EVALUAREA COMPLICAŢIILOR CARDIO-METABOLICE ASOCIATE OBEZITĂŢII: O METODĂ ANTROPOMETRICĂ SIMPLĂ UTILIZATĂ ÎNTR-O PROBLEMĂ COMPLICATĂ

Introducere. Măsurarea indicilor somato-metrici reprezintă o metodă clinică simplă, ce poate fi utilizată pentru evaluarea complicaţiilor cardio-metabolice asociate obezităţii. Obiective. Identifi carea complicaţiilor cardio-metabolice asociate obezităţii şi evaluarea relevanţei utilizării IMC sau a raportului circumferinţă talie-înălţime pentru diagnosticul precoce al acestora, într-un grup de copii şi adolescenţi obezi. Material şi metode. Studiul a inclus 174 de copii diagnosticaţi cu obezitate primară pe o perioadă de 3 ani. Varia bilele analizate au fost: indicii antropometrici (inclusiv IMC, raportul circumferinţă talie-înălţime) şi rezultatele investigaţiilor biochimice. Rezultate. 4,28% dintre copii prezentau suprapondere, 31,43% obezitate şi 64,29% obezitate extremă. Principalele complicaţii cardio-metabolice diagnosticate au fost: insulinorezistenţa (47,76%), hiperinsulinismul, alterarea metabolismului lipidic şi hipertensiunea arterială. Toţi copiii au avut un raport circumferinţă talieînălţime ≥ 0,5. Pentru compararea celor doi indici antropometrici s-a folosit testul ANOVA unifactorial şi analiza post-hoc; nu au existat diferenţe statistic semnifi cative între loturile analizate. Concluzii. Obezitatea defi nită prin valoarea IMC şi raportul circumferinţă talie-înălţime ≥ 0,5 se asociază, în majoritatea cazurilor, cu complicaţii cardio-metabolice. În practica medicală atât IMC, cât şi WHtR ar trebui utilizaţi ca şi metode de evaluare dar, raportul circumferinţă talie-înălţime prezintă câteva avantaje importante

THE EVALUATION OF OBESITY-RELATED CARDIOMETABOLIC DISEASES: A SIMPLE ANTHROPOMETRIC TOOL FOR A COMPLICATED MATTER

Introduction. Anthropometric measurements are simple clinical tools that can be used for the evaluation of obesity-related cardiometabolic complications. Objective. To identify obesity-related cardiometabolic outcomes and to compare the relevance of BMI or WHtR for early diagnosis in a group of obese children and adolescents. Material and methods. The study included 174 children diagnosed with simple obesity during a three year period. Anthropometric measurements (including BMI and WHtR) and biochemical variables were analyzed. Results. 4.28% of children were overweight, 31.43% were obese and 64.29% had extreme obesity. The main cardiometabolic complication was insulin resistance (47.76%) followed by hyperinsulinism, alteration of the lipid metabolism and hypertension. All children had a WHtR ≥ 0.5. One Way ANOVA with post-hoc t-test analysis was used for the comparative evaluation of the BMI and WHtR; there were no statistic signifi cant differences between groups. Conclusion. Obesity defi ned by BMI and a WHtR ≥ 0.5 is in the majority of cases associated with adverse cardiometabolic outcomes. Both anthropometric indexes should be used as evaluation tools in medical practice, but WHtR has some important advantages

Oral Glucose Tolerance Test in Patients with Cystic Fibrosis Compared to the Overweight and Obese: A Different Approach in Understanding the Results

(1) Background: In cystic fibrosis (CF), the oral glucose tolerance test (OGTT) is recommended from 10 years old annually to screen and diagnose cystic fibrosis-related diabetes (CFRD). Alternative OGTT characteristics (glucose curve shape, time to glucose peak, one-hour glucose value, and three-hour glucose value with the new shape curve) were studied in other populations considered at high risk for diabetes; (2) Methods: The study analyses classical and alternative OGGT characteristics from 44 children (22 CF, 22 obese without CF), mean age: 12.9 ± 2.2 years evaluated in a single-center from Romania. (3) Results: In 59.1% of children with CF, the predominant OGTT pattern was: abnormal glucose metabolism or CFRD, with a monophasic curve shape, a late peak glucose level, and 1 h glucose ≥ 155 mg/dL, showing a very different pattern compared with sex and age-matched obese children. Statistical estimation agreement between the late glucose peak (K = 0.60; p = 0.005), the 1 h glucose ≥ 155 mg/dL during OGTT (K = 0.69, p = 0.001), and the classical method of interpretation was found. (4) Conclusions: Late peak glucose and 1 h glucose level ≥ 155 mg/dL during OGTT can be used for diagnosing the early glucose metabolism alteration in children with CF

