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Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic – the “Video KiCK” program 由于COVID-19大流行,儿科门诊肥胖教学计划的远程医疗转型成功-“视频踢腿”计划
Pub Date : 2022-05-16 DOI: 10.1515/jpem-2022-0104
Felix Reschke, L. Galuschka, Sarah Landsberg, C. Weiner, C. Guntermann, E. Sadeghian, K. Lange, T. Danne
Abstract Objectives To investigate if digital approaches can ameliorate the known consequences of social-distancing restrictions in the context of the global COVID-19 pandemic for adolescent participants originally registered for a face-to-face outpatient weight regulation program and whether video-based multiprofessional outpatient obesity therapy is successful for a group of adolescents with preexisting obesity. Methods The certified KiCK outpatient training program for children and adolescents with overweight and obesity was remodeled as a consequence of the lockdown traditional face-to-face program to a completely digital and video-based format on short notice. The virtual approach was compared with the results of the conventional program regarding metabolic parameters, body mass index standard deviation score (BMI SDS), well-being, and physical fitness. Results Sixty-nine of 77 enrolled participants for KiCK (age 8 to 17 years, BMI z score >2.0) were able and willing to participate virtually. After the first lockdown significant improvements of BMI SDS (mean 0.18; p=0.02), homeostasis model assessment (HOMA) index (mean 1.4; p=0.016), triglycerides (mean 0.18 mmol/dL; p=0.021), 6 minute-walk-test (mean 97.0 m; p=0.030, and well-being according to the World Health Organization 5 (WHO-5) questionnaire (mean 2.5; p=0.002) were found after the virtual intervention, which was comparable to the results observed previously in matched pairs data from the program during the pre-COVID period. After the end of the second lockdown weight SDS, BMI SDS, HOMA INDEX, and cholesterol were also measured reduced compared to baseline parameters measured before program initiation. Walking distance in the 6 MWT and improvement in general well-being in the WHO-5 questionnaire also persisted. Conclusions These results indicate good acceptance and efficacy of the video-intervention for youth with overweight and obesity during the lockdown, supporting the use of virtual modules in future programs after the pandemic.
摘要:目的研究数字方法是否可以改善全球COVID-19大流行背景下社交距离限制对最初注册参加面对面门诊体重调节计划的青少年参与者的已知后果,以及基于视频的多专业门诊肥胖治疗是否成功用于一组既往存在肥胖的青少年。方法将针对超重和肥胖儿童和青少年的经认证的KiCK门诊培训项目进行改造,将传统的面对面培训项目锁定为完全数字化和基于视频的短时间通知格式。将虚拟方法与传统程序在代谢参数、体重指数标准偏差评分(BMI SDS)、幸福感和身体健康方面的结果进行比较。结果77名参加KiCK的参与者(年龄8 - 17岁,BMI z评分>2.0)中有69人能够并愿意虚拟参与。第一次封城后BMI SDS显著改善(平均0.18;p=0.02),稳态模型评估(HOMA)指数(平均1.4;p=0.016),甘油三酯(平均0.18 mmol/dL;P =0.021), 6分钟步行试验(平均97.0 m;p=0.030,根据世界卫生组织5 (WHO-5)问卷幸福感(平均2.5;p=0.002),这与之前在covid - 19前期间该计划的配对数据中观察到的结果相当。在第二次封锁结束后,体重SDS、BMI SDS、HOMA指数和胆固醇也被测量,与项目开始前测量的基线参数相比有所降低。6 MWT中的步行距离和WHO-5问卷中总体幸福感的改善也持续存在。结论上述结果表明,视频干预在封城期间对超重和肥胖青少年具有良好的接受性和有效性,为疫情后在未来项目中使用虚拟模块提供了支持。
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引用次数: 5
Global perspective on pediatric growth hormone registries: a systematic review 儿童生长激素登记的全球视角:一项系统综述
Pub Date : 2022-05-16 DOI: 10.1515/jpem-2022-0045
Parisa Eslami, F. Sayarifard, R. Safdari, L. Shahmoradi, Z. Karbasi
Abstract Background Registries are considered valuable data sources for identification of pediatric conditions treated with growth hormone (GH), and their follow-up. Currently, there is no systematic literature review on the scope and characteristics of pediatric GH registries. Therefore, the purpose of this systematic review is to identify worldwide registries reported on pediatric GH treatment and to provide a summary of their main characteristics. Content Pediatric GH registries were identified through a systematic literature review. The search was performed on all related literature published up to January 30th, 2021. Basic information on pediatric GH registries, their type and scope, purpose, sources of data, target conditions, reported outcomes, and important variables were analyzed and presented. Summary Twenty two articles, reporting on 20 pediatric GH registries, were included in this review. Industrial funding was the most common funding source. The main target conditions included in the pediatric GH registries were: growth hormone deficiency, Turner syndrome, Prader Willi syndrome, small for gestational age, idiopathic short stature, and chronic renal insufficiency. The main objectives in establishing and running pediatric GH registries were assessing the safety and effectiveness of the treatment, describing the epidemiological aspects of target growth conditions and populations, serving public health surveillance, predicting and measuring treatment outcomes, exploring new and useful aspects of GH treatment, and improving the quality of patient care. Outlook This systematic review provides a global perspective on pediatric GH registries which can be used as a basis for the design and development of new GH registry systems at both national and international levels.
