Abstract Objectives There are different approaches to diagnosing of the metabolic syndrome (MetS) in adolescents. We aim to compare the proportions of adolescents with abnormal values of MetS components between the NCEP/ATP criteria and the proposed cut-off values from the local population percentile distribution adjusted to gender. Methods Subjects were 358 high school students (246 girls, 112 boys) aged 14–17 years from three Croatian regions. The serum glucose levels were determined by hexokinase method, serum triglycerides by GPO-PAP method, and serum high-density lipoprotein-cholesterol by automated homogeneous assays on Beckman Coulter AU 680 analyser (Minneapolis, USA). Results Differences were seen between genders by NCEP/ATPIII modified criteria in the proportion of the adolescents with the proposed cut-off values for HDL-C levels, SBP, and DBP with a higher prevalence in boys. The proportion of girls differs between data set percentile criteria, and NCEP/ATP III modified criteria for HDL-C value, serum fasting glucose value and DBP value. The proportion of boys with higher values than suggested differs between proposed NCEP/ATP III modified criteria and percentile criteria for serum fasting glucose values and DBP. Conclusions Our study has shown differences in the proportion of 14–17-year-old adolescents between gender according to modified NCEP/ATPIII criteria for HDL-C, SBP and DBP with a higher prevalence of SBP and DBP related to other individual MetS components for both genders. Gender adjusted cut-off value from own populations avoids possible under- or over-estimation in the distribution of individual MetS components with no difference in the proportion of adolescents between gender.
摘要目的青少年代谢综合征(MetS)的诊断方法多种多样。我们的目的是比较NCEP/ATP标准和根据当地人口百分位数分布调整后的性别建议的临界值之间met成分异常值的青少年比例。方法以克罗地亚3个地区14-17岁的358名高中生为研究对象，其中女生246名，男生112名。采用己糖激酶法测定血清葡萄糖水平，采用GPO-PAP法测定血清甘油三酯水平，采用Beckman Coulter AU 680全自动均质法测定血清高密度脂蛋白胆固醇水平(Minneapolis, USA)。结果根据NCEP/ATPIII修订的标准，在具有建议的HDL-C水平、收缩压和舒张压临界值的青少年中，男孩的患病率较高，性别之间存在差异。在数据集百分位标准和NCEP/ATP III修改的HDL-C值、空腹血糖值和DBP值标准中，女孩的比例存在差异。在NCEP/ATP III修正标准和百分位血清空腹血糖值和DBP标准中，高于建议值的男孩比例存在差异。我们的研究显示，根据修改的NCEP/ATPIII标准，14 - 17岁青少年的HDL-C、收缩压和舒张压的比例存在性别差异，并且与其他个体MetS成分相关的收缩压和舒张压的患病率较高。来自自身人口的性别调整截断值避免了在青少年比例没有性别差异的情况下，对个别MetS组成部分分布可能的低估或高估。
{"title":"Differences in the proportion of Croatian adolescents with abnormal individual metabolic syndrome components adjusted to gender and different criterion for individual metabolic syndrome component","authors":"Olgica Martinis, N. Ruljancic","doi":"10.1515/jpem-2021-0774","DOIUrl":"https://doi.org/10.1515/jpem-2021-0774","url":null,"abstract":"Abstract Objectives There are different approaches to diagnosing of the metabolic syndrome (MetS) in adolescents. We aim to compare the proportions of adolescents with abnormal values of MetS components between the NCEP/ATP criteria and the proposed cut-off values from the local population percentile distribution adjusted to gender. Methods Subjects were 358 high school students (246 girls, 112 boys) aged 14–17 years from three Croatian regions. The serum glucose levels were determined by hexokinase method, serum triglycerides by GPO-PAP method, and serum high-density lipoprotein-cholesterol by automated homogeneous assays on Beckman Coulter AU 680 analyser (Minneapolis, USA). Results Differences were seen between genders by NCEP/ATPIII modified criteria in the proportion of the adolescents with the proposed cut-off values for HDL-C levels, SBP, and DBP with a higher prevalence in boys. The proportion of girls differs between data set percentile criteria, and NCEP/ATP III modified criteria for HDL-C value, serum fasting glucose value and DBP value. The proportion of boys with higher values than suggested differs between proposed NCEP/ATP III modified criteria and percentile criteria for serum fasting glucose values and DBP. Conclusions Our study has shown differences in the proportion of 14–17-year-old adolescents between gender according to modified NCEP/ATPIII criteria for HDL-C, SBP and DBP with a higher prevalence of SBP and DBP related to other individual MetS components for both genders. Gender adjusted cut-off value from own populations avoids possible under- or over-estimation in the distribution of individual MetS components with no difference in the proportion of adolescents between gender.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"59 1","pages":"880 - 889"},"PeriodicalIF":0.0,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75963461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erika L Zevin, A. Peterson, Ann M. Dodge, Xiao Zhang, A. Carrel
