The current study was designed to examine the relationship between body fat distribution, as evaluated by anthropometry and magnetic resonance imaging (MRI), and circulating insulin, sex hormone and SHBG levels in obese adolescent girls. Twenty-nine obese adolescent girls, aged 12.6-16.9 years with a mean BMI of 30.51+/-1.86 participated in this study. All girls had breast stage B4-5 and pubic hair stage P4-5. Percent obesity and BMI as indices of being overweight were calculated; the waist-to-hip ratio (WHR) and the waist-to-thigh ratio (WTR) were calculated to obtain two anthropometric indices for the pattern of body fat distribution. The areas of visceral (VAT) and subcutaneous adipose tissue (SAT) were evaluated by MRI at the L4-L5 level. Serum concentrations of total T, DHEAS, 17beta-estradiol, progesterone and SHBG were measured. Plasma glucose and insulin concentrations were evaluated during an oral glucose tolerance test. WHR was the only anthropometric parameter that was significantly associated with the area of VAT. Insulin level showed correlation with both WHR and the area of VAT; no correlation was found between insulin levels and WTR. Both WHR and VAT were negatively correlated with serum DHEAS level and positively correlated with T level. There were strong negative correlations between serum SHBG level and the area of VAT and WHR. Inverse correlation was found between serum SHBG level and insulin. Serum 17beta-estradiol and progesterone levels showed no significant correlation with all the patterns of body fat distribution. SAT was not significantly correlated with both anthropometric parameters and any of the sex hormones evaluated. We can draw two main conclusions. Firstly, in massively obese adolescent girls, the WHR seems to be a good indicator for the accumulation of VAT, and abdominal obesity, rather than adiposity per se, appears to be related to biochemical complications. Secondly, increased upper body adiposity and, in particular, the intra-abdominal fat area are associated with increased insulin levels in massively obese adolescent girls. The associated reductions in SHBG and DHEAS levels represent an early general risk factor for the development of metabolic and cardiovascular diseases in this population, as previously described for obese adult women.

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Summary:(BU) and cyclophosphamide (CY) can cure a high percentage of patients with compatible donors. Little is known about the long-term effects of BMT in patients with thalasThe aim of this study was to evaluate the treatment effects with recombinant human growth hormone semia in relation to the growth process as well as endocrine function. (rhGH) in a group of patients after bone marrow transplantation for thalassemia major. At the end of treat-In the present study we have analysed the treatment effects with recombinant human growth hormone (rhGH) ment we divided the subjects into two groups according to the outcome of the therapy: responder and nonin patients after BMT for thalassemia major. responder. Responder group: after 24 months of rhGH administration, growth rate was still significantly higher in respect to start of treatment (P Ͻ 0.0001). Plasma lev- Patients and methods els of IGF-I rose significantly (P Ͻ 0.003). The serum levels of serum asparate aminotransferase (SGOT) andThe study group comprised seven patients (five males, two females) ranging in age from 11.7 to 12.7 years alanine aminotransferase (SGPT) were higher compared to normal values but improved in non-responder (12.06 ± 0.76), affected by thalassemia major and who underwent BMT (mean age at BMT was 7.11 ± 3.31 years) patients. There was no difference in the mean concentration of these parameters before and after treatment in Pescara, Italy. Prior to the referral for BMT all patients had received multiple erythrocyte transfusions. The median (P = NS). Non-responder group: these patients had a worsening of the growth rate during rhGH adminisnumber of tranfusions was 114.71 ± 57.67 (range 13-180). They were administered daily doses of 0.9 IU/kg body tration. There was no increase of the IGF-I levels. Single values of transaminase and ferritin levels were higher weight per week subcutaneously of rhGH (SAIZEN Serono, Rome, Italy) for 24 consecutive months. than in responder patients before and after treatment. There was a significant correlation between IGF-I, Assessment of height, other auxologic parameters and laboratory measures were performed before treatment and SGOT, SGPT and ferritin in all patients before and after therapy. It appears from these data that rhGH at 6 monthly intervals during GH therapy.At the end of treatment we divided the subjects into two administration is worth serious consideration in patients after BMT for thalassemia major presenting impaired groups according to the outcome of the therapy: responder (four boys, one girl) and non-responder (one boy, one girl) growth hormone secretion. This treatment can offer good results only in cases where the normal hepatic synpatients whose height velocity increase was more than 2 cm/year above baseline or less, respectively. thesis of IGF-I is conserved and where liver damage has not reached irreversible conditions, as we have seen inInformed consent for the study was obtained from the patients' parents. the responder group.

There is uncertainty as to whether breast feeding protects against subsequent illnesses; it has been suggested that breast feeding may have some protective effects on the severity of long-term outcome of bronchiolitis and in reducing morbidity. We have assessed the effects of breast feeding in 266 patients and 199 controls, all patients were early wheezers (i.e., under 2 years old). Between these groups we found differences in socioeconomic, environmental, and atopic conditions, but there were no significant differences in the numbers who had been breastfed. However, within the group who had had early wheezing we found that infants who had been breastfed for at least one month subsequently had less severe wheezing. These results suggest that breast feeding may be a protective factor for early wheezing only during the first month of life, and a delaying factor in the following months.