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Introduction: Obesity is a gradually more important multifactorial disease in both children and adults. Obese children and adolescents are at higher risk of becoming obese in adulthood, which is associated with an increased risk of mortality and morbidity. There is subclinical systemic inflammation in obesity. The study aimed to evaluate the hematological parameters as an indicator of inflammation in obese adolescents and to show the relationship of monocyte/HDL-cholesterol ratio, having a lipid component, with other inflammatory hematological parameters. Materials and methods: We retrospectively reviewed the medical files of 60 patients, 30 obese and 30 healthy controls, aged between 11 and 16 years, who applied to the pediatric outpatient clinic. Laboratory tests, hematological parameters, gender, age, and BMI were compared between the groups. Correlations between monocyte/HDL-cholesterol ratio and other laboratory parameters in the obese group were examined. Results: BMI, Alanine aminotransferase (ALT), C-reactive protein (CRP), triglyceride, insulin, and HOMA-IR levels of the obese adolescent group were statistically significantly higher than the control group (p<0.05). There was no statistically significant difference between the obese and control groups in terms of inflammatory hematological ratios (NLR, PLR, MLR, and monocyte/HDL-cholesterol ratio) (p>0.05). There was no statistically significant relationship between monocyte/HDL-cholesterol and other inflammatory hematological rates (p>0.05). There was a positive, moderate (48.6%), and statistically significant relationship between monocyte/HDL-cholesterol and MLR (p<0.05). Conclusions: In our study, the NLR, PLR, MLR, and monocyte/HDL-cholesterol values of the obese adolescent group were similar to the control group. There was correlation between monocyte/HDL-cholesterol and monocyte/lymphocyte values. There was no correlation between other rates. Our data do not support the utility of inflammatory hematological rates as a biomarker in adolescent obesity. However, we believe that our study can shed light on other studies to be conducted.

Background: Glypican-4 is an adipose tissue-originated cytokine which enhances insulin signaling through direct interaction with the insulin receptors. Objectives: The aim of this study was to analyze the relationship between obesity and serum glipican-4 levels in adolescents. Methods:Our study was carried out on 80 volunteer adolescents, 49 were obese patients and 31 were healthy normal weight control cases. The adolescents with a body mass index (BMI) of 95% percentile and over were defined as obese in terms of age and sex. The Enzyme-Linked Immuno Sorbent Assay kit was utilized for the assessment of Glypican-4 in serum. Laboratory assays (glypican-4, glucose, urea, creatinine, AST, ALT, total cholesterol, triglyceride, HbA1c, insulin, HOMA-IR), age, sex and BMI were compared amidst the groups. Correlations between glypican-4 levels and laboratory factors were analyzed in the obese adolescent group. Results:The average age of the research participants was 13.2 ± 1.8 years. The mean BMI was 27.1 ± 5.1 kg/m 2 . Of the 49 obese adolescents, 41 were insulin resistant, and 8 did not have insulin resistance. The levels of glypican-4, BMI, AST, ALT, HbA1c, triglyceride, HOMA-IR and insulin were notably higher in the obese group than the control group (P < 0.05). In obese group, no statistically remarkable relationship was found between glypican-4 levels and other parameters (P > 0.05). Conclusions:We found high serum glypican-4 levels in obese adolescents. We suggest that glypican-4 levels may be increased in order to reduce insulin resistance in obese adolescents.

Background: Galectin-3 is a member of the family of soluble beta-galactoside binding lectins, which is involved in inflammation, cell differentiation, adhesion, proliferation, angiogenesis and cancer cell invasion. Increased galectin-3 levels in obese patients have been shown in previous studies. In our study; we aimed to investigate the galectin-3 levels in obese adolescents for the first time in the literature. Materials and methods: A total of 85 adolescent patients who were admitted to our pediatrics outpatient clinic between December 19th of 2018 and January 31st of 2019 were included in our study. Among those patients 52 were obese and 33 were normal-weighted. Adolescents having body mass index (BMI) 95% percentile and above according to their age and sex were defined as obese. Enzyme-Linked Immunosorbent Assay kit was used for the measurement of galectin-3 in serum. Laboratory tests (Galectin-3, HbA1c, glucose, insulin, HOMA-IR), sex, age and BMI were statistically compared between groups. Results: We found no statistically significant difference in terms of gender distribution rates, age, glucose or galectin-3 levels among obese adolescent and healthy control groups (p> 0.05). The BMI, HbA1c, HOMA-IR and insulin levels of the obese adolescent group were found to be significantly higher than the healthy control group (p <0.05). We found no statistically significant correlation between galectin-3 levels and other parameters in obese adolescent group (p> 0.05). Conclusion: In our study, we did not find any relationship between serum galectin-3 levels and obesity in adolescents. We believe that the effects of galectin-3 levels on obesity in adolescents should be more clearly explained by further investigations, which also measures other biomarkers of the mechanism of action. Keywords: Galectin-3, obesity, adolescent List of abbreviations: BMI: Body-Mass Index, CV: Variation coefficient, ELISA: Enzyme linked immunoassay, HOMA-IR: Homeostatic model of assessment-insulin resistance, IL: Interleukin, r: Correlation coefficient, SD: Standard deviation.