Abstract Objectives Childhood obesity and associated comorbidities, including insulin resistance, are increasing in the United States. Our objectives were to (1) determine the prevalence of insulin resistance in children seen in dyslipidemia clinic and (2) evaluate which aspects of the lipid profile correlate with insulin resistance. Methods Children and adolescents seen in a specialized pediatric dyslipidemia clinic without secondary diagnoses known to alter the lipid panel were included. Simultaneous fasting lipid panel, insulin, and glucose levels were available in 572 children (50.5% male). Results Mean patient age was 15.0 ± 3.6 years with the majority being over 10 years of age (92.5%). Mean BMI was 29.8 ± 8.1 kg/m2 and BMI standard deviation score was 1.80 ± 0.9. Mean HOMA-IR was 6.2 ± 5.7 with a range of 0.4–49.3, and interquartile range of 2.7–7.6. Triglyceride level had a positive correlation with HOMA-IR (p<0.001). HDL-C negatively correlated with HOMA-IR even controlling for triglyceride level by multivariate analysis (p=0.001) and HDL-C <30 mg/dL predicted IR with 41.5% PPV. Conclusions In children and adolescents with dyslipidemia, insulin resistance is common and significantly correlates with reduced HDL-C levels. Non-fasting samples are easier to obtain in children and low HDL-C, which is minimally affected on non-fasting samples, could be an easily obtained indicator of IR. Increasing detection of insulin resistance in children with dyslipidemia may provide greater opportunities for lifestyle interventions and possible pharmacotherapy to modify cardiovascular risk.
{"title":"Low HDL-C is a non-fasting marker of insulin resistance in children","authors":"Erika L Zevin, A. Peterson, Ann M. Dodge, Xiao Zhang, A. Carrel","doi":"10.1515/jpem-2021-0751","DOIUrl":"https://doi.org/10.1515/jpem-2021-0751","url":null,"abstract":"Abstract Objectives Childhood obesity and associated comorbidities, including insulin resistance, are increasing in the United States. Our objectives were to (1) determine the prevalence of insulin resistance in children seen in dyslipidemia clinic and (2) evaluate which aspects of the lipid profile correlate with insulin resistance. Methods Children and adolescents seen in a specialized pediatric dyslipidemia clinic without secondary diagnoses known to alter the lipid panel were included. Simultaneous fasting lipid panel, insulin, and glucose levels were available in 572 children (50.5% male). Results Mean patient age was 15.0 ± 3.6 years with the majority being over 10 years of age (92.5%). Mean BMI was 29.8 ± 8.1 kg/m2 and BMI standard deviation score was 1.80 ± 0.9. Mean HOMA-IR was 6.2 ± 5.7 with a range of 0.4–49.3, and interquartile range of 2.7–7.6. Triglyceride level had a positive correlation with HOMA-IR (p<0.001). HDL-C negatively correlated with HOMA-IR even controlling for triglyceride level by multivariate analysis (p=0.001) and HDL-C <30 mg/dL predicted IR with 41.5% PPV. Conclusions In children and adolescents with dyslipidemia, insulin resistance is common and significantly correlates with reduced HDL-C levels. Non-fasting samples are easier to obtain in children and low HDL-C, which is minimally affected on non-fasting samples, could be an easily obtained indicator of IR. Increasing detection of insulin resistance in children with dyslipidemia may provide greater opportunities for lifestyle interventions and possible pharmacotherapy to modify cardiovascular risk.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"7 1","pages":"890 - 894"},"PeriodicalIF":0.0,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81492330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objectives The golden standard test for diagnosing central precocious puberty (CPP) is the gonadotropin releasing hormone stimulation test, which has many limitations. This study aimed to investigate the value of insulin-like growth factor-1 (IGF-1), IGF binding protein-3 (IGFBP-3), and basal luteinizing hormone (LH) levels in diagnosing CPP. Methods Cross-sectional study of the levels of IGF-1, IGFBP-3, and basal LH in girls with a chief complaint of premature breast development. Seventy-nine girls with CPP and 37 girls with premature thelarche (PT) diagnosed at West China Second University Hospital from January 2016 to October 2018 were recruited. All patients underwent physical examination, laboratory tests, uterine and ovarian ultrasound, and bone age tests, only CPP patients underwent pituitary magnetic resonance imaging (MRI). Statistical analysis was performed using the SPSS software 21.0. A receiver operating characteristic curve was used to determine diagnostic value. Results The anthropometric data and hormone indicators between CPP and PT were statistically different (p<0.001), except for peak follicle stimulating hormone (FSH) levels (p=0.181). IGF-1, IGFBP-3, and basal LH levels were significantly higher in the subjects with CPP than in those with PT; IGF-1 and basal LH were positively correlated with peak LH and LH/FSH (peak) (p<0.001). The area under the curve (AUC) of IGF-1, IGFBP-3, and basal LH were 0.880, 0.853, and 0.915, respectively. When combined, the AUC reached the highest value of 0.978. Conclusions IGF-1, IGFBP-3, and baseline LH levels were useful in diagnosing CPP. The combined analysis improved the diagnostic effectiveness.
