children. Methods: We enrolled 84 obese children who visited the pediatric obesity clinic at Yeung-Nam university hospital. The patients were divided into two groups based on their alanine aminotransferase (ALT) level (separated at 40 IU/L), and the mean of ages, total cholesterol levels, HDL-cholesterol levels, LDL-cholesterol levels, triglyceride (TG) levels, as well as the mean obesity index, and body fat percentage of the two groups were then compared. Results: When the mean of ages ($10.5{\pm}1.6$ vs. $10.7{\pm}2.0$ years), total cholesterol levels ($183.0{\pm}29.1$ vs. $183.7{\pm}31.3$ mg/dL), HDL-cholesterol levels ($53.0{\pm}10.2$ vs. $55.7{\pm}13.0$ mg/dL), LDL-cholesterol levels ($113.4{\pm}30.2$ vs. $113.0{\pm}30.0$ mg/dL), triglyceride levels ($99.4{\pm}62.9$ vs. $114.2{\pm}47.3$ mg/dL), obesity indexes ($44.7{\pm}12.2$ vs. $47.9{\pm}15.1%$), and body fat percentages ($32.7{\pm}5.0$ vs. $34.0{\pm}4.8%$) of group 1 (ALT${\leq}$40 IU/L) were compared with those of group 2 (ALT${\geq}$41 IU/L), no significant differences were observed (p>0.05). However, hypertriglyceridemia (TG${\geq}$110 mg/dL) was more frequent in group 2 than in group 1 (p=0.023). Conclusion: TG may be an important risk factor in non-alcoholic steatohepatitis and further study regarding the risk factors in non-alcoholic steatohepatitis is required.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.276-285
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• 2020

Purpose: Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children. Methods: Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors. Results: The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability. Conclusion: The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.

• Childhood Kidney Diseases
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• v.24 no.2
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• pp.107-114
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• 2020

Purpose: The purpose of this study was to evaluate the prevalence, clinical characteristics, and long-term clinical effects of hypertension in Korean childhood-onset systemic lupus erythematous (SLE) patients. Methods: The medical records of SLE patients, diagnosed by 2019 SLE European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria, who visited Samsung Medical Center from January 2009 to May 2019 were reviewed. Disease activity and long-term damage were evaluated using the Modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and the Pediatric Systemic Lupus International Collaborating Clinics/ACR Damage Index (Ped-SDI), respectively. The sex-, age- and height-blood pressure standards recommended by the American Academy of Pediatrics 2017 guideline was used to define hypertension. Results: A total of 32 patients were enrolled in this study. The median follow-up duration was 7.3 years and females were predominant. The median ages at SLE and hypertension diagnoses were 14.2 and 14.3 years, respectively. The biopsy-proven lupus nephritis was detected in 90.6% and 37.5% were class IV. During the follow-up, 12 patients (37.5%) had hypertension. Among them, 2 patients had 3 episodes of posterior reversible encephalopathy syndrome and 5 patients had left ventricular hypertrophy (LVH). Univariate analysis showed baseline hypertension was significantly correlated with a lower estimated glomerular filtration rate, higher body mass index and SLEDAI at baseline. The development of hypertension during the follow-up was significantly correlated with obesity, LVH, and higher Ped-SDI. Conclusion: Our study revealed that hypertension in pediatric SLE is associated with obesity and renal function at SLE diagnosis and could affect long-term damage.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.5
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• pp.443-454
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• 2021

Purpose: Due to the increasing prevalence of obesity worldwide, non-alcoholic fatty liver disease (NAFLD) has reached epidemic dimensions over time. NAFLD is the most common cause of childhood chronic liver disease. There is a relationship between NAFLD and oxidative stress. This study aims to investigate the changes in thiol/disulfide homeostasis parameters to determine the oxidant/antioxidant balance in obese rats with diet-induced NAFLD and healthy rats. Methods: Twelve Wistar albino rats were used in this study. Experimentally produced NAFLD obese rats (n=6) and healthy rats were compared. Experimental NAFLD model was created with a special fatty liver diet (Altromin^® C1063, Fatty Liver Diet, Exclusivet, Lage, Germany). The biochemical and histopathological features of the groups, as well as serum thiol/disulfide homeostasis parameters, were analyzed and compared. Results: In the experimentally induced NAFLD rat model, they gained more weight than the control group. Steatosis (at least grade 2) occurred in all rats fed with special fatty liver diet for 12 weeks. Histopathologically, no high-grade inflammation was observed in rats with experimental NAFLD after feeding a diet for 12 weeks. Results revealed that aspartate transaminase and alanine transaminase levels were high, albumin levels were low, oxidant stress parameters increased, and antioxidant thiol groups decreased. Conclusion: Experimental NAFLD is characterized by increased oxidant stress accompanying fatty tissue in the liver. Analysis of thiol/disulfide homeostasis parameters in NAFLD can be used in further studies to develop effective treatment options.

