• Clinical and Experimental Pediatrics
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• 제62권6호
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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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• 제62권8호
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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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• 제20권2호
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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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• 제6권1호
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• pp.47-53
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• 2003

목 적: 소아 비만의 관리에 도움이 되는 평가자료를 삼고자 성장이 완료되는 사춘기 이후까지 비만아의 변화 상태를 조사하여 비교하였다. 방 법: 1992년에 7세였던 아동들 중 13세(1998년)와 17세(2002년)에 추적이 가능하였던 학생 1559명(남아 753명, 여아 806명)을 대상으로 체중과 신장을 측정하여 비만도를 계산하였다. 비만도는 1998년 대한소아과학회에서 측정한 한국 소아의 신장별 체중의 50백분위수를 표준 체중으로 하여 비만도를 계산하였다. 결 과: 1) 7세 때 비만의 유병률은 3.1%였고 13세 때 7.1%, 17세 때 13.0%로 증가하였다(p<0.05). 2) 남아에서 7세 비만아 중 66.6%가 17세에도 비만을 유지하고 있으며 여아에서는 68.4%가 17세에도 비만을 유지하고 있었다. 3) 비만아에서 비만율의 변화를 보면 남아에서 는 7세 때 경도 비만 60%, 중등도 비만 37.7%, 중증 비만 2.3%였고, 17세 때는 각각 50%, 41.1%, 8.9%였다. 여아 비만아에서는 7세 때 경도 비만은 73.7%, 중등도 비만은 21.1%, 중증 비만은 5.2%였고, 17세 때에는 각각 66.7%, 30%, 3.3%였다. 4) 성별에 따른 비만의 발생율은 7세 때 정상이었던 남아들 중에서는 12.7%가 17세 때 비만이 발생하였고, 여아 중에서는 9.8%가 17세 때 비만이 발생하였다(p>0.05). 결 론: 소아 비만아의 유병률은 연령이 증가할수록 사춘기 이후에도 유의하게 증가하고 있고, 남아에서 여아에 비해 유의하게 높았다. 비만한 남아에서는 여아와 달리 연령이 증가할수록 고도비만이 증가하는 추세이고, 경도와 중등도의 비만한 남아들이 중등도 비만이나 고도 비만으로 진행하는 경우도 여아에 비해 많았다. 따라서 소아 비만아에서 학동기 뿐만 아니라 사춘기에도 지속적인 관심과 적극적인 치료 대책이 마련되어야 할 것으로 생각한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup1호
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• pp.102-108
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• 2008

최근 소아, 청소년의 비만이 늘고 있는 추세이다. 소아 청소년의 비만치료는 섭취열량과 소비열량과의 균형을 맞추는 것이 가장 중요한 원칙이다. 소아, 청소년기는 성장과 발달이 왕성한 시기이므로 단식, 절식 등의 식이요법만으로 단시간 내에 체중을 감량하는 것은 바람직하지 않다. '몸짱'같은 건강한 몸매는 운동을 통하지 않고는 이룰 수 없다는 인식을 심어주며 성장에 지장을 주지 않는 범위 내에서 적당한 운동을 유도하는 것이 좋다. 소아는 의지가 약하고 인내심이 부족하므로 부모와 가족의 이해와 협력이 필요하며, 아동이 좋은 습관을 가질 수 있도록 아동의 수준에 맞는 적당한 운동 프로그램을 제시하는 것이 요망된다. 아동에게 억지로 운동을 강요해서는 안되며, 본인이 재미있어 하면서 충격이 심하지 않은 운동을 선택하도록 한다. 하루에 1시간 정도의 운동이 필요하지만 전혀 움직이지 않던 아동은 수시로 짬짬이 움직일 수 있는 상황을 제공해주는 것이 중요하다. 비만은 체중을 단기간에 감소시키는 것이 아니라 '평생에 걸쳐 조절하여야 하는 것'으로 인식되어야 할 것이다.