{"title":"Combined diagnostic value of insulin-like growth factor-1, insulin-like growth factor binding protein-3, and baseline luteinizing hormone levels for central precocious puberty in girls","authors":"Lixue Ouyang, Fan Yang","doi":"10.1515/jpem-2022-0161","DOIUrl":"https://doi.org/10.1515/jpem-2022-0161","url":null,"abstract":"Abstract Objectives The golden standard test for diagnosing central precocious puberty (CPP) is the gonadotropin releasing hormone stimulation test, which has many limitations. This study aimed to investigate the value of insulin-like growth factor-1 (IGF-1), IGF binding protein-3 (IGFBP-3), and basal luteinizing hormone (LH) levels in diagnosing CPP. Methods Cross-sectional study of the levels of IGF-1, IGFBP-3, and basal LH in girls with a chief complaint of premature breast development. Seventy-nine girls with CPP and 37 girls with premature thelarche (PT) diagnosed at West China Second University Hospital from January 2016 to October 2018 were recruited. All patients underwent physical examination, laboratory tests, uterine and ovarian ultrasound, and bone age tests, only CPP patients underwent pituitary magnetic resonance imaging (MRI). Statistical analysis was performed using the SPSS software 21.0. A receiver operating characteristic curve was used to determine diagnostic value. Results The anthropometric data and hormone indicators between CPP and PT were statistically different (p<0.001), except for peak follicle stimulating hormone (FSH) levels (p=0.181). IGF-1, IGFBP-3, and basal LH levels were significantly higher in the subjects with CPP than in those with PT; IGF-1 and basal LH were positively correlated with peak LH and LH/FSH (peak) (p<0.001). The area under the curve (AUC) of IGF-1, IGFBP-3, and basal LH were 0.880, 0.853, and 0.915, respectively. When combined, the AUC reached the highest value of 0.978. Conclusions IGF-1, IGFBP-3, and baseline LH levels were useful in diagnosing CPP. The combined analysis improved the diagnostic effectiveness.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"732 1","pages":"874 - 879"},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85007399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Verónica Gimeno-Hernández Garza, Irene Antoñanzas Torres, Esther Pitarch Roca, María Vázquez Sánchez, M. Ferrer Lozano, A. de Arriba Muñoz
Abstract Objectives Lockdown during the SARS-CoV-2 pandemic generated uncertainty regarding its effects on the control of type 1 diabetes (DM1). Our study aims to evaluate the influence of the pandemic on the control of paediatric patients with DM1. Methods Longitudinal, retrospective, observational study in patients with DM1 attended between 15/10/2019 and 15/03/2020. Data were collected at that visit and at the three subsequent visits. The second was remote in 50% of cases. The variables analysed were: type of insulin therapy, time in range (TIR), time in hypoglycaemia (THypo), time in hyperglycaemia (THyper), coefficient of variation (CV), glycosylated haemoglobin, insulin requirements and anthropometric data. Results 157 patients were recruited. At the post-lockdown visit, the TIR increased and the THyper decreased with respect to the first (p<0.00) and second (p<0.00) visits. Patients treated with subcutaneous infusion showed a higher TIR at the third visit (p=0.03) and lower insulin requirements at the fourth visit (p=0.03) compared to patients treated with multiple doses. Patients with a remote visit presented a higher TIR (p<0.00), a lower THyper (p=0.00) and lower insulin requirements (p=0.01) at the next visit. Patients aged less than 6 years presented a lower glycosylated haemoglobin (p=0.01) and insulin requirements at the third (p=0.03) and fourth (p=0.01) visits, and a lower increase in body mass index (p=0.03) over the year. Conclusions Metabolic control improved at the post-lockdown visit. Patients treated with subcutaneous infusion, those who had a remote visit during strict lockdown and those aged less than 6 years had a better evolution.
