Sexual Dimorphism of the Fat Mass Index and the Fat-Free Mass Index in Healthy Adolescents

Body mass index (BMI) does not allow to discriminate the composition of the different body compartments. This study points to the formulation of reference values of fat mass index (FMI) and fat-free mass index (FFMI) in healthy adolescents by means of anthropometric techniques, and the subsequent availability in clinical practice as reference charts. The following is a cross-sectional study in a group of 1040 healthy Caucasian adolescents (470 boys and 570 girls), aged 10.1 to 14.9 years. Weight, height and skinfold thickness were registered, and BMI, percentage of total body fat, FMI and FFMI, and FMI and FFMI percentiles were calculated. Boys show a significant increase in FFMI and a decline in body fat and FMI. By contrast, girls show an increase in body fat, FMI and FFMI. Except for the 10 years, FMI was higher (p < 0.05) in girls in all ages and FFMI was higher (p < 0.05) in boys in all ages. There were no significant differences in the values of BMI between sexes in all ages. The availability of reference values for FMI and FFMI in daily clinical practice would be helpful in the diagnosis and assessment of changes in body composition during the treatment of childhood obesity

Amino Acid Plasma Concentrations and Urinary Excretion in Young Diabetics

The aim of this study is to analyze amino acid plasma profile in a group of young diabetics and to evaluate its application as markers of metabolic control of the disease, as well as to analyze the urinary excretion of amino acids in these patients. A clinical assessment and metabolic study (amino acid serum concentrations and urinary excretion of amino acids) was accomplished in a group of 49 children diagnosed with diabetes, and a group of 48 healthy children (control group). The plasma levels of total amino acids as well as branchedchain, glucogenic and ketogenic amino acids were significantly higher (p < 0.05) in the diabetic group with respect to the control group. Total as well as branched-chain, glucogenic and ketogenic amino acids urinary levels were significantly lower (p < 0.05) in the diabetic group compared to the control group. The study of the amino acid plasma in the young diabetic reflect disturbances in protein/amino acid metabolism and, consequently, in metabolic control of the disease. The study of amino acid urinary excretion might have interest not only in the context of diabetic nephropathy, but also in the revealing of partial aspects of amino acid metabolism and, probably, in the metabolic control of the disease

Prevalence of Metabolic Syndrome in Obese Pediatric Population: Relation to Serum Leptin Concentrations

Childhood obesity represents the most relevant nutritional disorder in our environment. This study examines the prevalence of metabolic syndrome in an obese pediatric population and its relation to serum leptin concentrations. A cross-sectional clinical and metabolic study was accomplished in a group of 106 obese children (47 males and 59 females). Patients were classified into prepubertal group (Tanner stage I) and pubertal group (Tanner stages II–V). Prevalence of insulin resistance [homeostasis model assessment (HOMA)], hypertriglyceridemia, low high-density lipoprotein (HDL) and arterial hypertension (HTA) was 38.7, 45.3, 28.3 and 33.8%, respectively. Metabolic syndrome prevalence (30.2%) was significantly higher in the pubertal group (38%) than the prepubertal group (23.2%). There was a positive correlation between leptin and body mass index (BMI) (r = 0.529), leptin and HOMA indexes (r = 0.562) and leptin and triglycerides (r = 0.314). In addition, there was a positive correlation between HOMA indexes and triglycerides (r = 0.596). Clinical and metabolic disorders associated with obesity and related to the so-called metabolic syndrome are already present in pediatric population. Leptin could play an important role in the etiopathogenesis of the metabolic syndrome

Vitamin D Deficiency in Children

In addition to its contribution to bone metabolism, vitamin D seems to fulfill a broad spectrum of biological functions which justifies the interest in monitoring its body content. The aim of this study is to analyze the prevalence of hypovitaminosis D and associated factors in schoolchildren and adolescents living in a region of northern Spain. A cross-sectional clinical and analytical study (calcium, phosphorus, calcidiol, and parathyroid hormone) was accomplished in a group of 602 Caucasian individuals (aged 3.1–15.4 years). Gender, age, body mass index, residence, and season of the year were recorded, and their association with vitamin D deficiency was analyzed by multiple regression. Vitamin D status was defined according to the US Endocrine Society criteria. The prevalence of hypovitaminosis D was 60.4% (insufficiency: 44.6%; deficiency: 15.8%). The female sex, adolescence, season of blood sample collection (autumn, winter, and spring), an urban residence, and severe obesity showed an association with an increased risk of hypovitaminosis D

Neuroretinitis Caused by Bartonella henselae

Cat-scratch disease-related neuroretinitis is a relatively unusual pathology, with suspicious clinical epidemiological and serological diagnosis. We present a case of an adolescent suffering from unilateral neuroretinitis associated with Bartonella henselae infection characterized by abrupt loss of vision, optic disc swelling, and macular star exudates with optimal response to antibiotic treatment

Assessment of vitamin D status and parathyroid hormone during a combined intervention for the treatment of childhood obesity

