Vitamin D Deficiency and Insufficiency in Obese Children and Adolescents and Its Relationship with Insulin Resistance

Objectives. We aimed to determine the relationship between insulin resistance and serum 25-hydroxyvitamin D (25-OHD) levels in obese children and their nonobese peers. Materials and Methods. Included in the study group were 188 obese children (aged 9–15 years), and 68 age- and gender-matched healthy children of normal weight as control group. Anthropomorphic data were collected on patients and fasting serum glucose, insulin, serum lipids, alanine aminotransaminase (ALT) and 25-OHD were measured. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated in both groups. Results. The levels of 25-OHD in the obese group were significantly lower than those of the nonobese (). HOMA-IR, triglycerides, low-density lipoprotein, and ALT levels in the obese group were significantly higher than values of control group ( and , resp.). In the obese group, vitamin D deficiency, insufficiency, and sufficiency (25-OHD 10 ng/dl; > 20 ng/dl, resp.) were not correlated with HOMA-IR (, ). HOMA-IR was negatively correlated with BMI, BMI SDS, and BMI%, and triglycerides, low-density lipoprotein, and ALT levels (). Conclusion. The insulin resistance of the obese subjects who were vitamin D deficient and insufficient did not statistically differ from those with vitamin D sufficiency. Low 25-hydroxyvitamin D levels were not related with higher insulin resistance in obese children and adolescents. In obese subjects, insulin resistance was affected more from BMI, BMI SDS, and BMI% than from 25-hydroxyvitamin D levels

Total antioxidant and oxidant status in obese children without insulin resistance

Objective: Oxidative stress in obese children may lead in adulthood serious conditions such as coronary heart diseases or type 2 diabetes mellitus. In childhood oxidative stress is associated with insulin resistance or extreme obesity. In this study, we aimed to evaluate oxidative stress status in moderately obese children without insulin resistance. Methods: A total of 38 obese children (21 male, 17 female) without insulin resistance, mean aged 9.4±3.8 years) and 51 normal weight children (25 male, 26 female) as the control group, mean aged 9.3±3.9 years) were enrolled to the study. Total oxidative status (TOS), total antioxidant capacity (TAC) were measured and oxidative stress index (OSI) was calculated. Results: The results reveal that obese children had lower TAC than normal weight children (2,27±0,28 vs. 2.76±0.35 mmol Trolox Eq./L; p<0,001). There was no statistical difference between obese and control groups regarding TOS (6,08±3,63 vs 5.25±4.16 μmol H2O2 Eq./L; p=0.333). OSI was higher in obese group (2.65±1.52 vs 1.92±1.56; p=0.029) Conclusion: Balance between oxidant and antioxidant system is disrupted due to the reduced TAC even in moderately obese children without insulin resistance. Further studies should also be performed to evaluate the beneficial effects of dietary intake of antioxidants in these children

The Effect of Obesity Degree on Childhood Pulmonary Function Tests

Background: Childhood obesity has become a global epidemic. It is related to several chronic diseases such as essential hypertension, type 2 diabetes mellitus, and renal disease. The relationship between the degree of obesity and lung functions is well defined in adults, but limited information is available about the childhood period. Aims: This study aims to determine the impact of the degree of obesity on the pulmonary functions of school children and adolescents. Study Design: Cross sectional study. Methods: Included in the study were a total of 170 school children and adolescents (9-17 years old) referred to our paediatric outpatient clinic. Of these subjects, 42 were lean and non-obese (BMI % <85), 30 subjects were overweight (BMI % ˃85, <95), 34 subjects were obese (BMI % ˃95, <97), and 64 subjects were morbidly obese (BMI % ˃97). Anthropometric measurements were taken and spirometry was performed on all subjects. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced vital capacity 25-75 (FEV25-75) and peak expiratory flow (PEF) were used to measure the ventilatory functions for all the subjects. Results: The groups showed no significant differences in age or gender. Despite no statistically significant differences in FEV1, FVC, or FEV1/FVC, there were significant reductions in PEF (p<0.001) and FEV25-75 (p<0.001) in the overweight, obese and morbidly obese subjects, when compared with those who were non-obese. Conclusion: Overweight, obese and morbidly obese children have no obstructive abnormalities compared with healthy lean subjects