{"title":"Influence of the SARS-CoV-2 pandemic on paediatric patients with type 1 diabetes mellitus after one year of follow-up","authors":"Verónica Gimeno-Hernández Garza, Irene Antoñanzas Torres, Esther Pitarch Roca, María Vázquez Sánchez, M. Ferrer Lozano, A. de Arriba Muñoz","doi":"10.1515/jpem-2022-0222","DOIUrl":"https://doi.org/10.1515/jpem-2022-0222","url":null,"abstract":"Abstract Objectives Lockdown during the SARS-CoV-2 pandemic generated uncertainty regarding its effects on the control of type 1 diabetes (DM1). Our study aims to evaluate the influence of the pandemic on the control of paediatric patients with DM1. Methods Longitudinal, retrospective, observational study in patients with DM1 attended between 15/10/2019 and 15/03/2020. Data were collected at that visit and at the three subsequent visits. The second was remote in 50% of cases. The variables analysed were: type of insulin therapy, time in range (TIR), time in hypoglycaemia (THypo), time in hyperglycaemia (THyper), coefficient of variation (CV), glycosylated haemoglobin, insulin requirements and anthropometric data. Results 157 patients were recruited. At the post-lockdown visit, the TIR increased and the THyper decreased with respect to the first (p<0.00) and second (p<0.00) visits. Patients treated with subcutaneous infusion showed a higher TIR at the third visit (p=0.03) and lower insulin requirements at the fourth visit (p=0.03) compared to patients treated with multiple doses. Patients with a remote visit presented a higher TIR (p<0.00), a lower THyper (p=0.00) and lower insulin requirements (p=0.01) at the next visit. Patients aged less than 6 years presented a lower glycosylated haemoglobin (p=0.01) and insulin requirements at the third (p=0.03) and fourth (p=0.01) visits, and a lower increase in body mass index (p=0.03) over the year. Conclusions Metabolic control improved at the post-lockdown visit. Patients treated with subcutaneous infusion, those who had a remote visit during strict lockdown and those aged less than 6 years had a better evolution.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"367 1","pages":"867 - 873"},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74896709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objectives Niemann–Pick disease type A (NPDA, MIM: 257200) is an autosomal recessive sphingolipidosis caused by lysosomal acid sphingomyelinase (ASM) deficiency. A cluster of genes located at chromosome 11p15 have been reported to be imprinted genes, such as TSSC5, TSSC3, and ZNF215 that flanking SMPD1 gene. It was reported by a few recent studies that SMPD1 gene was paternally imprinted and maternally preferentially expressed. Case presentation A five-month-old boy with severe anemia, hepatosplenomegly and bone marrow foam cells was recruited from a complete cousin couple. To determine whether boy suffered from NPDA, ASM activity and SMPD1 gene sequencing were performed on available individuals of this pedigree including the proband, his parents and sister. The ASM activities of proband and parents showed deficiency (17.7 nmol/h/g-protein) and about 50% decreased (83.3 nmol/h/g-protein), respectively, compared with normal controls (204.5 nmol/h/g-protein). SMPD1 gene sequencing in the proband revealed a homozygous mutation c.1420_1421del, which leads to an open reading frameshift and a premature stop codon. The parents and some individuals of this family demonstrated heterozygous mutation at this locus. To investigate whether SMPD1 gene is imprinted as reported previously, the expression of RNA level was studied in the whole family members available. The members with heterozygous mutation for c.1420_1421del showed that both paternal and maternal inherited alleles were expressed. Conclusions This study reported a c.1420_1421del mutation in SMPD1 gene which caused ASM activity decrease and this locus was biallelically expressed in heterozygous subjects implicating SMPD1 is not imprinted in this family.