• Clinical and Experimental Pediatrics
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• 제61권1호
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• pp.6-11
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• 2018

Purpose: Mid-upper-arm circumference (MUAC) is considered an alternative screening method for obesity. The aims of this investigation were to examine the ability of MUAC to correctly identify children with elevated body mass index (BMI) and to determine the best MUAC cutoff point for identification of children with high BMI. Methods: Anthropometric measurements (height, weight, and MUAC) from a cross-sectional sample of 7,921 Pakistani children aged 5-14 years were analyzed. Pearson correlation coefficients between MUAC and other anthropometric measurements were calculated. Receiver operating characteristic curve analysis was used to determine the optimal MUAC cutoff point for identifying children with high BMI. Results: Among 7,921 children, the mean (${\pm}$standard deviation) age, BMI, and MUAC were 10.00 (${\pm}2.86years$), 16.16 (${\pm}2.66kg/m^2$), and 17.73 (${\pm}2.59cm$), respectively. The MUAC had a strong positive correlation with BMI. The optimal MUAC cutoff points indicating elevated BMI in boys ranged from 16.76 to 22.73, while the corresponding values in girls ranged from 16.38 to 20.57. Conclusion: MUAC may be used as a simple indicator of overweight/obesity in children, with reasonable accuracy in clinical settings.

• Clinical and Experimental Pediatrics
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• 제54권7호
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• pp.287-291
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• 2011

Multiple psychosocial problems and many chronic diseases of adulthood can be influenced by adolescent nutritional problems. In Korea, adolescent obesity and obesity related health risks have been increased and insufficient intakes of nutrients, such as calcium, iron and potassium, and distorted thinking about obesity are also common. However there are no comprehensive countermeasure because of the excessive burden of studies and the lack of community interest. And the nutrition guidelines that is suitable for Korean adolescent leaves something to be desired, and the pediatrician's concern is lacking yet. In the Korean dietary reference intakes 2010 that was revised according to the 2007 Korean National Growth Chart and 2007 Korean National Health and Nutrition Examination Survey, the range for adolescents is changed to the age 12-18 and dietary reference intakes of some nutrients mainly with vitamin D is changed. Recently several researches, about how school nutrition policies and media effect on eating habits and the weight concerns, and influences of public nutrition policies and fast food commercials have been actively studied to improve adolescent nutritive conditions. In this review, I summarize the dietary reference intakes for Korean adolescents that were revised in 2010, and current studies about the adolescent nutrition.

• Clinical and Experimental Pediatrics
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• 제55권9호
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• pp.344-349
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• 2012

Purpose: Short sleep duration is associated with obesity. Urinary 6-sulfatoxymelatonin (6-OHMS), the principal metabolite of melatonin, is closely related with sleep. We evaluated the difference in urinary 6-OHMS levels between obese girls and normal weight girls, and the relationship of urinary 6-OHMS with other hormones regulating body weight and metabolism. Methods: A total of 79 girls (6.3 to 12.4 years) were included in this study, of whom 34 were obese; 15, overweight; and 30, normal-weight. We examined their pubertal status and bone age. Fasting serum levels of total ghrelin, leptin, insulin, and first morning urinary 6-OHMS were measured. Homeostatic model assessment-insulin resistance (HOMA-IR) was calculated from the fasting insulin and glucose levels. Results: There was no significant difference in the creatinine adjusted 6-OHMS levels between the obese girls and the control group. Urinary 6-OHMS did not show any correlations with body mass index (BMI), BMI percentile, total ghrelin, leptin, and HOMA-IR. Negative correlations were found between urinary 6-OHMS levels and chronological and bone ages. Conclusion: Our results suggest that melatonin production is not reduced consistently in obese girls.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.147-151
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• 2017

Giant hydronephrosis (GH) is a rare urological entity and usually presents with more than a liter of fluid in the collecting system. It may mimic a progressive and benign abdominal cystic tumor. We report a case of GH in an 11-year-old obese boy who presented with abdominal distension and dyspnea on exercise. Hydronephrosis was caused by ureteropelvic junction obstruction, with 2,300 mL of fluid in the collecting system. Diagnostic and therapeutic features of this case are discussed, with reference to current literature.

• Childhood Kidney Diseases
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• 제2권2호
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• pp.200-203
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• 1998

The Laurence Moon-Bardet Biedl syndrome is characterized by obesity, mental retardation, visual impairment with retinitis pigmentosa, polydactyly, hypogonadism and renal manifestations. We experienced an 11 years old female with Laurence Moon-Baret Biedl syndrome associated chronic renal failure. She was diagnosed to have LMB syndrom according to the clinical manifestations of polydactyly on hands and feet, mental retardation, obesity, retinitis pigmentosa and chronic renal failure. She is on maintenance hemodialysis now.