摘要背景:对于使用生长激素(GH)治疗的儿童疾病及其随访,登记被认为是有价值的数据来源。目前,还没有关于儿科生长激素登记的范围和特点的系统文献综述。因此,本系统综述的目的是确定全球范围内关于儿科GH治疗的登记报告,并总结其主要特征。通过系统的文献回顾确定儿科GH登记处。检索截止到2021年1月30日发表的所有相关文献。对儿科GH登记的基本信息、类型和范围、目的、数据来源、目标条件、报告结果和重要变量进行了分析和介绍。本综述纳入了22篇文章,报告了20个儿科GH登记处。工业资金是最常见的资金来源。儿童生长激素登记的主要目标条件包括:生长激素缺乏,特纳综合征,Prader Willi综合征,小于胎龄,特发性身材矮小,慢性肾功能不全。建立和运行儿科生长激素登记的主要目标是评估治疗的安全性和有效性,描述目标生长条件和人口的流行病学方面,服务于公共卫生监测,预测和衡量治疗结果,探索生长激素治疗的新的和有用的方面,以及提高患者护理的质量。本系统综述提供了儿童生长激素登记的全球视角,可作为在国家和国际层面设计和开发新的生长激素登记系统的基础。
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引用次数: 0
Glycemic control among children with type 1 diabetes mellitus and its determinants in a resource-limited setting 资源有限条件下1型糖尿病儿童的血糖控制及其决定因素
Pub Date : 2022-05-12 DOI: 10.1515/jpem-2022-0144
Bereket Fantahun, T. W. Leulseged
Abstract Objectives Glycemic control is an important parameter that can predict long-term complications of diabetes mellitus. It can be affected by many factors. Hence, identifying those factors for improving disease outcomes is essential. The purpose of this study was to assess glycemic control in children who were treated with a conventional insulin regimen and to identify its associated factors. Methods A retrospective cohort study was conducted among children with type one diabetes mellitus (T1DM) who had follow-up from November 2015 to November 2020 at the pediatric endocrinology clinic of St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Glycemic control was assessed by measuring glycosylated hemoglobin (HbA1C) and children who had HbA1C within three to six months of the data collection were recruited. Results A total of 106 children with TIDM who were on conventional insulin therapy were included in this study. Their median age at diagnosis was nine years, 47.2% were females, and 57.5% were from urban areas. The average HbA1c of the children was 9.7%. The majority (85.2%) of the children had poor glycemic control (>7.5%). Younger age, longer disease duration, and urban residence were found to be significant predictors of good glycemic control. Conclusions A significant majority of children with T1DM had poor glycemic control. This calls for the need to create access to intensive diabetes care by health authorities and stakeholders to prevent the long-term complications of T1DM.