{"title":"A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree","authors":"Hannah Kang, Min Zhou, C. Xie, Kangmo Lu","doi":"10.1515/jpem-2021-0480","DOIUrl":"https://doi.org/10.1515/jpem-2021-0480","url":null,"abstract":"Abstract Objectives Niemann–Pick disease type A (NPDA, MIM: 257200) is an autosomal recessive sphingolipidosis caused by lysosomal acid sphingomyelinase (ASM) deficiency. A cluster of genes located at chromosome 11p15 have been reported to be imprinted genes, such as TSSC5, TSSC3, and ZNF215 that flanking SMPD1 gene. It was reported by a few recent studies that SMPD1 gene was paternally imprinted and maternally preferentially expressed. Case presentation A five-month-old boy with severe anemia, hepatosplenomegly and bone marrow foam cells was recruited from a complete cousin couple. To determine whether boy suffered from NPDA, ASM activity and SMPD1 gene sequencing were performed on available individuals of this pedigree including the proband, his parents and sister. The ASM activities of proband and parents showed deficiency (17.7 nmol/h/g-protein) and about 50% decreased (83.3 nmol/h/g-protein), respectively, compared with normal controls (204.5 nmol/h/g-protein). SMPD1 gene sequencing in the proband revealed a homozygous mutation c.1420_1421del, which leads to an open reading frameshift and a premature stop codon. The parents and some individuals of this family demonstrated heterozygous mutation at this locus. To investigate whether SMPD1 gene is imprinted as reported previously, the expression of RNA level was studied in the whole family members available. The members with heterozygous mutation for c.1420_1421del showed that both paternal and maternal inherited alleles were expressed. Conclusions This study reported a c.1420_1421del mutation in SMPD1 gene which caused ASM activity decrease and this locus was biallelically expressed in heterozygous subjects implicating SMPD1 is not imprinted in this family.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"106 1","pages":"1113 - 1116"},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80347386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abeer Alassaf, L. Gharaibeh, S. Ibrahim, Amirah Daher, Ayah Irsheid, J. Albaramki, R. Odeh
Abstract Objectives The global spread of coronavirus disease 2019 (COVID-19), had a great impact on patients worldwide, including those with chronic diseases. We aim to study the effect of COVID-19 pandemic on presentation patterns of patients with type 1 diabetes (T1D) in Jordan, as an example a developing country with limited resources. Methods Medical charts were reviewed for patients presented with new-onset T1D to Jordan University hospital during the first year of pandemic and the preceding year. Categorical data were compared using Pearson Chi-Square and Fisher’s exact test. Continuous data were compared using the Independent Sample t-Test. Results A total of 137 children were diagnosed with T1D during the study period, with 60.6% of those children were diagnosed in the pre-pandemic year compared to 39.4% during the first year of pandemic, p-value=0.013. Percentage of patients diagnosed with DKA as first presentation of T1D during the pre-pandemic year was 34.9% compared to 51.9% during the pandemic year, p-value=0.049. Significant differences in family monthly income (p-value=0.006) and paternal education level (p-value=0.036) were found between children with DKA and those without DKA in the pre-pandemic year, but they were not significant during the pandemic year. Conclusions The unprecedented COVID-19 pandemic had affected presentation pattern of newly diagnosed T1D patients, manifested by lower number of children diagnosed with T1D and higher percentage of DKA as first presentation compared to the preceding year. Health care services should be at utmost preparedness for possible future waves and other pandemics.
{"title":"Effect of COVID-19 pandemic on presentation and referral patterns of newly diagnosed children with type 1 diabetes in a developing country","authors":"Abeer Alassaf, L. Gharaibeh, S. Ibrahim, Amirah Daher, Ayah Irsheid, J. Albaramki, R. Odeh","doi":"10.1515/jpem-2022-0136","DOIUrl":"https://doi.org/10.1515/jpem-2022-0136","url":null,"abstract":"Abstract Objectives The global spread of coronavirus disease 2019 (COVID-19), had a great impact on patients worldwide, including those with chronic diseases. We aim to study the effect of COVID-19 pandemic on presentation patterns of patients with type 1 diabetes (T1D) in Jordan, as an example a developing country with limited resources. Methods Medical charts were reviewed for patients presented with new-onset T1D to Jordan University hospital during the first year of pandemic and the preceding year. Categorical data were compared using Pearson Chi-Square and Fisher’s exact test. Continuous data were compared using the Independent Sample t-Test. Results A total of 137 children were diagnosed with T1D during the study period, with 60.6% of those children were diagnosed in the pre-pandemic year compared to 39.4% during the first year of pandemic, p-value=0.013. Percentage of patients diagnosed with DKA as first presentation of T1D during the pre-pandemic year was 34.9% compared to 51.9% during the pandemic year, p-value=0.049. Significant differences in family monthly income (p-value=0.006) and paternal education level (p-value=0.036) were found between children with DKA and those without DKA in the pre-pandemic year, but they were not significant during the pandemic year. Conclusions The unprecedented COVID-19 pandemic had affected presentation pattern of newly diagnosed T1D patients, manifested by lower number of children diagnosed with T1D and higher percentage of DKA as first presentation compared to the preceding year. Health care services should be at utmost preparedness for possible future waves and other pandemics.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"13 1","pages":"859 - 866"},"PeriodicalIF":0.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89048450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaofan Jiang, T. Li, R. Xie, Huiya Mei, Renjuan Sun, Yuxiu Xi, Xiaoyu Chen, Ying Cui, Jinling Zhao, Yueying Liu
