• Nutrition Research and Practice
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• 제7권2호
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• pp.139-145
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• 2013

There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권2호
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• pp.163-173
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• 2020

Purpose: This study aimed to investigate the clinical and metabolic determinants of circulating soluble leptin receptor (CSLR) and free leptin index (FLI) in pre-pubertal obese male children. Methods: We conducted a preliminary cross-sectional study at three tertiary hospitals and one public primary school. Eighty obese male children without growth and developmental abnormalities aged 5-9 years were recruited. In these children, obesity was solely caused by excessive food intake, and not by acute illness, medications, endocrine abnormalities, or any syndrome. Body mass index (BMI), body fat mass, carbohydrate intake, fat intake, high density lipoprotein cholesterol level, low density lipoprotein cholesterol level, triglyceride level, and Homeostatic Model Assessment for Insulin Resistance are the potential determinants for leptin regulation, which is represented by CSLR level and FLI. Results: Carbohydrate was the main source of energy. BMI and body fat mass had negative weak correlation with CSLR and positive weak correlation with FLI. Furthermore, carbohydrate intake was found to be independently associated with CSLR based on the results of the multiple linear regression analysis. Following an increase in carbohydrate intake, CSLR level decreased progressively without any negative peak. Conclusion: Leptin regulation in prepubertal obese male children is associated with body composition and dietary intake. Carbohydrate intake is useful for predicting CSLR. Lipid profiles and insulin resistance are not related to both CSLR and FLI. Treatment and prevention of leptin resistance in obese children should focus on reducing BMI, fat mass, and carbohydrate intake.

• 대한소아치과학회지
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• 제37권1호
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• pp.57-64
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• 2010

본 연구는 수직적 안모형태와 치아성숙도의 관계를 평가하고 이러한 연관성에 대한 사춘기 성장의 영향을 평가하기 위한 것이다. 이번 연구를 위해 7세에서 9세, 13세에서 15세 환자 1306명을 Ricketts의 VERT index를 이용하여 수직적 안모 형태를 분류하였고 환자들의 치령을 Demirjian법으로 평가하여 다음과 같은 결과를 얻었다. 1. 모든 군에서 치령이 역령과 비교 시 통계적으로 유의한 수준에서 크게 측정되었다. 2. 사춘기 연령군에서 brachyfacial type의 경우가 dolichofacial type 보다 치아성숙도가 크게 나타나는 경향을 보였다. 여성의 경우는 통계적으로 유의성있게 차이가 나타났으며, 남성의 경우는 통계적 유의성은 보이지 않았다. 3. Brachyfacial type의 경우 사춘기전 군들과 비교 시 사춘기 군들에서 치아성숙도가 유의성있게 높게 나타났으며, dolichofacial type의 경우는 연령층간 치아성숙도의 차이를 보이지 않았다.

• Journal of mucopolysaccharidosis and rare diseases
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• 제2권2호
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• pp.35-37
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• 2016

Prader-Willi syndrome (PWS) often develops type 2 diabetes mellitus (T2DM) related to severe obesity. The prevalence of T2DM in adults with PWS (7-20%) exceeds greatly the prevalence in the general population (5-7%). It is uncommon for pre-pubertal children with PWS to develop overt diabetes or glucose intolerance. GH therapy and genotype did not influence the development of altered glucose metabolism. It has been assumed that T2DM in PWS develops as a consequence of morbid obesity and concomitant insulin resistance. However recent studies suggest the relationship between morbid obesity and T2DM development is more complex and appears to differ in PWS subjects compared to non-PWS subjects. PWS patients had relatively lower fasting insulin levels and increased adiponectin levels compared with BMI-matched obese control despite of similar levels of leptin. So PWS children may be protected to some extent form of obesity-associated insulin resistance. Although there's no data, it seems logical to approach diabetes management including weight loss and increased exercise, using similar pharmacological agents as with non-PWS obesity-related diabetes such as metformin or thiazolidinedione, with the introduction of insulin as required. On the other hand, several recent T2DM in PWS case reports suggest favorable outcomes using Glucagon-like peptide 1 (GLP-1) analog with regard to ghrelin reduction, control of glucose and appetite, weight loss and pre-prandial insulin secretion. The role of GLP-1 agonist therapy is promising, but has not yet been fully elucidated.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권3호
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• pp.147-154
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• 2014

