• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.710-717
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• 2006

Type 2 diabetes mellitus in children and adolescents has been increasing for last 10 years. The increase in frequency of type 2 diabetes appears to parallel the increase in prevalence and severity of obesity in children and adolescents. The metabolic syndrome, cluster of potent risk factors for atherosclerotic cardiovascular disease and type 2 diabetes, consists of insulin resistance, obesity, hypertension and hyperlipidemia. The atherosclerotic cardiovascular disease are rarely seen in the young, but the pathologic processes and risk factors are associated its development have been shown to begin during childhood. In pediatrician it is important to recognize early and treat aggressively for prevention of future cardiovascular disease in children and adolescents with metabolic syndrome.

• Clinical and Experimental Pediatrics
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• 제61권12호
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• pp.375-380
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• 2018

With the increase in the prevalence of overweight and obesity worldwide, early adiposity rebound, which is known to have a strong association with obesity, has recently been a focus of research. Early adiposity rebound is conventionally known to have a close relationship with non-communicable diseases. However, novel insights into early adiposity rebound have implied an acceleration of growth and puberty, which is directly reflected in the trends in the timing of adiposity rebound, in the 21st century compared with in the past. Furthermore, the observation that lean mass changes rather than fat mass changes show a more similar pattern to body mass index trajectories is interesting. In this article, the later outcomes and risk factors of early adiposity rebound are briefly summarized, and the current trends in the timing of adiposity rebound and novel insights into its relationship with body composition are reviewed.

• Clinical and Experimental Pediatrics
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• 제61권4호
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• pp.121-128
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• 2018

Purpose: Obesity has been associated with higher total blood mercury levels, based on animal studies; however, studies that focus on children and adolescents are lacking. We aimed to assess the association between total blood mercury levels and the incidence of overweight and abdominal obesity in Korean adolescents. Methods: The study population comprised 1,567 adolescents (793 boys and 774 girls; aged 10-19 years), who participated in the Korea National Health and Nutrition Examination Survey 2010-2013. We analyzed total blood mercury levels according to obesity status in all participants. Results: The geometric mean of total blood mercury levels was $1.93{\mu}g/L$. Participants with overweight ($2.20{\mu}g/L$) and obesity ($2.17{\mu}g/L$) had higher levels than those with normal weight ($1.86{\mu}g/L$, P<0.0001). The prevalence of overweight significantly increased with elevation of the total blood mercury quartile in both sexes. Increased incidence of abdominal obesity corresponding to increased total blood mercury level was observed in boys. After adjusting for covariates, those in the highest total blood mercury quartile were found to be at higher risk of overweight/obesity than those in the lowest quartile in both sexes (odds ratio [95% confidence interval]: boys, 3.27 [1.66-6.41]; girls, 1.90 [1.03-3.49]). The association between total blood mercury quartile and abdominal obesity was significant after controlling for covariates in boys (2.35 [1.05-5.24]). Conclusion: Our results suggest an association between total blood mercury levels and overweight in Korean adolescents.

• Clinical and Experimental Pediatrics
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• 제62권7호
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• pp.261-268
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• 2019

Purpose: This study aimed to evaluate the time trends of waist circumference (WC) and waist-height ratio (WHR), and to present WC and WHR distributions with optimal WHR cutoff for abdominal obesity in Korean children and adolescents. Methods: We performed a retrospective cross-sectional analysis of data from 13,257 children and adolescents (6,987 boys and 6,270 girls) aged 6-18 years who were included in the third to sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2005-2015). Linear regression analyses were used to identify secular changes in WC and WHR by age, sex, and KNHANES waves. A receiver operating characteristic curve analysis was used to determine the optimal WHR cutoff values for abdominal obesity and cardiometabolic risk factors. Results: The mean WC and WHR distributions from 2005 to 2015 showed no significant secular changes between the KNHANES 4 waves (P for trend ${\geq}0.05$ in all ages and both sexes). The mean WCs in the present study were lower than those in the 2007 Korean National Growth Charts. The mean WHR at ages <13 years was statistically higher in the boys than in the girls, but did not significantly differ between the sexes among those aged 13 to 18 years. The optimal WHR cutoff for abdominal obesity was 0.48 (area under the curve, 0.985; 95% confidence interval, 0.985-0.985) in the 13- to 18-year-old adolescents. Conclusion: WC and WHR showed no secular changes over 10 years. The optimal WHR cutoff for abdominal obesity of 0.48 is useful for diagnosing and managing obesity and thus preventing obesity-related cardiometabolic complications in 13- to 18-year-old Korean adolescents.

• Clinical and Experimental Pediatrics
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• 제60권2호
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• pp.31-37
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• 2017

Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers. Psychosocial issues frequently affect adherence to glucocorticoid treatment. Therefore, the safe transition of adolescents to adult care requires regular follow-up of patients by a multidisciplinary team including pediatric and adult endocrinologists. The major goals for management of adults with 21-hydroxylase deficiency are to minimize the long-term complications of glucocorticoid therapy, reduce hyperandrogenism, prevent adrenal or testicular adrenal rest tumors, maintain fertility, and improve quality of life. Optimized medical or surgical treatment strategies should be developed through coordinated care, both during transition periods and throughout patients' lifetimes. This review will summarize current knowledge on the management of adults with CAH, and suggested appropriate approaches to the transition from pediatric to adult care.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.7-12
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• 2014

만성 콩팥병의 장기 예후를 결정하는 요인 중 심혈관계 합병증의 중요성은 잘 알려져 있다. 그러나 소아 환자의 경우 전형적인 증상 발현이 적어 그 임상적 중요성이 간과되는 경향이 있다. 현재까지 알려진 심혈관계 합병증의 위험인자로는 고혈압, 당뇨병, 이상지질혈증, 비만과 같은 전통적인 위험 인자와 빈혈, 이차성 부갑상선 기능항진증, 산화 스트레스, 염증과 같은 새로운 위험 인자 등이 알려져 있다. 소아 만성 콩팥병의 경우 주로 좌심실 비대나 경동맥 내중막 두께의 증가 및 관상동맥의 석회화 같이 대부분 겉으로 드러나지 않는 증상이므로 위험 인자에 대한 철저한 관리와 지속적인 추적 관찰이 필수적이다.