目的血糖控制是预测糖尿病长期并发症的重要指标。它可能受到许多因素的影响。因此,确定改善疾病结果的这些因素至关重要。本研究的目的是评估接受常规胰岛素治疗的儿童的血糖控制情况,并确定其相关因素。方法对2015年11月至2020年11月在埃塞俄比亚亚的斯亚贝巴圣保罗医院千禧医学院儿科内分泌科门诊随访的1型糖尿病(T1DM)患儿进行回顾性队列研究。通过测量糖化血红蛋白(HbA1C)来评估血糖控制,并招募在数据收集后3至6个月内患有HbA1C的儿童。结果本研究共纳入106例接受常规胰岛素治疗的TIDM患儿。确诊时的中位年龄为9岁,47.2%为女性,57.5%来自城市地区。儿童的平均HbA1c为9.7%。多数(85.2%)患儿血糖控制不良(>7.5%)。年龄较小、病程较长和居住在城市是血糖控制良好的重要预测因素。结论:绝大多数T1DM患儿血糖控制较差。这就要求卫生当局和利益攸关方创造获得糖尿病重症监护的机会,以预防1型糖尿病的长期并发症。
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引用次数: 2
Ten year analysis of the clinic profile of the tertiary paediatric endocrine service in Western Australia 西澳大利亚州三级儿科内分泌服务的十年临床分析
Pub Date : 2022-05-05 DOI: 10.1515/jpem-2022-0055
Nadya Birdus, M. Grant, P. Stevenson, C. Choong, A. Siafarikas
Abstract Objectives There is a paucity of information regarding the profile of entire paediatric endocrine clinics and how they are changing. This study aimed to analyse the clinic profile of the Western Australian tertiary paediatric endocrine outpatient service over 10 years and compare to national and international data. Methods Retrospective analysis of the Western Australian Paediatric Endocrine Database (WAPED) between 2007 and 2017 looking at the frequency, proportion and longitudinal change of diagnosis categories, specific diagnoses, and gender breakdown. Results In total, 2,791 endocrine diagnoses were recorded for 2,312 patients. The most frequent reason for referral (22.1% of patients), was for evaluation of abnormalities in thyroid function. The most common diagnosis being hypothyroidism (76.7%). Evaluation of short stature was the reason for referral in 19.2% of patients, 14.6% of whom were diagnosed with growth hormone deficiency. Evaluation of puberty disorders, syndromes with endocrine features and disorders of calcium and phosphate metabolism were other common reasons for clinic referral, seen in 11.3, 9.8 and 8.2% of patients respectively. Between 2007 and 2017, the odds ratio of a thyroid diagnosis increased by 1.07 per year (95% CI: 1.02–1.12), whilst the odds ratio of a short stature diagnosis decreased by 0.91 per year (95% CI: 0.87–0.95). Conclusions The profile of the WAPED is similar to previously published national and international data. The analysis of the profile of diagnoses and its longitudinal change over a ten-year period offer a unique opportunity to guide clinic planning, resource allocation and future research.
摘要目的关于整个儿科内分泌诊所的概况及其变化的信息缺乏。本研究旨在分析西澳大利亚州三级儿科内分泌门诊服务10年来的临床概况,并与国内和国际数据进行比较。方法回顾性分析2007年至2017年西澳大利亚儿科内分泌数据库(wape)的诊断类别、具体诊断和性别细分的频率、比例和纵向变化。结果2312例患者共记录内分泌诊断2791例。最常见的转诊原因(22.1%的患者)是甲状腺功能异常的评估。最常见的诊断是甲状腺功能减退(76.7%)。19.2%的患者因身材矮小而转诊,其中14.6%的患者被诊断为生长激素缺乏症。评估青春期障碍、内分泌特征综合征和钙磷酸盐代谢障碍是其他常见的临床转诊原因,分别占11.3、9.8和8.2%。2007年至2017年间,甲状腺诊断的优势比每年增加1.07 (95% CI: 1.02-1.12),而身材矮小诊断的优势比每年下降0.91 (95% CI: 0.87-0.95)。结论:wape的概况与以前发表的国家和国际数据相似。对十年来诊断概况及其纵向变化的分析为指导临床计划、资源分配和未来研究提供了独特的机会。
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引用次数: 0
Considering metformin as a second-line treatment for children and adolescents with prediabetes 考虑二甲双胍作为儿童和青少年前驱糖尿病的二线治疗
Pub Date : 2022-05-03 DOI: 10.1515/jpem-2021-0200
C. Hosey, Kelsee Halpin, Yun Yan
Abstract Overweight and obesity affect approximately 1/3 of children in the United States and are risk factors for prediabetes and type 2 diabetes. Progression from prediabetes to diabetes carries substantial long-term health burdens, culminating in decreased life-expectancy. Earlier development of type 2 diabetes is associated with poorer prognoses, and children lose glycemic control more rapidly than adults. Metformin is approved by the USFDA for the treatment of type 2 diabetes in children, has limited toxicity, and may help prevent the development of type 2 diabetes. The more rapid disease progression in children and the safety of metformin suggests that initiation of metformin treatment to children with prediabetes who have not effectively responded to lifestyle changes may help prevent short- and long-term health damage resulting from prediabetic and diabetic dysglycemia.
