Obezite Derecesinin Kronolojik ve Metabolik Yaş Açılarından Değerlendirilmesi

Aim: Obesity degree is the ratio of current weight to standart weight of the individual. Metabolic age (MA) compares the individual’s basal metabolic rate to an average for the individual’s age group. In this study, considering the close association of obesity with chronic diseases, the aim is to evaluate the association between obesity degree and chronological age (CA) as well as MA and to derive a more descriptive index related to age. Materials and Methods: In this study, 287 adults between 18 and 79 years of age [10 underweight, 86 individuals with normal body mass index (BMI), 90 overweight, 81 obese ve 20 morbid obese] were evaluated. Anthropometric measurements were performed. The values for BMI were calculated. Obesity degree, MA, visceral adiposity values were recorded using TANITA body composition monitor. Differences between CA and MA were calculated. Statistical analyses were performed. Results: The mean±SD values for CA and MA for the study population were calculated as 43.2±16.0 and 46.3±16.3 years, respectively. This value for visceral adiposity was 8.2±4.8. A weak correlation was observed between obesity degree and CA. No correlation was observed between obesity degree and MA. However, a strong negative correlation was found between CA-MA and obesity degree. There was also a strong correlation between this index and visceral adiposity. Conclusions: It is concluded that during the evaluation of obesity degree, this new index, considering the difference between CA and MA, would give much more useful information rather than CA or MA.Amaç: Obezite derecesi, bireyin mevcut ağırlığının ideal ağırlığına olan oranıdır. Metabolik yaş (MY), bireyin bazal metabolik hız (BMH)’ının, bireyin kronolojik yaş grubunun ortalama BMH’ı ile kıyaslanmasını sağlayan bir parametredir. Bu çalışmada, obezitenin kronik hastalıklarla olan yakın ilişkisi gözönüne alınarak, obezite derecesi ile kronolojik yaş (KY) ve MY arasındaki ilişkinin değerlendirilmesi ve yaşla ilgili daha belirleyici bir indeksin türetilmesi amaçlanmıştır. Klinisyenlerin antenatal fetal hareketlerde azalma gördükleri gebelerde, fetal kayıp olabileceği için tedirgin olup olmamaları gerektiğine, perinatal sonuçlar değerlendirilerek farkındalık yaratmak amaçlanmıştır. Materyal ve Metot: Çalışmada 18 ile 79 yaş arasında 287 yetişkin birey [10 düşük kilolu, 86 normal vücut kitle indeksi (VKİ)’ne sahip, 90 fazla kilolu, 81 obez ve 20 morbid obez] değerlendirildi. Antropometrik ölçümler kaydedildi. VKİ değerleri hesaplandı. Obezite derecesi, MY, viseral adipozite değerleri TANITA body composition monitor kullanılarak kaydedildi. KY-MY hesaplandı. İstatistiksel analizler gerçekleştirildi. Bulgular: Çalışma populasyonunun KY ve MY ortalama±SS değerleri sırasıyla 43.2±16.0 yıl ve 46.3±16.3 yıl olarak hesaplandı. Viseral adiposite için bu değer 8.2±4.8 idi. Obezite derecesi ile KY arasında zayıf bir korelasyon gözlendi. Obezite derecesi ile MY arasında herhangi bir ilişki saptanamadı. Obezite derecesi ile KY-MY arasında güçlü bir negatif ilişki bulundu. Bu indeks ile viseral adipozite arasında da güçlü bir ilişki hesaplandı. Sonuç: Obezite derecesinin değerlendirilmesinde KY ya da MY’ın değil, aralarındaki farkı göz önüne alan bu yeni indeksin çok daha yararlı bilgiler vereceği saptandı

Associatıon of Depression and Trace Elements in Obese Childre

Depression, anxiety disorders, learning disability are common problems requiring pediatric care and found to be associated with obesity. Elevated and reduced levels of trace elements may be indicators of depression. Deficiencies or toxicities of some elements may also cause weight gain leading obesity, which is a health problem increasing worldwide particularly among children and adolescents. In this review, the physical and mental health consequences of pediatric and adolescent obesity will be evaluated from the trace elements point of view. Better understanding of the participation of trace elements in the metabolic pathways related to neurophysiological processes, their interactions and cumulative effects will help to improve health and also the effects of treatment