Abstract Objectives The goal of this study was to determine the quality of these disinfectants’ effects on thyroid function and neurological scores in premature newborns aged 28 to 36 gestational weeks (GW). Methods This cohort study was conducted from October 2020 to September 2021 among 28–36 GW preterm infants at the neonatal care unit of Jiangnan University Hospital. We divided this 12 month period into two consecutive 6 month periods. Composite iodine disinfectants and alcohol are used for skin and umbilical cord disinfection of preterm infants, respectively. Urinary iodine concentration (UIC), thyroid hormone levels, and neonatal behavioral and neurological assessment (NBNA) scores were determined in both groups. Results A total of 126 patients were included in the study, 65 in the iodine exposed group and 61 in the alcohol group. The second UIC and the incidence of serum T4≤5 μg/dL and TSH≥10 mIU/L in the iodine exposed group were significantly higher than those in the alcohol group (p<0.05). The first NBNA score was lower in the iodine exposed group than in the alcohol group (p<0.05). However, whether it has clinical significance remains to be explored. There was a linear relationship between the two NBNA scores (iodine exposure group, R2=0.344; alcohol group, R2=0.227). No sepsis or other adverse outcomes occurred in the two groups of preterm infants after disinfection with different disinfectants. Conclusions Iodine-containing disinfectants seem to have the potential to cause an increased rate of thyroid dysfunction and a decreased neurological score and should be evaluated in further studies.
{"title":"The effects of topical iodine containing antiseptics on thyroidal status and early neurodevelopment of preterm infants","authors":"Xiaofan Jiang, T. Li, R. Xie, Huiya Mei, Renjuan Sun, Yuxiu Xi, Xiaoyu Chen, Ying Cui, Jinling Zhao, Yueying Liu","doi":"10.1515/jpem-2022-0023","DOIUrl":"https://doi.org/10.1515/jpem-2022-0023","url":null,"abstract":"Abstract Objectives The goal of this study was to determine the quality of these disinfectants’ effects on thyroid function and neurological scores in premature newborns aged 28 to 36 gestational weeks (GW). Methods This cohort study was conducted from October 2020 to September 2021 among 28–36 GW preterm infants at the neonatal care unit of Jiangnan University Hospital. We divided this 12 month period into two consecutive 6 month periods. Composite iodine disinfectants and alcohol are used for skin and umbilical cord disinfection of preterm infants, respectively. Urinary iodine concentration (UIC), thyroid hormone levels, and neonatal behavioral and neurological assessment (NBNA) scores were determined in both groups. Results A total of 126 patients were included in the study, 65 in the iodine exposed group and 61 in the alcohol group. The second UIC and the incidence of serum T4≤5 μg/dL and TSH≥10 mIU/L in the iodine exposed group were significantly higher than those in the alcohol group (p<0.05). The first NBNA score was lower in the iodine exposed group than in the alcohol group (p<0.05). However, whether it has clinical significance remains to be explored. There was a linear relationship between the two NBNA scores (iodine exposure group, R2=0.344; alcohol group, R2=0.227). No sepsis or other adverse outcomes occurred in the two groups of preterm infants after disinfection with different disinfectants. Conclusions Iodine-containing disinfectants seem to have the potential to cause an increased rate of thyroid dysfunction and a decreased neurological score and should be evaluated in further studies.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"44 1","pages":"851 - 858"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73758966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaclyn Khil, J. Darbinian, Lynn Guo, Louise C. Greenspan, N. Ramalingam, J. Lo
Abstract Objectives Polycystic Ovary Syndrome (PCOS) is a common female endocrine disorder presenting as early as adolescence. Recent data suggest that Asians may be at increased risk. This study examines PCOS prevalence by race/ethnicity in a large, diverse population of adolescent females. Methods This retrospective study included 244,642 females (ages 13–17) with well-child visits during 2012–2018 in a Northern California healthcare system. Race/ethnicity and Asian ethnicity were classified using self-reported data. Body mass index was classified as healthy, overweight, and moderate/severe obesity. PCOS was determined by clinical diagnosis within one year of the visit. Results The overall prevalence of PCOS was 0.7% and increased substantially with weight. Among those with obesity, PCOS prevalence was 4.2, 2.9, 2.4, 2.1% in Asian/Pacific Islander (PI), Hispanic/Latina, Non-Hispanic White, Black adolescents and 7.8, 6.7, 5.7, 3.4% in South Asian, Chinese, Filipina, Native Hawaiian/PI adolescents, respectively. Compared to White adolescents, Asian/PIs had two-fold higher risk of PCOS, and Hispanic/Latinas had 1.3-fold higher risk. Compared to Chinese adolescents, South Asians had 1.7-fold higher risk, while Native Hawaiian/PIs had half the risk. Conclusions The increased burden of diagnosed PCOS in Asian/PI and Hispanic/Latina adolescents, especially those with obesity, calls for further examination and clinical surveillance of at-risk populations.
