• Nutrition Research and Practice
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• v.7 no.2
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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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• v.23 no.2
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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.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.57-64
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• 2010

The purpose of this investigation was to study the relationship between vertical facial pattern and dental maturation in children in pubertal and pre-pubertal periods. The material consisted of lateral head films and panoramic radiographs of 1306 patients. The subjects were selected according to Ricketts's VERT index and other including criteria. These subjects were divided by VERT index to brachyfacial group and dolichofacial group. In each selected subject, dental age was determined according to Demirjian's dental maturity score. All subjects were distributed according to age, vertical facial type and sex, mean and standard deviation of chronological age, dental age and age difference were determined in each group. And the data were analysed to find the difference of tooth maturation by facial pattern. Findings of this study include: 1. In all groups, dental age was determined higher than chronological age in statistically significant level. 2. Compared by vertical facial pattern, in pubertal age groups, it seems that subjects with brachyfacial type presented the tendency to have an advanced dental maturation, only in female group. 3. Compared by pubertal period, brachyfacial groups presented more advanced dental maturation in pubertal groups than pre-pubertal groups.

• Journal of mucopolysaccharidosis and rare diseases
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• v.2 no.2
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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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• v.17 no.3
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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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• v.34 no.2
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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.

• The korean journal of orthodontics
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• v.39 no.3
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• pp.168-176
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• 2009

Objective: The purpose of this study was to evaluate how airway changes influence facial growth during puberty in Korean children. Methods: Thirty-six patients aged 9 to 11 (mean age: 10.7 years) were selected. Cephalograms and hand-wrist x-rays were taken at pre-treatment (T1) and post-treatment (T2). The sample was divided into narrow (5.2 - 8.6 mm, AW-Narrow), medium (8.9 - 11.5 mm, AW-Medium), and wide (11.7 - 16.0 mm, AW-Wide) groups according to the airway width at T1. Cephalometric measurements at T1, T2 and growth from T1 to T2 were compared between groups. Results: The degree of increase in airway size in each group was 4.55 mm, 3.84 mm and 1.94 mm in the AW-Narrow, AW-Medium, and AW-Wide groups, respectively. Moreover, the differences were statistically significant. The significant smallest posterior facial height was found in the AW-Narrow group at T1. For the growth values from T1 to T2, the AW-Narrow group showed significantly larger values of PFH/AFH, facial axis, ANS (T1 - T2), and Gn (T1 - T2) than the AW-Medium group. Conclusions: The compensational changes in the airway width and facial growth were found in the narrow group. Surgical approach of the airway to prevent unfavorable facial growth in these years of age should be carried out, but with careful deliberation because these problems may be improved naturally.