Background: Obesity is associated with vitamin D deficiency. The aim of this work is to analyze the changes in vitamin D status and PTH levels in a group of children with obesity receiving combined intervention program in order to get BMI status reduction. Methods: Longitudinal study in 119 children with obesity, aged 9.1–13.9 years, included in a 1-year combined dietarybehavioral-physical activity intervention. Anthropometric measurements (weight, height, BMI and fat mass index) were registered every 3 months and blood testing (calcium, phosphorous, 25(OH)D and PTH) were collected at the beginning and after 12 months of follow-up. A control group was recruited (300 healthy children, aged 8.1–13.9 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D. Results: Vitamin D deficiency was significantly higher in obesity group (31.1 vs. 14%). There was negative correlation between 25(OH)D and fat mass index (r = −0.361, p = 0.001). Patients with BMI reduction throughout combined intervention were 52 (43.7%). There was a significant increase in the prevalence of hypovitaminosis D in patients without BMI reduction at the end of follow-up, but in those patients with BMI reduction there was no changes of vitamin D status. Conclusions: Obesity increases the prevalence of suboptimal vitamin D status, and a BMI status reduction in children with obesity may be required to at least stabilize vitamin D status

Hypovitaminosis D and cardiometabolic risk factors in adolescents with severe obesity

Background/Objectives. Obesity is associated with cardiometabolic risk factors and with Vitamin D deficiency. The aim of this study was to examine the relationship between 25(OH)D concentrations and cardiometabolic risk factors in adolescents with severe obesity. Subjects/Methods. A cross-sectional clinical assessment (body mass index, fat mass index, fat-free mass index, waist-to-height ratio, and blood pressure) and metabolic study (triglycerides, total cholesterol, HDL-C, LDL-C, glucose, insulin, HOMA-IR, leptin, calcium, phosphorous, calcidiol, and PTH) were carried out in 236 adolescents diagnosed with severe obesity (BMI z-score > 3.0, 99th percentile), aged 10.2–15.8 years. The criteria of the US Endocrine Society were used for the definition of Vitamin D status. Results. Subjects with Vitamin D deficiency had significantly elevated values (p < 0.05) for BMI z-score, waist circumference, waist z-score, body fat percentage, fat mass index, systolic and diastolic blood pressure, total cholesterol, triglycerides, LDL-C, insulin, HOMA-IR, leptin, and PTH than subjects with normal Vitamin D status. There was a significant negative correlation (p < 0.05) of serum 25(OH)D levels with body fat percentage, FMI, systolic BP, total cholesterol, triglyceride, LDL-C, glucose, insulin, HOMA-IR, leptin, and PTH. Conclusions. Low Vitamin D levels in adolescents with severe obesity were significantly associated with some cardiometabolic risk factors, including body mass index, waist circumference, fat mass index, high blood pressure, impaired lipid profile, and insulin resistance

Characteristics of Catch-Up Growth in Very Low Birth Weight Infants (&lt;1500 g)

Features of catch-up growth are not well established in very low birth weight infants (VLBW). The aim of this study is to analyze the catch-up growth in height and some factors associated in a cohort of VLBW (<1500 g) from birth to age 14 years. Retrospective registration of weight and height at birth and ages 0.5, 1, 2, 3, 4, 6, 8, 10, 12 and 14 years in a cohort of 170 VLBW have been recorded Anthropometric variables were compared with those from a control group. Sixty-nine (40.6%) were small for gestational age (SGA subgroup) and 101 (59.4%) were appropriate for gestational age (AGA subgroup). Thirty-seven (21.8%) were extremely low birth weight (ELBW), and 32 (18.8%) extremely preterm (EPT). At age 2, 4 and 10 years, 49.4%, 78.9% and 87.1% VLBW, respectively, did reach normal height. Between 4 and 10 years of age, only 8.2% of VLBW reached normal height. At 10 years of age, 7% of VLBW (1000–1500 g) and 35% of ELBW (<1500 g) showed short stature (p = 0.001). Almost the entire sample of VLBW with normal height at age 2, 4 and 10 have reached an adequate catch-up growth in weight in the previous evaluations. ELBW, SGA and EPT were found to be independent predictors for inadequate catch-up growth in height at 2, 4, and 10 years of age. The growth pattern of children born preterm has particular features: they have a lower rate and/or slowness in the catch-up growth in height with respect to that described in full-term small-for-gestational-age infants. Catch-up in weight appears to be a decisive factor for catch-up in height, and, on this basis, we recommend a rigorous nutritional follow-up in these individuals. If these measures do not help improve catch-up in height, they may be eligible for the establishment of rhGH therapy

Effects of the application of a prolonged combined intervention on body composition in adolescents with obesity

Background: The aim of this study is to describe the effects of a prolonged dietary-behavioral-physical activity intervention (24 months) on body composition in a group of adolescents with obesity. Methods: Longitudinal study in 196 individuals with obesity (86 boys and 110 girls) aged 10.1–14.9 years that completed a prolonged combined intervention (24 months). Values for weight, height, skinfold thickness, waist circumference, BMI, body fat, fat mass index (FMI) and fat-free mass index (FFMI) were registered or calculated. A good response to treatment was reported when a BMI z-score reduction of greater than or equal to 0.5 units of the initial value occurred after 24 month of follow up. Results: A good response after 24 months of follow-up reached 58.2% (n = 114). In boys with obesity and BMI status improvement, weight z-score, BMI z-score, body fat, and FMI significantly decreased (p < 0.05). In girls with obesity and BMI status improvement, weight z-score, BMI z-score, waist circumference, waist z-score, body fat and FMI significantly decreased (p < 0.05). In both sexes the height and FFMI increased significantly (p < 0.05). The multiple logistic regression analysis showed that girls and younger age were associated with BMI status improvement; concurrently, the place of residence (urban or rural) and degree of obesity were not associated with BMI status improvement. Conclusion: The application of long-term combined strategies in the treatment of childhood obesity seems to be effective. As BMI decreases, a reduction in fat mass is also detected, with evident sexual dimorphism, in the absence of changes in fat-free mass and, consequently, in longitudinal growing