A Case with Laron Syndrome

Laron syndrome (LS) is a rare disorder leading to short stature as a result of growth hormone (GH) insensitivity. It is caused by mutations in GH receptor gene and characterized by post-natal growth retardation, craniofacial abnormalities, high serum GH and low insulin-like growth factor-1 (IGF-I) levels. Several different genetic mutations have been documented up to date. In this article, a patient with LS is reported

Pseudohypoparathyroidism Type Ia with Normocalcemia

Pseudohypoparathyroidism (PHP) is a heterogeneous group of disorder with parathormone target organ resistance, characterized by hypocalcemia, hyperphosphatemia and high blood parathormone (PTH). Typical phenotypic symptoms and additional hormonal resistance can be observed in type Ia, which is also known as Albright hereditary osteodystrophy. Our patient was an eight-year and nine-month old girl with typical Albright's hereditary osteodystrophy phenotype including short stature, obesity, round face, low nasal bridge, shortened metacarpals, and mild mental retardation. In her biochemical examination, high PTH level and hypothyroidism is detected in spite of normal calcium and phosphor levels. As a result of clinic and laboratory tests, the findings were consistent with PHP type Ia with normocalcemia. In her guanine nucleotide binding protein (G protein), alpha stimulating activity polypeptide 1 (GNAS 1) gene serial analysis, C-308T>C (p1103T) transformation was detected, which was previously reported in a PHP type Ia patient. In this report, we've aimed to emphasize the fact that calcium and phosphor level in the blood of the patient with PHP type Ia can be measured normal

Association of physical activity level with depression, anxiety, and quality of life in children with type 1 diabetes mellitus

Background: Children with type 1 diabetes mellitus (T1DM) have low physical activity levels and are at high risk for psychosocial morbidities, including depression, heightened anxiety and low health-related quality of life (HRQoL)

An investigation of the foot ankle joint mobility, muscle strength, and foot structure in adolescent with type 1 diabetes

Muscle strength and joint mobility were decreased with type 1 diabetes mellitus (T1DM). However, the literature is limited about foot muscle strength, joint mobility, and structure in adolescent aged 13-17 with T1DM. The purpose of this study was to compare foot structure, muscle strength, and joint mobility of adolescents aged between 13 and 17 with T1DM to those of healthy adolescents. Cross-sectional study design including adolescents with T1DM aged 13-17 years, and healthy adolescents was used in the study. The range of motion (ROM) was measured by using a digital goniometer, and muscle strength was evaluated by using handheld-dynamometry. Footprint was used for foot structure. Assessments were performed by using the digital images, and Clarke's angle (CA), Staheli Arch index (SAI), and Chippaux-Smirak index (CSI) were calculated by using a scientific image-analysis program, ImageJ. Forty-one T1DM and 28 healthy adolescents were included with a mean age of 15.29 +/- 1.55 and 15.04 +/- 1.42, respectively. The T1DM group had significantly lower dorsiflexion, inversion and eversion ROM, and lower tibialis anterior and gastrocnemius muscle test (p 0.05). Adolescents with T1DM have lower ankle and foot joint mobility and muscle strength and altered foot structure compared to their healthy contemporaries. This indicates that early screening of muscle strength and foot structure are important to determine and avoid various risks such as foot deformities, gait deviations, and ulcer

TİP 1 DİYABETİ OLAN ERGENLERDE FİZİKSEL AKTİVİTE SEVİYESİ İLE DEPRESYON, ANKSİYETE, YAŞAM KALİTESİ VE BENLİK SAYGISI ARASINDAKİ İLİŞKİ

Purpose: The aim of this study was to assess the relationship between physical activity (PA) level and depression, anxiety, quality of life, self-esteem and HbA1c in adolescents with type 1 diabetes mellitus (T1DM)

RELATIONSHIP BETWEEN PHYSICAL ACTIVITY LEVEL AND DEPRESSION, ANXIETY, QUALITY OF LIFE, SELF-ESTEEM, AND HBA1C IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS

Purpose: The aim of this study was to assess the relationship between physical activity (PA) level and depression, anxiety, quality of life, self-esteem and HbA1c in adolescents with type 1 diabetes mellitus (T1DM)