{"title":"Ethnic diversity and burden of polycystic ovary syndrome among US adolescent females","authors":"Jaclyn Khil, J. Darbinian, Lynn Guo, Louise C. Greenspan, N. Ramalingam, J. Lo","doi":"10.1515/jpem-2022-0160","DOIUrl":"https://doi.org/10.1515/jpem-2022-0160","url":null,"abstract":"Abstract Objectives Polycystic Ovary Syndrome (PCOS) is a common female endocrine disorder presenting as early as adolescence. Recent data suggest that Asians may be at increased risk. This study examines PCOS prevalence by race/ethnicity in a large, diverse population of adolescent females. Methods This retrospective study included 244,642 females (ages 13–17) with well-child visits during 2012–2018 in a Northern California healthcare system. Race/ethnicity and Asian ethnicity were classified using self-reported data. Body mass index was classified as healthy, overweight, and moderate/severe obesity. PCOS was determined by clinical diagnosis within one year of the visit. Results The overall prevalence of PCOS was 0.7% and increased substantially with weight. Among those with obesity, PCOS prevalence was 4.2, 2.9, 2.4, 2.1% in Asian/Pacific Islander (PI), Hispanic/Latina, Non-Hispanic White, Black adolescents and 7.8, 6.7, 5.7, 3.4% in South Asian, Chinese, Filipina, Native Hawaiian/PI adolescents, respectively. Compared to White adolescents, Asian/PIs had two-fold higher risk of PCOS, and Hispanic/Latinas had 1.3-fold higher risk. Compared to Chinese adolescents, South Asians had 1.7-fold higher risk, while Native Hawaiian/PIs had half the risk. Conclusions The increased burden of diagnosed PCOS in Asian/PI and Hispanic/Latina adolescents, especially those with obesity, calls for further examination and clinical surveillance of at-risk populations.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"32 1","pages":"821 - 825"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73749848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Babiker, Bothainah Alaqeel, A. Al-Eyadhy, Nawaf A Selayem, Sharifah D. A. Alissa, Areej Alsofyani, E. Masuadi, Fahad Al Juraibah, S. Elwatidy, M. Maghnie
Abstract Objectives Endocrinopathy can occur as a postoperative sequel in children treated for supratentorial tumors (STTs). We assessed prediction of a residual hypothalamic/pituitary insufficiency (HPI) in these patients and factors associated with prolonged length of hospital stay (LOS). Methods This is a retrospective cohort study of children who had surgery for STTs in two tertiary centers in Saudi Arabia (2009–2019). We assessed PICU postoperative management and risk of HPI. Data were analyzed using SPSS V24.0 and a logistic regression model for a prediction of a prolonged LOS. Results Data included 55 children (1–18 years, mean 9.5 ± 4.9 years) who required STT surgeries, 32 (54%) females. Craniopharyngioma (27.3%) was the commonest STTs and 20% of patients had initial symptoms of HPI. PICU management included the use of different types of intravenous fluids (IVFs) and medications such as steroids and desmopressin (DDAVP). An early postoperative DI was reported in 21.8% (n=12/55). Residual HPI included 24 (43.6%) presumed cortisol deficient and 18 (32.7%) central DI patients. Risk factors for postoperative HPI were female gender, age <6 years, headache and preoperative pituitary symptoms. LOS (Median=25.5 ± 12.2 days) was significantly prolonged in patients who required two or more doses of DDAVP [B=13; 95% CI= (1.7–24.3) days] and reduced in patients who had suspected preoperative HPI [B=−19.6; 95% CI= (−31.1, −8.2) days]. Conclusions Prediction of postoperative HPI in pediatric STTs enhances an early initiation of treatment in PICU and reduces LOS. A meticulous use of IVF and medications supervised by a multidisciplinary team is essential for a favorable outcome.