Trace elements and physical activity in children and adolescents with depression

Abstract: Depression is a common mental health problem among adolescents. Depressive symptoms are also important and may appear even during the preschool period. Physical activity, which may improve some mental health problems, is inversely associated with depression. Due to the presence of some clinical evidence about the relation between the use of antidepressants and suicide, there is a need for supportive agents during antidepressant therapy. Within this context, essential trace elements gain importance for further consideration. Protection of the developing brain from the negative effects of iron deficiency is important because of iron deficiency's association with poor mental development. Reactions between copper and serotonin may contribute to the development of depression because copper may cause alterations in dopamine and norepinephrine levels. Some links between zinc deficiency and depression-like behavior have been noted. The antidepressant-like activity of zinc involves interaction with the serotonergic system. Selenium supplementation significantly improves individuals' mood scores. Low selenium status is associated with depression and anemia, which may lead to poor mental development. The influence of physical activity on trace elements should also be considered. The possible associations between members of neurotransmitter systems and metals as well as physical activity are reviewed here in relation to depression in the youth population. Elevated or reduced levels of metals may be indicators of depression. Intervention toward normalization of the profile of essential trace elements may prevent the development of depression and support the effects of therapy in depressive individuals. Key words: Child, adolescent, trace element, metal, depression, physical activity Çocuklarda ve genç erişkinlerde görülen depresyonda eser elementler ve fiziksel aktivite Özet: Depresyon genç erişkinler arasında yaygın görülen bir akıl sağlığı problemidir. Depresyon belirtileri okul öncesi dönemde bile ortaya çıkabilir. Bazı akıl sağlığı problemleri üzerinde olumlu etkisi gözlenen fiziksel aktivite depresyon ile ters ilişkilidir. Antidepressan kullanımı ve intihar arasındaki ilişki ile ilgili bazı klinik delillere bağlı olarak, antidepressan tedavi sırasında destekleyici ajanlara gereksinim duyulmaktadır. Bu bağlamda, esansiyel eser elementler ileriye yönelik araştırmalar için önem kazanmaktadır. Gelişmekte olan beyinin, yetersiz zekâ gelişimi ile olan ilişkisi nedeniyle demir eksikliğinin olumsuz etkilerinden korunması, demir düzeyinin önemine işaret etmektedir. Bakır, dopamin ve norepinefrin düzeylerinde değişikliklere neden olabildiğinden, bakır ve serotonin arasındaki reaksiyonlar depresyonun gelişmesine katkıda bulunabilir. Çinko eksikliği ile depresyon benzeri davranışlar arasında bazı bağlantılar bildirilmiştir. Çinkonun antidepresan benzeri aktivitesi serotonerjik sistem ile olan etkileşimi içermektedir. Selenyum desteği, bireylerin ruhsal durumlarını önemli ölçüde iyileştirmektedir. Düşük selenyum düzeyi, depresyon ve yetersiz zihinsel gelişmeye yol açabilen anemi ile birliktelik göstermektedir. Fiziksel aktivitenin eser elementler üzerine olan etkisi de göz önüne alınması gereken bir husustur. Bu makalede, fiziksel aktivite ile metaller ve nörotransmitter sistemlere ilişkin parametreler arasındaki olası ilişkiler, çocuk ve gençlerde görülen depresyonla bağlantılı biçimde gözden geçirilmiştir. Artmış ya da azalmış metal düzeyleri depresyon göstergeleri olabilirler. Esansiyel eser element profilinin normalleştirilmesine yönelik girişimler, depresyonun gelişmesini önleyebilir ve depresyonlu bireylerde tedavinin etkisini destekleyebilir. Anahtar sözcükler: Çocuk, genç erişkin, eser element, metal, depresyon, fiziksel aktivit