Nonalcoholic fatty liver disease (NAFLD) is the most commonly diagnosed liver disease in the recent years, with a prevalence of 15-20% among normal population. Liver steatosis is also a complication of obesity and affects 22-52% of obese children. In this aspect, it is an important public health problem. Increases in the amount of fatty acids entering the liver, increase in fatty acid synthesis and disorders in its secretion are included in its pathogenesis. The relationship between zinc, which is the second most abundant trace element found in the body after iron and necessary for many enzymes to function properly, and fatty liver disease has been shown in previous studies. The aim of this review is to discuss the relationship between zinc and liver steatosis in the light of current studies and contribute to the literature.

Objective: Zinc is an essential trace element for the body that is involved in various significant body functions such as protein synthesis, DNA synthesis, and cellular growth. It is found in almost every cell and plays an important role in the immune system, affecting both innate and acquired immunity. Patients with beta-thalassemia major are at risk of zinc deficiency. Beta-thalassemia major is an inherited disease caused by a reduction or complete absence of beta-globin chains and the affected patients need repeated blood transfusions to survive. Accordingly, it causes oxidative stress and tissue damage, alteration of antioxidant enzymes, and changes in other essential trace element levels due to iron overload. Zinc levels in beta-thalassemia major patients were reported to be significantly reduced in most of the studies. Serum zinc levels of the patients with beta-thalassemia major should be monitored regularly and zinc supplementation should be provided to these patients.

Background: Omentin-1 is an adipocytokine secreted from visceral adipose tissue that is thought to increase insulin sensitivity. Non-alcoholic fatty liver disease (NAFLD) is a comparatively extensive problem in obese adolescents. Decreased omentin-1 levels have been reported in obese patients, but the relationship between NAFLD and omentin-1 is contradictory. Objectives: We aimed to evaluate the omentin-1 levels in the sera of obese adolescents with and without NAFLD and compare them with each other. Methods: In this study, a total of 88 adolescents (56 obese and 32 normal-weight) were enrolled. Abdominal ultrasonography (US) identified 28 obese adolescents with grade 2-3 hepatosteatosis constituting the NAFLD group and 28 without hepatosteatosis on US constituting the non-NAFLD group. The control group included 32 age- and gender-matched cases without hepatosteatosis and with normal percentile body mass index (BMI). Serum omentin-1 levels were evaluated and compared. Results: The mean age of the research group was 12.72 ± 1.91 years. Unsurprisingly, BMI, glycated hemoglobin (HbA1c), liver transaminases (AST, ALT), total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin rates were noticeably elevated in obese adolescents compared to controls (P < 0.05). However, omentin-1 and high-density lipoprotein cholesterol (HDL) levels were remarkably lower in the obese group (P < 0.05). No significant difference was found between the NAFLD and non-NAFLD groups regarding omentin-1, HbA1c, glucose, urea, creatinine, AST, C-reactive protein (CRP), total cholesterol, triglyceride, HDL, LDL, thyroid stimulating hormone, 25-hydroxyvitamin D3, HOMA-IR, and insulin. The BMI and ALT grades of the non-NAFLD group were notably lower than the NAFLD group (P < 0.05). While there was no significant difference between omentin-1 and other parameters in obese adolescents without NAFLD (P > 0.05), we found a significant difference between omentin-1 and BMI, AST, ALT, HOMA-IR, and insulin values in obese adolescents with NAFLD (P < 0.05). Conclusions: Omentin-1 levels were decreased in obese adolescents regardless of the presence of NAFLD. However, in obese patients with NAFLD, there was a significant difference between omentin-1 and several markers of obesity and insulin resistance.

The concepts of games and toys have a very important role in children’s lives. It contributes to the development of cognitive, motor, psychosocial, emotional, and linguistic skills. It also plays a key role in raising self-confident, creative, and happy children. Therefore, attention should be paid to the concepts of games and toys, which are so important for the child to be a part of society as a healthy individual at every stage of his development. On the other hand, providing playgrounds where children can play comfortably and safely are essential in reducing the risk of accidents related to toys. All health-care components, especially pediatricians and family physicians, should take an active role in ensuring that these play processes, which are the most beautiful parts of childhood, are healthy and safe.