超重和肥胖影响了大约1/3的美国儿童,是前驱糖尿病和2型糖尿病的危险因素。从糖尿病前期发展到糖尿病会带来长期的健康负担,最终导致预期寿命缩短。2型糖尿病的早期发展与较差的预后有关,儿童比成人更快地失去血糖控制。二甲双胍被美国食品和药物管理局批准用于治疗儿童2型糖尿病,毒性有限,可能有助于预防2型糖尿病的发展。儿童疾病进展更快和二甲双胍的安全性表明,对生活方式改变没有有效反应的前驱糖尿病儿童开始二甲双胍治疗可能有助于预防由前驱糖尿病和糖尿病血糖异常引起的短期和长期健康损害。
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引用次数: 2
Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents 喀麦隆儿童和青少年先天性肾上腺增生的临床、生化和生物分子方面
Pub Date : 2022-05-02 DOI: 10.1515/jpem-2021-0696
S. Ngo Um, R. M. Betoko, I. Mekone, Adéle Bodieu Chetcha, V. Tardy, S. Dahoun, P. Mure, I. Plotton, Y. Morel, Martine Claude Etoa Etoga, Jocelyn Tony Nengom, B. Moifo, F. Tambo, E. Sobngwi, P. K. Ndombo
Abstract Objectives Congenital adrenal hyperplasia (CAH) remains one of the most challenging endocrine disorders to diagnose, manage, and treat, especially in Africa where there is lack of neonatal screening program, and limited access to care. Data on biomolecular anomaly are sparse, therefore type of mutations are unknown, increasing management challenges and genetic counseling. The present study aims to describe clinical, biomolecular aspects of a group of Cameroonian patients. Methods We did an observational retrospective study at the pediatric endocrinology unit of the Mother and Child Centre of the Chantal Biya Foundation in Yaounde from May 2013 to December 2019, including all patients diagnosed with CAH. Results We consecutively included 31 patients aged less than 21 years, diagnosed CAH. Median age at diagnosis was 1.71 years (IQR 0.08–2.57 years). Abnormal genitalia was the main complain in 48.4%(n=15). The most prevalent genetic anomaly found in our study population (n=24) was on CYP11, found in 16 patients (66.6%) followed by CYP21A2 mutation found in 8 patients. Homozygous mutation of p.Q356X was found in half of patients with 11 hydroxylase deficiency. This mutation was mostly found in people from semi-Bantu tribes, declared non consanguineous. Conclusions 11 hydroxylase deficiency is the most prevalent form of CAH found in this group of Cameroonian children.
先天性肾上腺增生(CAH)仍然是诊断、管理和治疗最具挑战性的内分泌疾病之一,特别是在缺乏新生儿筛查计划和有限的护理机会的非洲。关于生物分子异常的数据很少,因此突变类型未知,增加了管理挑战和遗传咨询。本研究旨在描述临床,生物分子方面的一组喀麦隆患者。方法2013年5月至2019年12月,我们在雅温得Chantal Biya基金会母婴中心儿科内分泌科进行了一项观察性回顾性研究,包括所有诊断为CAH的患者。结果我们连续纳入31例年龄小于21岁,诊断为CAH的患者。中位诊断年龄为1.71岁(IQR为0.08 ~ 2.57岁)。生殖器官异常占48.4%(n=15)。在我们的研究人群(n=24)中发现的最普遍的遗传异常是CYP11,在16例患者中发现(66.6%),其次是CYP21A2突变在8例患者中发现。11羟化酶缺乏症患者中半数存在p.Q356X纯合突变。这种突变主要发生在半班图部落的人身上,他们被宣布为非近亲。结论11羟化酶缺乏症是喀麦隆儿童CAH最常见的形式。
{"title":"Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents","authors":"S. Ngo Um, R. M. Betoko, I. Mekone, Adéle Bodieu Chetcha, V. Tardy, S. Dahoun, P. Mure, I. Plotton, Y. Morel, Martine Claude Etoa Etoga, Jocelyn Tony Nengom, B. Moifo, F. Tambo, E. Sobngwi, P. K. Ndombo","doi":"10.1515/jpem-2021-0696","DOIUrl":"https://doi.org/10.1515/jpem-2021-0696","url":null,"abstract":"Abstract Objectives Congenital adrenal hyperplasia (CAH) remains one of the most challenging endocrine disorders to diagnose, manage, and treat, especially in Africa where there is lack of neonatal screening program, and limited access to care. Data on biomolecular anomaly are sparse, therefore type of mutations are unknown, increasing