Effect of Body Weight on Bone Age and Hormonal Parameters in Children With Premature Adrenarche

Abstract

beats/minute; P ϭ .05). The nondippers also presented greater end-systolic diameter (28.7 vs 25.9 mm; P ϭ .001) and left-ventricular end-diastolic diameter (47.8 vs 45.1 mm; P ϭ .040) and greater LVMI (90.2 vs 78.3 g/m 2 ; P ϭ .044) compared with the dippers. During stepwise multiple regression, the most important factors affecting LVMI were mean HR (day) (b ϭ Ϫ0.40; P ϭ .001), high-frequency variable of heart rate variability (b ϭ 0.38; P ϭ .016), and hemoglobin A1c: (b ϭ 0.67; P ϭ .001). CONCLUSIONS: A group of normotensive diabetic adolescents with abnormal nocturnal BP reduction and impaired heart rate variation also had impaired leftventricular function. Our findings suggest that an altered diurnal BP profile, as a result of autonomic dysfunction, may contribute to the development of left-ventricular hypertrophy in patients with type 1 diabetes mellitus. ADIPONECTIN AND PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR ␥ EXPRESSION IN SUBCUTANEOUS AND OMENTAL ADIPOSE TISSUE IN CHILDREN Submitted by Xiaonan LiXiaonan Li, Susanne Lindquist, Gertrud Angsten, Torbjorn Myrnas, Jun Yi, Ronghua Chen, Stenlund Hans, Tommy Olsson, Olle Hernell INTRODUCTION:Adiponectin is an adipocyte-specific protein with insulin-sensitizing properties. Peroxisome proliferator-activated receptor ␥ (PPAR␥) may be involved in its gene transcription. OBJECTIVE: The aim of this study was to compare the expression levels of the genes that encode adiponectin and PPAR␥ in subcutaneous and omental adipose tissue in children in relation to age and anthropometric variables. METHODS: Paired biopsies (from subcutaneous and omental adipose tissue) were obtained from 53 children (age: 0.2-14.0 years; BMI: 12.5-25.8 kg/m 2 ). Messenger RNA (mRNA) levels of adiponectin and PPAR␥ were measured by using reverse-transcription and quantitative real-time polymerase chain reaction. RESULTS: Adiponectin mRNA levels in adipose tissue were positively associated with PPAR␥ mRNA levels in children (subcutaneous adipose: r ϭ 0.73, P Ͻ .001; omental adipose: r ϭ 0.78, P Ͻ .001). In overweight children, the median adiponectin mRNA level was lower in omental adipose tissue (odds ratio: 0.51 [95% confidence interval: 0.1-2.17]) compared with subcutaneous adipose tissue (odds ratio: 1.29 [95% confidence interval: 0.16 -5.08]) (P ϭ .032) but not in normal-weight children (P ϭ .54), and the difference remained significant after adjustment for age (P ϭ .045). CONCLUSIONS:The close association between adiponectin and PPAR␥ expression supports the hypothesis that PPAR␥ is involved in adiponectin gene regulation. The fact that adiponectin expression was decreased in omental adipose tissue relative to subcutaneous adipose tissue in overweight children suggests that a risk of insulin resistance may be present in childhood, which allows such resistance to develop after a relatively short duration of overweight. EFFECT OF BODY WEIGHT ON BONE AGE AND HORMONAL PARAMETERS IN CHILDREN WITH PREMATURE ADRENARCHE Submitted by Asteroula PapathanasiouAsteroula Papathanasiou, Garyfallia Lekk...

An Approach to the Evaluation and Management of the Obese Child With Early Puberty

“…Regarding the mechanism for BA advancement in obesity, dehydroepiandrosterone sulfate (DHEAS) may play a role as higher DHEAS levels are often found in obese children. Increased adrenal androgen production, with subsequent aromatization to estrogens, may be a key driver of bone maturation and as such, a strong predictor of BA advancement [ 60 , 61 , 108 , 109 ]. Therefore, some have recommended measuring DHEAS as an additional part of assessment for accelerated growth and BA advancement in obese individuals with early puberty [ 110 ].…”

Παιδική Παχυσαρκία

“…Σύμφωνα με άλλα ερευνητικά δεδομένα για τις επιπτώσεις της παχυσαρκίας στο παιδικό μυοσκελετικό σύστημα, παρατηρείται επιτάχυνση της οστικής/σκελετικής ωρίμανσης τόσο σε παχύσαρκα παιδιά, όσο και σε παιδιά με πρώιμη αδρεναρχή[180]. Ειδικότερα, διερευνώντας την επίδραση του σωματικού βάρους στην οστική ηλικία σε παιδιά με πρώιμη αδρεναρχή, διαπιστώθηκε μεγαλύτερη συχνότητα παχυσαρκίας και προχωρημένης οστικής ηλικίας, αλλά και ισχυρή συσχέτιση μεταξύ οστικής ηλικίας και βαθμού παχυσαρκίας[181]. Τα παραπάνω ευρήματα συνηγορούν υπέρ της διαμεσολάβησης ορμονικών παραγόντων, που ενισχύουν τον αντίκτυπο του υπέρμετρου σωματικού βάρους στην προαγωγή της οστικής ηλικίας σε άτομα με παχυσαρκία /και ή πρώιμη αδρεναρχή[182].Σε μία σχετική έρευνα στην οποία συμμετείχαν 20 παχύσαρκα παιδιά προεφηβικής ηλικίας και 23 λίγο μεγαλύτερης ηλικίας με φυσιολογικό ΒΣ διερευνήθηκαν οι τιμές της BMD (oστικής πυκνότητας) και ΒUA (εξασθένησης ευρέος φάσματος υπερήχων) με τη μέθοδο απορροφησιομετρίας διπλής δέσμης ακτινών Χ (DEXA).…”