Morbid Obez ve Metabolik Sendromlu Çocuklarda Yeni Nesil Enflamatuvar Belirteçlerin Değerlendirilmesi

Aim: Technological advancements, unbalanced nutrition, sedentary life style, are important factors in obesity. Obesity-inflammation relationis beingexamined. In this study, the relationships among new generation inflammatory markers in children with normal body mass index (C) as well as obese (OB), morbid obese (MO) children and those with metabolic syndrome (MetS) were investigated.Materials and Methods: A total of 172 children participated in the study.Group 1 comprised children with normal body-mass index (control group) (C). Obese (OB) children were in Group 2, MO children constituted Group 3 and Group 4 included MO children with MetS. The number of cases were 37, 34, 51 and 50 in groups 1, 2, 3 and 4, respectively. Anthropometric measurements were recorded. Serum spexin, adropin, adipolipin, fibroblast growth factor-21 and fetuin-A levels were determined. Statistical analyses were performed.Result: Spexin and adipolin levels were significantly lower in obese groups than C group (p<0.05). Although adropin and FGF-21 levels did not differ significantly between groups, levels were lower in OB, MO, and MetS groups than C group.There were no significant differences among fetuin- A levels of the groups. Correlations between spexin and adipolin were the highest. These cytokines werenegatively correlated with obesity parameters. The correlations between these cytokines were weakened from C group to MetS group.Conclusion: Decreasing spexin and adipolin levels in accordance with increasing obesity degrees and weakening of the correlation between these cytokines in MO group compared to C group may be helpful during the further investigation of obesity.Amaç: Teknolojideki gelişmeler, dengesiz beslenme, sedanter hayat tarzı gibi yaşam değişiklikleri obezitenin gelişmesi için önemli faktörlerdir. Enflamasyon-obezite ilişkisi güncel bir konu olarak halen incelenmektedir. Bu çalışmada obez (OB), morbid obez (MO), metabolik sendromlu morbid obez (MetS) çocuklar ile sağlıklı, normal vücut kitle indeksi (K) olan çocuklarda yeni nesil enflamatuar belirteçler arasındaki ilişkiler araştırılmıştır. Materyal ve Metot: Toplam 172 çocuk çalışma kapsamına alındı. Normal vücut kitle indeksine sahip çocuklar birinci grubu (kontrol grubu) (K) oluşturdu. Grup 2’de OB, Grup 3’te MO, Grup 4’te MetS’lu (MetS) çocuklar yer aldı. Olgu sayıları Grup 1,2, 3 ve 4 için sırasıyla 37, 34, 51 ve 50 olarak belirlendi. Antropometrik ölçümler alındı. Serum speksin, adropin, adipolin, fibroblast büyüme faktörü-21 ve fetuin-A düzeyleri ölçüldü. İstatistiksel analizler gerçekleştirildi. Bulgular: Speksin ve adipolin düzeyleri obez gruplardaK grubuna göre anlamlı düzeyde düşük bulundu (p<0.05). Adropin ve FGF-21değerlerindegruplar arasında anlamlı bir fark bulunmamasına rağmendüzeylerin, K grubuna göre OB, MO and MetS gruplarında azalmış olduğu saptandı. Fetuin-A düzeylerinde gruplar arasında anlamlı bir farklılık bulunamadı.En yüksek korelasyonlar speksin ve adipolin düzeyleri arasında bulundu. Bu sitokinler obezite parametreleri ile negatif bir ilişki içindeydi. Aynı sitokinler arasındaki ilişki K grubundan MetS grubuna doğru zayıflamakta idi. Sonuç: Artan obezite derecelerine paralel olarak speksin ve adipolin seviyelerindeki azalma ve bu iki parametre arasındaki korelasyonun K grubuna göre MO grupta zayıflaması, obezitenin ileri düzeyde araştırılmasında yardımcı olabileceği düşüncesini ortaya koymaktadır