management challenges and genetic counseling. The present study aims to describe clinical, biomolecular aspects of a group of Cameroonian patients. Methods We did an observational retrospective study at the pediatric endocrinology unit of the Mother and Child Centre of the Chantal Biya Foundation in Yaounde from May 2013 to December 2019, including all patients diagnosed with CAH. Results We consecutively included 31 patients aged less than 21 years, diagnosed CAH. Median age at diagnosis was 1.71 years (IQR 0.08–2.57 years). Abnormal genitalia was the main complain in 48.4%(n=15). The most prevalent genetic anomaly found in our study population (n=24) was on CYP11, found in 16 patients (66.6%) followed by CYP21A2 mutation found in 8 patients. Homozygous mutation of p.Q356X was found in half of patients with 11 hydroxylase deficiency. This mutation was mostly found in people from semi-Bantu tribes, declared non consanguineous. Conclusions 11 hydroxylase deficiency is the most prevalent form of CAH found in this group of Cameroonian children.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"21 1","pages":"777 - 783"},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81556996","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}
引用次数: 0
Relationship between height age, bone age and chronological age in normal children in the context of nutritional and pubertal status 正常儿童在营养和青春期状态下身高、骨龄和实足年龄的关系
Pub Date : 2022-04-29 DOI: 10.1515/jpem-2021-0698
V. Khadilkar, C. Oza, A. Khadilkar
Abstract Introduction Bone age (BA) is a quantitative determination of skeletal maturation. The role of puberty in variations in BA is poorly understood as hypothalamic-pituitary-gonadal (HPG) axis maturation and skeletal maturation are regulated in parallel but independently by multiple different factors. In countries like India where there is rapid nutrition transition and increase in prevalence of obesity, their impact on height and BA is not well understood. Objectives To study if in 2–17 year old healthy children, the difference between chronological age (CA), height age (HA) and BA is less than 1 year on either side of the chronological age and to assess relationship of BA with height, weight and BMI with special reference to gender and puberty. Methods This cross-sectional study included 804 preschool/school-going Indian children. Anthropometric measurements and pubertal assessments were performed using standard protocols and were converted to age and sex standardized z-scores using Indian references while BA was estimated by Tanner-Whitehouse (TW3) method. p<0.05 was considered statistically significant. Results The mean age and gender standardized z-scores for height, weight, body mass index (BMI) and BA were −0.3 ± 0.7, −0.7 ± 0.8, −0.1 ± 1.0, and −0.2 ± 0.9 respectively. HA was more delayed in girls while BA was more delayed in boys. The mean BA z-score increased with increasing BMI. After the onset of puberty, there was higher increment in BA in girls and HA in boys (p<0.05). Conclusions HA, BA and CA were tightly correlated in healthy Indian children with a significant role of nutritional status and puberty in causing variation in the same.