{"title":"Postoperative intensive care management and residual endocrinopathy of pediatric supratentorial brain tumors: a retrospective cohort study","authors":"A. Babiker, Bothainah Alaqeel, A. Al-Eyadhy, Nawaf A Selayem, Sharifah D. A. Alissa, Areej Alsofyani, E. Masuadi, Fahad Al Juraibah, S. Elwatidy, M. Maghnie","doi":"10.1515/jpem-2021-0779","DOIUrl":"https://doi.org/10.1515/jpem-2021-0779","url":null,"abstract":"Abstract Objectives Endocrinopathy can occur as a postoperative sequel in children treated for supratentorial tumors (STTs). We assessed prediction of a residual hypothalamic/pituitary insufficiency (HPI) in these patients and factors associated with prolonged length of hospital stay (LOS). Methods This is a retrospective cohort study of children who had surgery for STTs in two tertiary centers in Saudi Arabia (2009–2019). We assessed PICU postoperative management and risk of HPI. Data were analyzed using SPSS V24.0 and a logistic regression model for a prediction of a prolonged LOS. Results Data included 55 children (1–18 years, mean 9.5 ± 4.9 years) who required STT surgeries, 32 (54%) females. Craniopharyngioma (27.3%) was the commonest STTs and 20% of patients had initial symptoms of HPI. PICU management included the use of different types of intravenous fluids (IVFs) and medications such as steroids and desmopressin (DDAVP). An early postoperative DI was reported in 21.8% (n=12/55). Residual HPI included 24 (43.6%) presumed cortisol deficient and 18 (32.7%) central DI patients. Risk factors for postoperative HPI were female gender, age <6 years, headache and preoperative pituitary symptoms. LOS (Median=25.5 ± 12.2 days) was significantly prolonged in patients who required two or more doses of DDAVP [B=13; 95% CI= (1.7–24.3) days] and reduced in patients who had suspected preoperative HPI [B=−19.6; 95% CI= (−31.1, −8.2) days]. Conclusions Prediction of postoperative HPI in pediatric STTs enhances an early initiation of treatment in PICU and reduces LOS. A meticulous use of IVF and medications supervised by a multidisciplinary team is essential for a favorable outcome.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"101 1","pages":"795 - 802"},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72829583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We would like to share ideas on the publication “Increased anxiety symptoms in pediatric type 1 diabetes (T1D) during the acute phase of COVID-19 lockdown [1]”. This study provides a picture of mental well-being in a heterogeneous community of patients with T1D in the acute phase of a crisis, and highlights the need for fast, accurate medical information and allocation of medical services for the juvenile T1D population, according to Wade et al. [1]. COVID-19 pandemic and lockdown, we agree, can have an impact on patients. The current study is a telephone survey with potential reliability issues. In most circumstances, the survey respondent is also the child’s primary caretaker. As a result, the observed anxiety does not match the perspective of T1D patients. Furthermore, the study’s control groupmay not be a good control group. The average age of the study (T1D) and control groups differs significantly (13.8 years vs. 5.3 years). There could be a bias, and a too young control group could have a different level of worry than the T1D group, which is often a teenager. Finally, in a pediatric T1D situation, we must account for the impact of concurrent medical conditions. In a prior study, a pediatric patient with an obesity condition was found to be more prone to anxiety [2].
{"title":"Anxiety, pediatric type 1 diabetes and COVID-19 lockdown","authors":"Sookaromdee Pathum, W. Viroj","doi":"10.1515/jpem-2022-0169","DOIUrl":"https://doi.org/10.1515/jpem-2022-0169","url":null,"abstract":"We would like to share ideas on the publication “Increased anxiety symptoms in pediatric type 1 diabetes (T1D) during the acute phase of COVID-19 lockdown [1]”. This study provides a picture of mental well-being in a heterogeneous community of patients with T1D in the acute phase of a crisis, and highlights the need for fast, accurate medical information and allocation of medical services for the juvenile T1D population, according to Wade et al. [1]. COVID-19 pandemic and lockdown, we agree, can have an impact on patients. The current study is a telephone survey with potential reliability issues. In most circumstances, the survey respondent is also the child’s primary caretaker. As a result, the observed anxiety does not match the perspective of T1D patients. Furthermore, the study’s control groupmay not be a good control group. The average age of the study (T1D) and control groups differs significantly (13.8 years vs. 5.3 years). There could be a bias, and a too young control group could have a different level of worry than the T1D group, which is often a teenager. Finally, in a pediatric T1D situation, we must account for the impact of concurrent medical conditions. In a prior study, a pediatric patient with an obesity condition was found to be more prone to anxiety [2].","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"101 1","pages":"819 - 819"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79147962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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