Yağ Kütle ve Kantitatif İnsulin Sensitivite Kontrol İndekslerinden Türetilmiş Yeni Bir İnsulin Sensitivite İndeksi

Aim Obesity has recently become one of the most important health problems throughout the world. This fact led to the controversies on the clinical use of insulin sensitivity indices. Indices previously described or introduced in this study have been evaluated to choose one, which is capable of exhibiting significant distinctions between healthy children and those involved in the classes of childhood obesity. Material and Methods A total of 179 girls; 81 morbidly obese(MO), 42 obese(O), 16 overweight(OW) and 40 normal(N) participated in the study. Groups were constituted based upon age- and sex-specific body mass index percentiles tabulated by World Health Organization. Homeostasis Model Assessment of Insulin Resistance(HOMA-IR), HOMA-IR/BMI, log HOMA-IR, fasting glucose/fasting insulin ratio(FGIR), quantitative insulin sensitivity check index(QUICKI), Raynaud, reciprocal insulin indices and also new indices HOMAIR*BMI, HOMA-IR*fat mass index(FMI), QUICKI*BMI, QUICKI*FMI were calculated. The cut-offs 3.16 and 2.5 for HOMA-IR, 7 and 6 for FGIR, 0.357 and 0.328 for QUICKI were evaluated to estimate insulin resistance. Statistical analyses were performed with Predictive Analytics SoftWare(PASW) Statistics 18. Results and Conclusion QUICKI*FMI was able to make a clear-cut separation between the groups. A new trilogy for cut-offs (HOMA>2.5, FGIR2.5, FGIR<7, QUICKI<0.328) ortaya kondu. QUICKI nin çok yönlü özelliği gözlendi. QUICKI nin, 0.328 cut-off noktası kullanıldığında MO i O den, 0.357 cut-off noktası kullanıldığında ise O i OW den ayırt edebildiği belirlendi. QUICKI*FMI indeksinin, çocukluk çağı obezitesi bağlamında N-OW, OW-O ve O-MO gruplar arasındaki farklılıkların ileri düzeyde (p?0.005) tanımlanmasında eşsiz bir indeks olduğu sonucuna varıldı

Evaluation of Gender Difference in Pediatrıc Trauma Patients Admitted to The Emergency Department

Aim:A significant proportion of pediatric trauma patients admitted to the emergency department are injured by preventable causes. Accidental injuries are the most common causes of deaths in childhood. The purpose of this study was to analyze the demographic features of the parents and the gender difference of the cases in pediatric patients with trauma admitted to the emergency department (ED).Materials and Methods:Over a 1-year period (April 2015 through May 2016), a total of 502 consecutive paediatric patients who presented to our tertiary-care university hospital ED with symptoms of trauma of various causes (falling from a height, injury, burni traffic accident and physical abuse assault) were enrolled in this prospective clinical study.Results:In this study, the boy to girl gender ratio was found to be 1.52 (p = 0.868). The mean ages were 7.74 ± 4.97 in boys and 7.67 ± 5.25 in girls. 17.2% of the boys and 21.1% of the girls were detected fracture on direct radiographs (p=0.306). Upper extremity fractures were encountered more frequently than other fractures. The frequency of falling from a height was the first among all cases of trauma with the rate of 69.3%, 42.4% of which occurred in boys and 26.9% in girls (p=0.559). The rates of upper extremity injuries were 19.9% for boys and 15.7% for girls (p=0.126). The rates of head injuries were 22.5% for boys and 12% for girls (p=0.177). When the type of injury was evaluated, the rate of contusion was 60%, 36.3% of which occurred in boys and 23.7% in girls (p=0.952). When the parents of the pediatric trauma patients were classified according to their educational status, the largest group consisted of primary school graduated parents with rates of 41.4% for mothers (p=0.080) and 37.3% for fathers (p=0.008). 46.0% of the pediatric trauma patients were the first children of their families, 27.3% of which were boys and 18.7% were girls (p=0.657).Conclusion:We emphasized the importance of raising awareness about the issue at the individual and community-based level and the necessity of increasing the protective measures for indoor and outdoor accidents in order to be able to create a safe environment so that the pediatric trauma patients can be reduced in our country and in the world