骨龄(Bone age, BA)是骨骼成熟度的定量测定指标。青春期在BA变化中的作用尚不清楚,因为下丘脑-垂体-性腺(HPG)轴成熟和骨骼成熟是平行调节的,但由多种不同因素独立调节。在像印度这样的国家,营养转型迅速,肥胖患病率上升,它们对身高和体重的影响还不太清楚。目的探讨2 ~ 17岁健康儿童的生理年龄(CA)、身高年龄(HA)和BA在生理年龄两侧的差异是否小于1岁,探讨BA与身高、体重和BMI的关系,并特别参考性别和青春期。方法对804名学龄前/学龄印第安儿童进行横断面研究。使用标准方案进行人体测量和青春期评估,并使用印度参考文献转换为年龄和性别标准化z分数,而BA采用Tanner-Whitehouse (TW3)方法估计。P <0.05为差异有统计学意义。结果年龄、性别平均身高、体重、体质指数(BMI)和BA标准化z分数分别为- 0.3±0.7、- 0.7±0.8、- 0.1±1.0和- 0.2±0.9。HA在女孩中更迟发生,而BA在男孩中更迟发生。平均BA - z分数随BMI的增加而增加。青春期开始后,女孩的BA和男孩的HA的增加量较高(p<0.05)。结论HA、BA和CA在印度健康儿童中密切相关,营养状况和青春期对HA、BA和CA的变化有重要影响。
{"title":"Relationship between height age, bone age and chronological age in normal children in the context of nutritional and pubertal status","authors":"V. Khadilkar, C. Oza, A. Khadilkar","doi":"10.1515/jpem-2021-0698","DOIUrl":"https://doi.org/10.1515/jpem-2021-0698","url":null,"abstract":"Abstract Introduction Bone age (BA) is a quantitative determination of skeletal maturation. The role of puberty in variations in BA is poorly understood as hypothalamic-pituitary-gonadal (HPG) axis maturation and skeletal maturation are regulated in parallel but independently by multiple different factors. In countries like India where there is rapid nutrition transition and increase in prevalence of obesity, their impact on height and BA is not well understood. Objectives To study if in 2–17 year old healthy children, the difference between chronological age (CA), height age (HA) and BA is less than 1 year on either side of the chronological age and to assess relationship of BA with height, weight and BMI with special reference to gender and puberty. Methods This cross-sectional study included 804 preschool/school-going Indian children. Anthropometric measurements and pubertal assessments were performed using standard protocols and were converted to age and sex standardized z-scores using Indian references while BA was estimated by Tanner-Whitehouse (TW3) method. p<0.05 was considered statistically significant. Results The mean age and gender standardized z-scores for height, weight, body mass index (BMI) and BA were −0.3 ± 0.7, −0.7 ± 0.8, −0.1 ± 1.0, and −0.2 ± 0.9 respectively. HA was more delayed in girls while BA was more delayed in boys. The mean BA z-score increased with increasing BMI. After the onset of puberty, there was higher increment in BA in girls and HA in boys (p<0.05). Conclusions HA, BA and CA were tightly correlated in healthy Indian children with a significant role of nutritional status and puberty in causing variation in the same.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"14 1","pages":"767 - 775"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91262846","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}
引用次数: 4
Rituximab therapy in ROHHAD(NET) syndrome 利妥昔单抗治疗ROHHAD(NET)综合征
Pub Date : 2022-04-26 DOI: 10.1515/jpem-2022-0085
K. Hawton, R. Doffinger, A. Ramanan, S. L. Langton Hewer, H. Evans, D. Giri, Julian Hamilton Shield
Abstract Objectives Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, autonomic dysregulation, and neural-crest tumour (ROHHAD(NET)) is a rare syndrome presenting in early childhood associated with high morbidity and mortality. There is no specific diagnostic biomarker and diagnosis is based on clinical features. An autoimmune origin has been postulated. Case presentation Management is largely supportive. We report a case of a five-year old female who presented in respiratory arrest after 6-months of rapid weight gain. She had central hypoventilation, central diabetes insipidus, growth hormone deficiency and hyperprolactinaemia. She displayed elevated interleukin-6 levels on cytokine serology which normalised after rituximab treatment. After rituximab treatment, her weight reduced significantly from greatly above the 99.6th to the 50th centile in 12 months. Conclusions This response possibly reflects an underlying, immune-inflammatory pathology driving excess adiposity in this condition. Potentially, other aspects of ROHHAD(NET) may be mediated through autoimmune dysregulation in which case rituximab may provide benefits for prognosis and survival.