Oral Glucose Tolerance Test in Patients with Cystic Fibrosis Compared to the Overweight and Obese: A Different Approach in Understanding the Results

(1) Background: In cystic fibrosis (CF), the oral glucose tolerance test (OGTT) is recommended from 10 years old annually to screen and diagnose cystic fibrosis-related diabetes (CFRD). Alternative OGTT characteristics (glucose curve shape, time to glucose peak, one-hour glucose value, and three-hour glucose value with the new shape curve) were studied in other populations considered at high risk for diabetes; (2) Methods: The study analyses classical and alternative OGGT characteristics from 44 children (22 CF, 22 obese without CF), mean age: 12.9 ± 2.2 years evaluated in a single-center from Romania. (3) Results: In 59.1% of children with CF, the predominant OGTT pattern was: abnormal glucose metabolism or CFRD, with a monophasic curve shape, a late peak glucose level, and 1 h glucose ≥ 155 mg/dL, showing a very different pattern compared with sex and age-matched obese children. Statistical estimation agreement between the late glucose peak (K = 0.60; p = 0.005), the 1 h glucose ≥ 155 mg/dL during OGTT (K = 0.69, p = 0.001), and the classical method of interpretation was found. (4) Conclusions: Late peak glucose and 1 h glucose level ≥ 155 mg/dL during OGTT can be used for diagnosing the early glucose metabolism alteration in children with CF

Clinical Factors Associated with COVID-19 Severity in Chronic Hospitalized Infants and Toddlers: Data from a Center in the West Part of Romania

Background: The risk factors for developing a severe form of COVID-19 in young children are poorly understood. Methods: A single-center retrospective study was conducted to quantify and analyze the clinical risk profile of children admitted to the Pediatric Clinic for Nutritional Recovery. Results: Overall, 51.5% (n = 17) of children were infected with SARS-CoV-2, all symptomatic, and five of them (29.4%) developed a severe form. A positive clinical pulmonary exam was only associated with the severe outcome (OR: 2.00; 95% CI, 0.33–5.66; p = 0.02). Other factors such as age under 3 months, prematurity, birth weight, malnutrition or positive history of congenital cardiac, neurodevelopmental, or genetic diseases, fever, temperature, cough, and digestive symptoms were not found to be significant risk factors. Conclusions: Clinical guidelines based on risk stratification for SARS-CoV-2 infection in children are needed in order to manage, monitor and establish priority access for some groups to high medical care

DEFICIT STATURAL ASOCIAT PROLACTINOMULUI

Glanda hipofi ză este situată la baza creierului, într-o formaţiune anatomică osoasă numită şaua turcească (sella turcica). Are un rol extrem de important în reglarea funcţiilor neuro-endocrine datorită hormonilor secretaţi. Prolactinomul reprezintă o tumoră benignă a glandei hipofi ze (adenom), ce produce în exces un hormon numit prolactina. Autorii prezintă cazul unui adolescent în vârstă de 16 ani, evaluat în ambulator pentru defi cit staturo-ponderal, ocazie cu care s-au decelat valori crescute ale prolactinei serice. Ulterior, pacientul se internează în Clinica II Pediatrie pentru investigaţii suplimentare şi precizare de diagnostic

Genetic Predisposition to Primary Lactose Intolerance Does Not Influence Dairy Intake and Health-Related Quality of Life in Romanian Children: A Hospital-Based Cross-Sectional Study

Background: Primary lactose intolerance (PLI) is characterized by the inability to digest lactose. Homozygotes for the lactase gene polymorphisms (CC or GG) are considered to be genetically predisposed to PLI. Still, symptoms may only be present later in life. The evidence supporting a link between PLI, dairy intake, and quality of life (QoL) is limited in children. Aim: This study investigates the link between LCT polymorphisms and suggestive symptoms and the influence of the genetic predisposition to PLI on dairy intake and QoL in Romanian children. Materials and methods: We recruited consecutive children evaluated in our ambulatory clinic. We asked all participants to complete a visual-analog symptoms scale, a dairy intake, and a QoL questionnaire. We used strip genotyping to identify genetic predisposition to PLI. Results: 51.7% of children had a CC genotype, and 34.5% also had a GG genotype. Most children reported no or mild symptoms. Dairy intake and QoL were similar across study groups. Conclusions: Our study shows that genetic predisposition does not necessarily assume the presence of specific symptoms. Genetic predisposition to PLI did not lead to dairy avoidance, nor did it negatively influence our children’s QoL