• Journal of the Korean Dietetic Association
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• v.18 no.2
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• pp.186-199
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• 2012

The present study was conducted to investigate dietary habits and biochemical indices according to the obesity index of elementary school students visiting a hospital for diagnosis. The subjects of this study were 150 elementary school students and their mothers. The overweight rates of child subjects were 37.5% for males and 40.9% for females, whereas the rates of underweight children were 35.0% for males and 14.5% for females. Children's obesity index significantly decreased with an increase in the average monthly income of children's families. Children's obesity index, mothers' weights, BMI, and percent ideal body weight were all positively correlated. Blood biochemical values in children (hemoglobin, hematocrit, albumin, globulin, glucose, total cholesterol, and triglyceride levels) and their obesity index also showed positive correlation. For the underweight group, the frequency of iron-deficiency anemia was significantly high, whereas for the overweight group, the frequency of dyslipidemia was high. There was a significant increase in children's obesity index and a decrease in frequency of regular exercise with time spent on the TV/computer. The normal weight group recorded the highest total scores for mothers' nutritional knowledge, whereas the overweight group recorded the lowest total scores. Therefore, to maintain healthy weight in children, nutritional education programs for mothers and children should be developed.

• Journal of the Korean Society of School Health
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• v.11 no.1
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• pp.99-110
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• 1998

The purpose of this study is to investigate the effect of obese school children's life style habits in order to help school nurse in controlling and preventing the obesity by health education The survey group is extracted from the students of two elementary schools located in Seongnam city Out of 280 children randomly sampled, 102 children were evaluated to be obese and 178 ones to be normal by the standard of the 1985 Korea Pediatric Association Height and Weight Standard Chart The obese children group was compared with the normal one. For this purpose, the surveyors designed a self questionnaire to obtain the description of general background, exercise including play behavior, eating behavior, and family environment of the sampled children. The results are as follows The number of the obese children who took extracurricular physical exercises was significantly (p<0.05) more than that of the normal ones The significantly (p<0.05) more obese children went without a meal to control their weight than the normal ones. In relation to the degree of obesity, the children with the high degree of obesity watched the television significantly (p<0.05) longer than the ones with the mild and the moderate degree of obesity In gender relations, the obese girls participate in outdoorplays and physical exercises significantly (p<0.05) longer and more regularly than the normal ones, while no significant difference was found between the male groups The obese boys had significantly (p<0.05) their mothers occupying in a vocation. Combining television watching habit and mother's vocation of the obese boy, the obesity is resulted from complicated situation It can not be due to the simple absence of the mother, but rather due to the absence of a person responsible for controlling snacking and television watching time of the child Looking at the results, it is necessary for both school and home to actively involve in guiding children and providing an environment to modify life style habits and prevent childhood obesity.

• Clinical and Experimental Pediatrics
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• v.62 no.6
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• pp.206-212
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• 2019

Purpose: The present study aimed to determine the prevalence of childhood obesity and overweight in Iranian children under 5 years of age using a systematic review and meta-analysis. Methods: We searched MEDLINE (PubMed), Web of Science, Google Scholar, Scopus, CINHAL, and the Iranian databases, including Scientific Information Database (www.sid.ir), Iranian Research Institute for Information Science and Technology (Irandoc.ac.ir), Iranmedex (www.iranmedex.com), and Magiran (www.magiran.com), for all articles published between January 1989 and August 2017. Sources of heterogeneity were determined using subgroup analysis and meta-regression. Results: Six articles were ultimately included in the meta-analysis to estimate the pooled prevalence, based on which the prevalence of obesity and overweight were estimated to be 8% (95% confidence interval [CI], 6%-10%) and 9% (95% CI, 7%-11%), respectively. The results of the subgroup analysis showed that the prevalence of obesity in boys and girls was 9% (95% CI, 6%-13%) and 7% (95% CI, 4-10%), respectively, and the prevalence of overweight in boys and girls was 10% (95% CI, 5%-15%) and 9% (95% CI, 5%-13%), respectively. Conclusion: Despite high heterogeneity among the results of the articles included in the meta-analysis, the prevalence of obesity and overweight is higher in Iranian children under 5 years of age. Therefore, parents and the health system must pay more attention to the lifestyle, nutritional habits, and physical activity of these children.