Purpose: Gender differences in paediatric patients with inflammatory bowel disease (IBD) are frequently reported as a secondary outcome and the results are divergent. To assess gender differences by analysing data collected within the Swiss IBD cohort study database since 2008, related to children with IBD, using the Montreal classification for a systematic approach. Methods: Data on gender, age, anthropometrics, disease location at diagnosis, disease behaviour, and therapy of 196 patients, 105 with Crohn's disease (CD) and 91 with ulcerative or indeterminate colitis (UC/IC) were retrieved and analysed. Results: The crude gender ratio (male : female) of patients with CD diagnosed at <10 years of age was 2.57, the adjusted ratio was 2.42, and in patients with UC/IC it was 0.68 and 0.64 respectively. The non-adjusted gender ratio of patients diagnosed at ${\geq}10$ years was 1.58 for CD and 0.88 for UC/IC. Boys with UC/IC diagnosed <10 years of age had a longer diagnostic delay, and in girls diagnosed with UC/IC >10 years a more important use of azathioprine was observed. No other gender difference was found after analysis of age, disease location and behaviour at diagnosis, duration of disease, familial occurrence of IBD, prevalence of extra-intestinal manifestations, complications, and requirement for surgery. Conclusion: CD in children <10 years affects predominantly boys with a sex ratio of 2.57; the impact of sex-hormones on the development of CD in pre-pubertal male patients should be investigated.

• Reproductive and Developmental Biology
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• 제34권2호
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• pp.81-88
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• 2010

Our objective of current study was to investigate the development of bone and heart in association with diabetes mellitus (DM). DM was induced by administering an intraperitoneal injection of streptozotocin (STZ; 60 mg/kg) to 4-week-old Sprague-Dawley rats. Body weight and blood glucose were monitored, and rats were sacrificed after 2 or 5 weeks. The left ventricle (LV), including the interventricular septum, was weighed, and body weight and tibial bone length were assessed. Young diabetic rats showed reduced growth in terms of tibial length and body weight compared to controls. Moreover, diabetic males showed more significant growth suppression and reduced LV size than diabetic females. Morphometric analysis of tibiae from diabetic rats revealed suppressed bone growth at 2 and 5 weeks, with no difference between genders. STZ-induced diabetes decreased bone growth and retarded pre-pubertal heart development. As a result, diabetes may increase cardiovascular risk factors and lead to eventual heart failure. Therefore, new therapeutic approaches are required for diabetic children exhibiting growth retardation. Heart growth factor, exercise, and cardiopulmonary physical therapy may be required to promote heart development and physiological function.

• 대한치과교정학회지
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• 제39권3호
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• pp.168-176
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• 2009

본 연구의 목적은 아동에서 사춘기 성장 동안 기도의 변화가 안면 성장에 미치는 영향을 평가하는 것이었다. 9 - 11세(평균 10.7세)의 교정환자 36명을 대상으로 하여 초진 시(T1)와 치료 종료 시(T2)에 각각 측모두부방사선사진과 수완부 방사선 사진을 촬영하였다. 측모두부방사선사진상의 기도 폭경을 기준으로 하여 대상을 세 그룹으로 나누었다; 폭경이 좁은 그룹(AW-Narrow: 5.2 - 8.6 mm), 중간 그룹(AW-Medium: 8.9 - 11.5 mm), 넓은 그룹(AW-Wide: 11.7 - 16.0 mm). T1과 T2시기에 각 그룹 간의 안면 계측치의 차이를 비교하였으며 T1 - T2 사이의 계측치의 변화량을 각 그룹별로 비교하여 성장을 평가하였다. 각 그룹의 기도 폭경 증가량은 AW-Narrow, AW-Medium, AW-Wide group에서 각각 4.55 mm, 3.84 mm, 1.94 mm였으며 통계적으로 유의한 차이를 보였다. T1시기의 각 그룹 간의 비교에서 AW-Narrow group에서 다른 그룹에 비해 PFH가 유의하게 작은 값을 나타냈다. T1 - T2 사이의 성장 평가에서는 AW-Narrow group에서 다른 그룹에 비해 PFH/AFH, facial axis, ANS (T1 - T2), and Gn (T1 - T2)의 변화가 유의하게 큰 값을 보였다. 이 시기의 안면 성장 기간 동안 기도 폭경이 좁은 그룹에서 기도 폭경 및 안면 성장의 보상성 변화가 일어난 것으로 생각된다. 바람직하지 않은 안면 성장을 예방하기 위한 외과적 기도 처치를 고려할 때 자발적인 개선 가능성을 고려하여 좀 더 신중한 평가가 필요할 것으로 생각된다.