部分型成長ホルモン分泌不全を伴う乳幼児肥満の原因としてのβアドレナリン受容体遺伝子多型(東京女子医科大学東医療センター小児科開局40周年記念論文集)

成人領域では,肥満に影響を及ぼす様々な遺伝子多型が近年発見され,βアドレナリン受容体もその1つである.今回,東医療センター小児科に成長ホルモン治療のため通院している男児27人,女子19人を対象として,1～6歳までの身体所見(身長,体重)縦断的データをβ2,3アドレナリン両遺伝子多型群間で比較検討を行った.日本人に多いとされるβ3アドレナリン受容体遺伝子コドン64の変異群では,非変異群と比較して6歳時までの肥満度(%)が+17.7対+1.3と有意に大きく推移していた.β2コドン16では同様の遺伝子変異による差を認めなかった.就学前という低年齢時より肥満度の差を呈していることから,β3アドレナリン受容体遺伝子多型は本邦における小児肥満の原因の1つであることが示唆された.Over the last years, several single nucleotide polymorphisms influencing early-onset obesity have been characterized. As candidate genes, recent studies have focused on the adrenergic receptor system. A descriptive study using the medical charts of 46 children (19 girls and 27 boys) were of short stature and treated by growth hormone (GH). Anthropometric data of the children were recorded longitudinally from 1 to 6 years of age prior to the commencement of GH treatment. The mean percent overweight increased linearly during the 5-year study period, from -5.3% to 17.7% in the group of children with the mutation of the β3-adrenergic receptor codon 64 polymorphism, and -5.0% to 1.3% in those without this mutation. In contrast, the differences among the subtypes of the β2-adrenergic receptor gene codon 16 polymorphism did not attain statistical significance at any time point during this study. Trp64Arg polymorphism of the β3-adrenergic receptor gene appears to be a genetic risk factor for obesity in Japanese preschool children

日本人肥満小児における骨成熟の促進 : 肥満度との関連についての検討(東京女子医科大学東医療センター小児科開局40周年記念論文集)

当科外来を受診した207人の肥満小児(男子130人,女子77人,3～16歳,肥満度22.0～157.7%)の骨年齢を日本人標準化Tanner-Whitehouse 2 (TW2)法を用いて評価した.20-Bone法,RUS法による骨成熟促進度は低年齢群では男女ともに肥満度と正の相関関係にあったが,高年齢群では女子でのみ正の相関関係がみられた.またCarpal法では低年齢群でも相関関係はみられなかった.暦年齢と身長SDスコアによる検討では低年齢群では標準体型の児にくらべて高身長であったが,高年齢群ではその傾向はなかった.肥満小児における骨年齢の促進現象の機序は不明であるが,肥満度との相関が強いことから,体脂肪量の影響,すなわち脂肪細胞の分泌するホルモンなどの関与が示唆され今後の検討が期待される.The prevalence of obesity in children has increased strikingly over the past two decades, presumably due to life style changes in Japan. We evaluated bone ages in obese children using the Tanner-Whitehouse 2 (TW2) bone age standard for Japanese children and analyzed the relation of bone maturation to percent overweight. A group of 207 obese children (130 boys and 77 girls, ranging in age from 3 to 16 years) was studied. Percent overweight ranged from 22.0-157.7% in boys and 23.7-105.4% in girls. Bone ages of both sexes were demonstrated to be advanced relative to chronological age and to correspond to height ages in young children (boys<12.3 years old, girls<10.5 years old). An advanced rate of radius, ulna and short (RUS), but not carpal (CARP), bone age was significantly correlated with percent overweight in both sexes (r=0.345 in boys, r=0.594 in girls) in the young group but only in girls (r=0.364) in the older group. The promotion of RUS bone maturation in obese Japanese children was demonstrated using the recently established TW2-Japanese method, and correlated significantly with percent overweight. The volume of body fat or factors secreted by adipose tissues are suggested to be associated with promoting RUS bone maturation in obese children

日本人肥満小児における骨成熟の促進 : 肥満度との関連についての検討(東京女子医科大学東医療センター小児科開局40周年記念論文集)

当科外来を受診した207人の肥満小児(男子130人,女子77人,3～16歳,肥満度22.0～157.7%)の骨年齢を日本人標準化Tanner-Whitehouse 2 (TW2)法を用いて評価した.20-Bone法,RUS法による骨成熟促進度は低年齢群では男女ともに肥満度と正の相関関係にあったが,高年齢群では女子でのみ正の相関関係がみられた.またCarpal法では低年齢群でも相関関係はみられなかった.暦年齢と身長SDスコアによる検討では低年齢群では標準体型の児にくらべて高身長であったが,高年齢群ではその傾向はなかった.肥満小児における骨年齢の促進現象の機序は不明であるが,肥満度との相関が強いことから,体脂肪量の影響,すなわち脂肪細胞の分泌するホルモンなどの関与が示唆され今後の検討が期待される.The prevalence of obesity in children has increased strikingly over the past two decades, presumably due to life style changes in Japan. We evaluated bone ages in obese children using the Tanner-Whitehouse 2 (TW2) bone age standard for Japanese children and analyzed the relation of bone maturation to percent overweight. A group of 207 obese children (130 boys and 77 girls, ranging in age from 3 to 16 years) was studied. Percent overweight ranged from 22.0-157.7% in boys and 23.7-105.4% in girls. Bone ages of both sexes were demonstrated to be advanced relative to chronological age and to correspond to height ages in young children (boys<12.3 years old, girls<10.5 years old). An advanced rate of radius, ulna and short (RUS), but not carpal (CARP), bone age was significantly correlated with percent overweight in both sexes (r=0.345 in boys, r=0.594 in girls) in the young group but only in girls (r=0.364) in the older group. The promotion of RUS bone maturation in obese Japanese children was demonstrated using the recently established TW2-Japanese method, and correlated significantly with percent overweight. The volume of body fat or factors secreted by adipose tissues are suggested to be associated with promoting RUS bone maturation in obese children.東京女子医科大学東医療センター小児科開局40周年記念論文