• Clinical and Experimental Pediatrics
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• v.62 no.8
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• pp.317-323
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• 2019

Purpose: Investigating the prevalence of hyperuricemia and its association with metabolic syndrome (MetS) and cardiometabolic risk factors (CMRFs) in Korean children and adolescents. Methods: This cross-sectional survey used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2017); 1,256 males and females aged 10-18 years were included. Hyperuricemia was defined as serum uric acid levels were >6.6 mg/dL at 10-11 years of age (both sexes), >7.7 mg/dL for males at 12-18 years of age and >5.7 mg/dL for females at 12-18 years of age. MetS was defined by the International Diabetes Federation criteria. Logistic regression analysis was used to analyze hyperuricemia-associated risk factors. Results: The prevalence of hyperuricemia was 9.4% (male, 8.4%; female, 10.5%) (P<0.281). After adjusting for sociodemographic factors and health behaviors in multivariate analysis (model 1), the odds ratio (OR) for hyperuricemia of MetS was 3.05 (95% confidence interval [CI], 1.17-7.92; P=0.022). After adjusting for the same variables in model 1 plus obesity and all MetS components (model 2), only abdominal obesity was significant, and the OR for hyperuricemia was 3.38 (95% CI, 1.72-6.63; P<0.001) After adjusting for the same variables in model 1 plus body mass index (BMI) z scores and all MetS components except abdominal obesity (model 3), only BMI z scores was significant, and the OR for hyperuricemia was 1.59 (95% CI, 1.34-1.89; P<0.001). Conclusion: MetS, abdominal obesity, and BMI z scores were CMRFs significantly associated with hyperuricemia in Korean children and adolescents. Therefore, attention should be paid to hyperuricemia in patients with obesity or MetS.

• Advances in pediatric surgery
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• v.20 no.2
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• pp.62-64
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• 2014

Gallbladder stones in children are not common without underlying hemolytic diseases or other risk factors like obesity. Ceftriaxone, a third generation cephalosporin, is known to make biliary precipitations that can be mistaken for biliary stones. We here report two children with biliary pseudolithiasis with different treatment modalities. One child was mistaken for symptomatic gallbladder stones and underwent elective laparoscopic cholecystectomy, while the other child, after thorough history taking on the ceftriaxone medication, was suspected of biliary pseudolithiasis and was treated conservatively. Both children had the history of usage of ceftriaxone in previous hospitals for infectious diseases. The ceftriaxone history of the first child was missed before the surgery. When gallbladder stones are found in children without any underlying diseases, specific history taking of the usage of ceftriaxone seems to be absolutely required. In this case, immediate interruption of the antibiotic could resolve the episode and avoid unnecessary surgical procedure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.1
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• pp.47-53
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• 2003

Purpose: We studied the prevalence and long-term trend of childhood obesity after puberty to help in managing and treating obesity. Methods: We surveyed obesity index of children at age 13 and 17 who was diagnosed as obesity at their age 7. 1,559 students consisting of 753 boys and 806 girls had followed up since 1992 until 2002. Obesity was defined as the obesity index over 20 percent. Results: The prevalence of obesity was 3.1% at age 7, 7.1% at age 13 and 13.0% at age 17, which increased significantly with getting older in age in both sex. Among obese children at age 7, 67.5 percent remained obese at age 17. 66.6% of the obese boys at age 7 and 68.4% of the obese girls at age 7 remained obese at age 17. The proportion of severe obesity in obese boys was increased as they were old, but not in obese girls. The progression to moderate and severe obesity at age 17 was prominent for obese boys at age 7, compared to the obese girls. 12.7% of normal weight boys at age 7 and 9.8% of normal weight girls at age 7 became obese at age 17. Conclusion: We think that the prevention and treatment of obesity during puberty is as important as those in the childhood.