摘要目的快速发作性肥胖合并低通气、下丘脑功能障碍、自主神经失调和神经嵴肿瘤(ROHHAD(NET))是一种罕见的儿童期早期综合征,具有较高的发病率和死亡率。没有特定的诊断性生物标志物,诊断基于临床特征。据推测是自身免疫引起的管理层在很大程度上是支持的。我们报告一例5岁的女性谁提出呼吸停止后6个月的快速体重增加。她有中枢性呼吸不足、中枢性尿崩症、生长激素缺乏和高催乳素血症。她在细胞因子血清学上显示白细胞介素-6水平升高,经利妥昔单抗治疗后恢复正常。经利妥昔单抗治疗后,患者体重在12个月内由99.6以上显著下降至50百分位。结论:这种反应可能反映了这种情况下驱动过度肥胖的潜在免疫炎症病理。潜在地,ROHHAD(NET)的其他方面可能通过自身免疫失调介导,在这种情况下,利妥昔单抗可能对预后和生存有好处。
{"title":"Rituximab therapy in ROHHAD(NET) syndrome","authors":"K. Hawton, R. Doffinger, A. Ramanan, S. L. Langton Hewer, H. Evans, D. Giri, Julian Hamilton Shield","doi":"10.1515/jpem-2022-0085","DOIUrl":"https://doi.org/10.1515/jpem-2022-0085","url":null,"abstract":"Abstract Objectives Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, autonomic dysregulation, and neural-crest tumour (ROHHAD(NET)) is a rare syndrome presenting in early childhood associated with high morbidity and mortality. There is no specific diagnostic biomarker and diagnosis is based on clinical features. An autoimmune origin has been postulated. Case presentation Management is largely supportive. We report a case of a five-year old female who presented in respiratory arrest after 6-months of rapid weight gain. She had central hypoventilation, central diabetes insipidus, growth hormone deficiency and hyperprolactinaemia. She displayed elevated interleukin-6 levels on cytokine serology which normalised after rituximab treatment. After rituximab treatment, her weight reduced significantly from greatly above the 99.6th to the 50th centile in 12 months. Conclusions This response possibly reflects an underlying, immune-inflammatory pathology driving excess adiposity in this condition. Potentially, other aspects of ROHHAD(NET) may be mediated through autoimmune dysregulation in which case rituximab may provide benefits for prognosis and survival.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"70 1","pages":"1102 - 1106"},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86770940","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}
引用次数: 6
The role of circulating miRNAs in leptin resistance in obese children 循环mirna在肥胖儿童瘦素抵抗中的作用
Pub Date : 2022-04-22 DOI: 10.1515/jpem-2022-0063
Emre Murat Altınkılıç, Selami Bayrakdar, Gülcan Seymen Karabulut, B. Haliloglu, R. Attar
Abstract Objectives Leptin resistance is one of the important causes of obesity in children. Besides known causes of leptin resistance like mutations in leptin and leptin receptor genes, overexpression of SOCS3 in arcuate nucleus is a potential cause of leptin resistance. We aimed to determine the effects of circulating miRNAs on leptin resistance in obese children by targeting SOCS3 pathway. Methods miRNAs potentially targeting SOCS3 were determined by using online target prediction databases. Polymorphisms in miRNA target sequences were determined by using online genome browsers. miRNA expression levels of obese (n=35) and non-obese (n=30) children were determined by qPCR method, genotyping were performed by real-time PCR method and serum leptin, leptin receptor and SOCS3 levels were measured by ELISA method. Results miRNA profiling have shown that serum miR-218-5p levels are significantly (p<0.05) increased in accordance with serum leptin levels in obese children. Conclusions In this study we used target prediction methods for evaluating potential miRNAs which may involve in development of leptin resistance. We have shown that miR-218-5p might be taking part in leptin resistance in obese children.
目的瘦素抵抗是儿童肥胖的重要原因之一。除了已知的瘦素抵抗的原因,如瘦素和瘦素受体基因的突变,弓形核中SOCS3的过度表达是瘦素抵抗的潜在原因。我们旨在通过靶向SOCS3途径确定循环mirna对肥胖儿童瘦素抵抗的影响。方法利用在线靶标预测数据库确定潜在靶向SOCS3的mirna。利用在线基因组浏览器确定miRNA靶序列的多态性。采用qPCR法检测肥胖儿童(n=35)和非肥胖儿童(n=30)的miRNA表达水平,采用实时荧光定量PCR法进行基因分型,ELISA法检测血清瘦素、瘦素受体和SOCS3水平。结果miRNA分析显示,肥胖儿童血清miR-218-5p水平与血清瘦素水平同步显著升高(p<0.05)。在本研究中,我们使用了靶标预测方法来评估可能参与瘦素抵抗发展的潜在mirna。我们已经证明miR-218-5p可能参与肥胖儿童瘦素抵抗。
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引用次数: 3
Clinical characteristics and genetics analysis for the ITD of congenital hypothyroidism 先天性甲状腺功能减退症ITD的临床特点及遗传学分析
Pub Date : 2022-04-20 DOI: 10.1515/jpem-2022-0052
L. Gong, N. Yang, Jin-qi Zhao, Yueling Tang, Lulu Li, Hai-he Yang, Y. Kong
Abstract Objectives Iodide transport defect (ITD) is one of the principal causes of congenital hypothyroidism (CH) and its primary molecular mechanism is a mutation of the sodium/iodide symporter (NIS) gene. This study aims to analyse the clinical characteristics and genetic mutations of ITD. Methods The participants were a pair of siblings diagnosed with congenital hypothyroidism. Inductively coupled plasma mass spectrometry was used to determine the concentration of salivary iodine and serum iodine and to calculate their ratio. At the same time, next-generation sequencing (NGS) was applied to detect all exons of congenital hypothyroidism-related genes. All suspicious variants were further validated in the patients and their parents by PCR and Sanger sequencing. Results Both patients were conclusively diagnosed with thyroid iodine transport defect (ITD). NGS identified two variants of the NIS gene in the siblings: c.1021G>A (p.Gly341Arg) with paternal origin and c.1330-2A>C with maternal origin. Both of these variants have not been reported to date. They are predicted to be pathogenic based on these clinical symptoms and comprehensive software analysis. Conclusions This is the first reported family study of congenital hypothyroidism with SLC5A5 mutation in China. Next-generation sequencing technology is an effective means of studying the genetics of congenital hypothyroidism. The therapeutic effect of potassium iodide needs to be further evaluated.
