Vitamin D, Insulin Resistance and Cytokine Levels in Obese Pubertal Children

Insulin resistance (IR) develops in obese children because of low vitamin levels and increased pro-inflammatory cytokine levels. This study aimed to analyze the relation between vitamin D, insulin resistance, tumor necrosis factor-alpha and interleukin 6 (IL-6) levels at admission and after weight loss. This study included 84 obese and 28 healthy pubertal children. Patient group was divided into four: IR positive and negative; weight loss (WL) positive and negative. Baseline and follow-up (6th month) values of serum 25-hydroxyvitamin D and other parameters were evaluated. The prevalence of serum vitamin D deficiency and insufficiency were 3.6% and 21.4% in the control group, 15.2% and 10.9% and 7.9% and 15.8% in the obese insulin positive and negative group; respectively. There was no relationship between vitamin D and IRand IL-6 levels, whereas cytokine levels were lower in obese children. As WL increased, vitamin D level and IR improved. No significant difference was found between vitamin D levels of obese and control subjects. In obese children with weight loss, an insignificant increase was observed in vitamin D, cytokines, quantitative insulin sensitivity check index values and an insignificant decrease was noted in homeostatic model assessment for IR value. Further longitudinal studies with larger patient series with greater WL are warranted

Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

Diyabetli Türk çocuklarında insülin pompası kullanımı izlem sonuçları

Amaç: Çocuklarda kullanımı giderek yaygınlaşmasına rağmen, diyabetli Türk çocuklarında insülin pompası uygulanımma dair yayınlanmış veri yoktur. Bu çalışmanın amacı diyabetli Türk çocuklarında insülin pompası uygulanmanın sonuçlarım araştırmaktır. Gereç ve Yöntemler: Yaş ortalaması 14.7±2.6 yıl, pompa kullanım süresi 3-24 ay olan on diyabetik çocuğun verileri incelenmiş, ve pompa kullanımı öncesi bir senelik sürede elde edilen verilerle karşılaştırılmıştır. Bulgular: İstatistiksel olarak anlamlı olmamakla birlikte, HbAlc düzeyi pompa öncesi döneme kıyasla azalma eğiliminde idi. Vücut kitle indeksi Z skorları benzerdi (Pompa öncesi ve sonrası sırasıyla; 0.45±0.76 ve 0.54±0.53 kg/m2, p>0.05). Ortalama insülin dozu azalmıştı (Pompa öncesi ve sonrası sırasıyla; l.l±0.2 ve 0.9±0.1 U/kg/gün, p0.05). Sonuç: İzlemde değerlendirilen önemli parametrelerde istikrarlı düzelme sağlanmış olması, insülin pompası tedavisinin diyabetli Türk çocuklarında etkili ve güvenilir bir yöntem olduğunu göstermektedir.Purpose: Although its use is increasing in children, there are no data about pump use in Turkish children with diabetes. The aim of this study was to investigate the outcome measures of insulin pump use in diabetic Turkish children. Materials and Methods: Ten children (age; 14.7±2.6 years, pump therapy duration; 3-24 months) were prospectively studied. Main outcome measures were compared with those of the 12 months prior to pump therapy. Results: Although statistically insignificant, HbAlc tended to be lower compared to the pre-pump period. Body mass index Z scores remained similar (0.45±0.76 vs. 0.54±0.53 kg/m2, p>0.05). Insulin doses decreased (l.l±0.2 vs. 0.9±0.1 U/kg/day, p0.05). Conclusion: The consistency of the improvements in main outcome measures and their maintenance over time in our study suggest that pump therapy is safe and effective in diabetic Turkish children

Insulin-like growth factor-I and insulin-like growth factor binding protein-3 levels of children living in an iodine- and selenium-deficient endemic goiter area

Serum insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) levels were investigated in 31 children living in an endemic goiter area and 33 healthy subjects living in an nonendemic area. Serum lGF-I and IGFBP-3 levels of iodine- and selenium deficient children were found to be lower than those of control subjects (p<0.001). There was a positive correlation between the IGF-I with chronological age and body mass index. There was also positive correlation between the lGF-I and IGFBP-3. No significant difference was found between the goitrous and nongoitrous children. These results suggest that IGF-I and IGFBP-3 levels are affected by thyroid dysfunction as a result of iodine and selenium deficiency. However, IGF-I and IGFBP-3 levels are not associated with goiter

Hypothyroidism developing in adolescent girls who lost weight with inappropriate diets

Obezite nedeniyle bilinçsiz diyet uygulayarak hızlı kilo veren ergenlerde pek çok endokrin ve metabolik sorunlar ortaya çıkabilmektedir. Bunların başında tiroid fonksiyon bozuklukları gelmektedir. Burada kilo verebilmek için, çok düşük kalorili, düzensiz bir diyetle 3-4 ay içerisinde 8-12 kilo kaybeden ve hipotiroidi tanısı alan iki ergen kız olgu sunulmuştur.Several endocrine and metabolic abnormalities may develop in adolescent who has lost weight very rapidly with inappropriate diets due to obesity. One of the common seen endocrine disturbances is thyroid dysfunction. In this study we describe two adolescent girls who have lost 8-12 kg. within 3-4 months with very low caloric and uncontrolled diet and diagnosed as hypothyroidism

Serum adiponectin, leptin, resistin and RBP4 levels in obese and metabolic syndrome children with nonalcoholic fatty liver disease

Aim: To investigate the relationship of adiponectin, leptin, resistin and RBP4 levels in obese and metabolic syndrome children with nonalcoholic fatty liver disease (NAFLD). Patients & methods: Group I consisted of 63 obese children with liver steatosis, group II consisted of 12 obese children with elevated serum ALT activity from group I, and group III included 85 obese children without liver steatosis. Results: Leptin levels were higher in the NAFLD children than in the control group. Serum RBP4 levels in obese children with NAFLD were higher than those in obese children without NAFLD and controls. Adiponectin and resistin levels were negatively correlated and RBP4 levels positively correlated with ALT activity and ultrasonographic grading. Conclusion: These data suggest that adiponectin, resistin and RBP4 may have a role in the pathogenesis of NAFLD in obese children. Adiponectin, leptin, resistin and RBP4 may be suitable markers for predicting metabolic syndrome and NAFLD