A New Insulin Sensitivity Index Derived From Fat Mass Index and Quantitative Insulin Sensitivity Check Index

AimObesity has recently become one of the most important health problems throughout the world. This fact led to the controversies on the clinical use of insulin sensitivity indices. Indices previously described or introduced in this study have been evaluated to choose one, which is capable of exhibiting significant distinctions between healthy children and those involved in the classes of childhood obesity.Material and MethodsA total of 179 girls; 81 morbidly obese(MO), 42 obese(O), 16 overweight(OW) and 40 normal(N) participated in the study. Groups were constituted based upon age- and sex-specific body mass index percentiles tabulated by World Health Organization. Homeostasis Model Assessment of Insulin Resistance(HOMA-IR), HOMA-IR/BMI, log HOMA-IR, fasting glucose/fasting insulin ratio(FGIR), quantitative insulin sensitivity check index(QUICKI), Raynaud, reciprocal insulin indices and also new indices HOMA-IR* BMI, HOMA-IR*fat mass index(FMI), QUICKI*BMI, QUICKI*FMI were calculated. The cut-offs 3.16 and 2.5 for HOMA-IR, 7 and 6 for FGIR, 0.357 and 0.328 for QUICKI were evaluated to estimate insulin resistance. Statistical analyses were performed with Predictive Analytics SoftWare(PASW) Statistics 18.Results and ConclusionQUICKI*FMI was able to make a clear-cut separation between the groups. A new trilogy for cut-offs (HOMA>2.5, FGIR<7, QUICKI<0.328); each giving the similar results, has been suggested. Multifaceted character of QUICKI was also introduced. QUICKI was capable of discriminating MO from O when 0.328 cutoff was used, and O from OW when 0.357 cut-off was used. QUICKI*FMI index, a new one, was unique in detecting the advanced level of differences(p≤0.005) between N-OW, OW-O and O-MO groups during childhood obesity

What Is the Important Point Related to Follow-Up Sonographic Evaluation for the Developmental Dysplasia of the Hip?

Developmental dysplasia of the hip (DDH) is an important cause of childhood disability. Subluxation or dislocation can be diagnosed through pediatric physical examination; nevertheless, the ultrasonographic examination is necessary in diagnosing certain borderline cases. It has been evaluated routine sonographic examination of 2,444 hips of 1,222 babies to determine differences in both, developmental dysplasia and types of hips, and evaluated their development on the 3-month follow-up. Evaluating the pathologic alpha angles under 59, there was no statistically significant differences between girls and boys in both right (55.57 +/- 3.73) (56.20 +/- 4.01), (p = 0.480), and left (55.79 +/- 3.96) (57.00 +/- 3.84), (p = 0.160) hips on the 45th day of life. Routine sonographic examinations on the 45th day of life revealed that 51 of (66.2%) 77 type 2a right hips were girls and 26 (33.8%) were boys. The number of the right hips that develop into type 1 was 38 (74.5%) for girls and 26 (100%) for boys on the 90th day of life (p = 0.005). A total of 87 type 2a left hips included 64 girls (73.6%) and 23 boys (26.4%). In the 90th day control, 49 right hip of girls (76.6%) and 21 right hip of boys (91.3%) developed into type 1 (p = 0.126). In the assessment of both left and right hips, girls showed a significantly higher frequency in latency and boys showed significantly higher development in the control sonography. A total of 31 girls (2.5%) and 11 boys (0.9%) accounted for a total of 42 (3.4%) cases who showed bilateral type 2a hips in 1,222 infants. On the 90th day control, 26 girls (83.9%) and all 11 boys (100%) developed into type 1 (p = 0.156). The study emphasizes the importance of the sonographic examination on the 90th day of life. Results of the investigation include the data of sonographic screening of DDH on the 45th day, and also stress the importance of the 90th-day control sonography after a close follow-up with physical examination between 45th and 90th days of life