碘离子转运缺陷(ITD)是先天性甲状腺功能减退症(CH)的主要病因之一,其主要分子机制是钠/碘化物同调体(NIS)基因的突变。本研究旨在分析ITD的临床特征和基因突变。方法研究对象为一对诊断为先天性甲状腺功能减退症的兄弟姐妹。采用电感耦合等离子体质谱法测定唾液碘和血清碘的浓度,并计算其比值。同时,应用新一代测序(NGS)检测先天性甲状腺功能减退症相关基因的所有外显子。所有可疑变异均通过PCR和Sanger测序在患者及其父母中进一步验证。结果两例患者均确诊为甲状腺碘转运缺陷(ITD)。NGS在兄弟姐妹中发现了两种NIS基因变体:父系起源的C . 1021g >A (p.Gly341Arg)和母系起源的C .1330- 2a >C。这两种变型到目前为止还没有报道。根据这些临床症状和综合软件分析,预测其致病性。结论:这是国内首次报道的先天性甲状腺功能减退伴SLC5A5突变的家族研究。新一代测序技术是研究先天性甲状腺功能减退症遗传学的有效手段。碘化钾的治疗效果有待进一步评价。
{"title":"Clinical characteristics and genetics analysis for the ITD of congenital hypothyroidism","authors":"L. Gong, N. Yang, Jin-qi Zhao, Yueling Tang, Lulu Li, Hai-he Yang, Y. Kong","doi":"10.1515/jpem-2022-0052","DOIUrl":"https://doi.org/10.1515/jpem-2022-0052","url":null,"abstract":"Abstract Objectives Iodide transport defect (ITD) is one of the principal causes of congenital hypothyroidism (CH) and its primary molecular mechanism is a mutation of the sodium/iodide symporter (NIS) gene. This study aims to analyse the clinical characteristics and genetic mutations of ITD. Methods The participants were a pair of siblings diagnosed with congenital hypothyroidism. Inductively coupled plasma mass spectrometry was used to determine the concentration of salivary iodine and serum iodine and to calculate their ratio. At the same time, next-generation sequencing (NGS) was applied to detect all exons of congenital hypothyroidism-related genes. All suspicious variants were further validated in the patients and their parents by PCR and Sanger sequencing. Results Both patients were conclusively diagnosed with thyroid iodine transport defect (ITD). NGS identified two variants of the NIS gene in the siblings: c.1021G>A (p.Gly341Arg) with paternal origin and c.1330-2A>C with maternal origin. Both of these variants have not been reported to date. They are predicted to be pathogenic based on these clinical symptoms and comprehensive software analysis. Conclusions This is the first reported family study of congenital hypothyroidism with SLC5A5 mutation in China. Next-generation sequencing technology is an effective means of studying the genetics of congenital hypothyroidism. The therapeutic effect of potassium iodide needs to be further evaluated.","PeriodicalId":16746,"journal":{"name":"Journal of Pediatric Endocrinology and Metabolism","volume":"130 1","pages":"741 - 748"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81223092","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}
引用次数: 0
期刊
Journal of Pediatric Endocrinology and Metabolism
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