• Clinical and Experimental Pediatrics
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• 제54권11호
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• pp.436-442
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• 2011

An anthropometric survey is one of the most important approaches to use when evaluating the health status of children. Secular trends in body sizes, such as height, weight, head circumference, chest circumference, and body mass index showed significant changes over 40 years in Korea. A series of periodic surveys were conducted in 1967, 1975, 1985, 1997, and 2005 by the Korean Pediatric Society and Ministry of Health and Welfare. The quality of data from school health examinations and the Korea National Health and Nutrition Examination Survey has improved, so we can use them now as resources for anthropometric analysis. The final height differences between 1965 and 1997 were 4.5 cm both in boys (168.9 cm in 1965; 173.4 cm in 1997) and girls (155.9 cm in 1965; 160.4 cm in 1997). The differences between 1997 and 2005 were 0.9 cm in boys (174.3cm in 2005) and 0.8 cm in girls (161.2 cm in 2005). There was no difference in final height measurements between 2005 and 2010. An increase in body size at earlier teen ages was pronounced during these decades compared to the previous generation; however, little change has been identified more recently. Body size has been increasing, and obesity has become more prevalent. Systems that gather data should be updated in order to cope with these secular trends. In an upcoming era of secular trends that would be in a slow transition, several surveys that include body measurements should be prepared to meet future needs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권4호
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• pp.269-272
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• 2013

Association between celiac disease and intussusception has been reported in adult. Although intussusception is common in children, it rarely has been reported in association with celiac disease. Two children, 5 and 7 years old, with celiac disease are reported here, whose initial presentation was intussusception prior to investigation for concomitant failure to thrive. They presented with acute and severe abdominal distention with vomiting, and donuts and pseudo- kidney appearance in abdominal ultrasonography. One patient's intussusception had reducted spontaneously, however the other had required surgery. In investigation for concomitant failure to thrive, tissue transglutaminase levels were very high and duodenal biopsies revealed celiac disease. Thus celiac testing is recommended in children with intussusception and growth failure.

• Clinical and Experimental Pediatrics
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• 제59권5호
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• pp.231-238
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• 2016

Purpose: Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute phase protein, derived from the liver, which is present in high concentrations in plasma. Data regarding the association between circulating plasma LBP levels and obesity-related biomarkers in the pediatric population are scarce. We aimed to determine whether there was a difference in plasma LBP levels between overweight/obese and normal-weight adolescents and to assess the correlation of circulating LBP levels with anthropometric measures and obesity-related biomarkers, including insulin resistance, liver enzyme levels, and lipid profiles. Methods: The study included 87 adolescents aged 12-13 years; 44 were overweight/obese and 43 were of normal-weight. We assessed anthropometric and laboratory measures, including body mass index (BMI), blood pressure, insulin resistance, liver enzyme levels, and lipid profiles. Plasma LBP levels were measured using an enzyme-linked immunosorbent assay. Results: The mean age of the participants was $12.9{\pm}0.3$ years. Circulating plasma LBP levels were significantly increased in overweight/obese participants compared with those in normal-weight participants ($7.8{\pm}1.9{\mu}g/mL$ vs. $6.0{\pm}1.6{\mu}g/mL$, P<0.001). LBP levels were significantly and positively associated with BMI, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose and insulin, and insulin resistance as indicated by the homeostatic model assessment of insulin resistance (HOMA-IR) (all P<0.05). In multivariate linear regression analysis, BMI and HOMA-IR were independently and positively associated with plasma LBP levels. Conclusion: LBP is an inflammatory biomarker associated with BMI and obesity-related insulin resistance in adolescents. The positive correlation between these parameters suggests a potentially relevant pathophysiological mechanism linking LBP to obesity-related insulin resistance in adolescents.

• 한국학교보건학회지
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• 제10권1호
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• pp.99-111
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• 1997

The purpose of this study is to investigate the effect of obese children's life style habits in order to contribute to the prevention and management obesity. The survey group included B,D, and J elementary school children. Out of 731 children, 380 were in the obese group and 351 were in a control group following the 1985 Korea Pediatric Association Height and Weight Standard Chart. Through a self questionnaire, a description of background, exercise including play behavior, diet intake, eating behavior and, environment were obtained. The results included that children's obesity is related to parents' obesity and, girls in both control and obese groups participate less in exercise than boys. Also, aspects of the amount of diet intake and speed of eating was significantly more (p<.001) and faster (p<.05) for the obese group. Furthermore, outdoor playing time for the obese group was significantly more than the control group (p<.05). Looking at the results, it is necessary for both school and home to actively involve themselves in guidance and providing an environment that modifies life style habits to prevent childhood obesity.