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The effect of puberty on insulin resistance in obese children.
No full textJ Endocrinol Invest. 2009 May;32(5):401-5.
The effect of puberty on insulin resistance in obese children.
Pilia S, Casini MR, Foschini ML, Minerba L, Musiu MC, Marras V, Civolani P, Loche
S.
Pediatric Endocrinology Unit, Microcitemico Hospital, ASL Cagliari, Cagliari,
Italy.
OBJECTIVE: Insulin resistance (IR) increases during puberty in normal children.
IR is the first adverse metabolic event of obesity, and the marker of the
metabolic syndrome. We aimed to study the effect of puberty on IR in obese and
normal-weight children.
DESIGN: Cross-sectional evaluation of fasting glucose, insulin concentrations,
and homeostasis model assessment of IR (HOMA-IR) in obese and control children
throughout puberty.
PATIENTS AND METHODS: We recruited 424 obese children (207 pre-pubertal and 217
pubertal divided in Tanner stages 2-3, 4, and 5) and estimated IR using the
HOMA-IR index. Data were compared to those obtained in 123 healthy normal-weight
children (40 pre-pubertal and 83 pubertal divided in Tanner stages 2-3, 4, and
5).
RESULTS: In the obese children mean HOMA-IR increased progressively across Tanner
stages, and was significantly higher in all groups (pre-pubertal and Tanner
stages 2-3, 4, and 5) of obese than in control children. HOMA-IR was
significantly correlated with BMI.
CONCLUSIONS: HOMA-IR in obese children increases at puberty more than in
normal-weight children and does not return to pre-pubertal values at the end of
puberty.
PMID: 19794287 [PubMed - indexed for MEDLINE
Effect of the growth hormone treatment in a patient with GH deficiency and non-syndromic intrahepatic paucity of bile ducts
No full textTurner syndrome mosaicism: an unusual case with a de novo large dicentric marker chromosome: mos 45,X/46,X, ter rea(X;X)(p22.3;p22.3)
No full textEffect of the growth hormone treatment in a patient with GH deficiency and non-syndromic intrahepatic paucity of bile ducts
No full text
rs9939609 in the FTO gene is associated with obesity but not with several biochemical parameters in Sardinian obese children
No full textSeveral studies have reported an association of the intronic single nucleotide polymorphism (SNP) rs9939609 of the fat mass and obesity-associated (FTO) gene with obesity and with a number of obesity-related features. We studied the association of rs9939609 with obesity in 912 obese children and adolescents (426 males and 486 females, mean ± SD age 10.5 ± 3.3 years) and in 543 normal weight subjects. A number of biochemical and clinical parameters was also evaluated in 700 of these patients. In the obese group, mean body mass index standard deviation score (BMI-SDS) was similar between the three genotypes. The A allele was present in 55% of the patients' and in 43% of controls' chromosomes. The distribution of heterozygotes was similar between patients and controls (47%), while the distribution of AA homozygotes was significantly higher in patients (31% vs. 20%). Logistic regression analysis on the genotypes yielded a χ(2) of 35.5 with an odds ratio of 1.6 (CI = 1.3-1.8), P < 1 × 10(-5) . None of the clinical and metabolic parameters tested was associated with the genotype. In conclusion, we have confirmed the strong association between FTO and obesity, and shown that only AA homozygotes are predisposed to develop obesity while TT homozygotes might be protected. Finally, we found no association between rs9939609 and a number of obesity-related abnormalities
An INSIG2 polymorphism affects glucose homeostasis in Sardinian obese children and adolescents
No full textAllelic variants of a single nucleotide polymorphism (SNP), rs7566605, located approximately 10 kb upstream of the INSIG2 gene have been found in association with body weight and with other clinical features related to obesity in some populations but not in others. Our objective was to test the association of this SNP in obese children and adolescents from the genetically isolated population of Sardinia. We tested the association of rs7566605 with body mass index (BMI) and with serum glucose and insulin concentrations and a surrogate measure of insulin resistance (HOMA-IR) in a cohort of 747 Sardinian obese children and adolescents. A case control analysis was performed using 548 ethnically-matched healthy controls. Allelic frequencies of the SNP were similar between patients and controls. Mean glucose and insulin concentration and mean HOMA-IR values were significantly higher in patients carrying the CC genotype than in the CG and GG carriers. In the patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), allele C was significantly more frequent than in controls. Although INSIG2 polymorphisms do not consistently associate with BMI, the observation of an association with glucose concentration would support a role for this gene in the metabolic complications of obesity
The role of the rs9939609 FTO gene polymorphism on BMI is age-dependent
No full textBackground: In a large sample of obese Sardinian children and controls we have confirmed that the rs9939609 variant of the FTO gene is strongly associated with BMI, with a frequency of the A allele of 55% in patients’ and of 43% in controls’ chromosomes. It has been recently suggested that this association may be age-dependent.
Objective: Aim of this study is to evaluate whether this association is uniformly present in all ages.
Methods: 1004 Sardinian obese children and adolescents were genotyped for rs9939609 by using TaqMan probes (472 boys and 532 girls, age 1-20 y). Association analyses were performed by chi-square test (2x1 table), after evaluation of the sample statistical power. Association analyses were then repeated separately in four age groups: ≤ 5 years, 6-10, 11-15 and ≥ 16.
Results: In the whole dataset the A allele was significantly more frequent (54.6%) than the T variant (P = 3.3 x 10-5). Analysis in the different age groups showed that the A allele was associated to obesity only in the age groups 6-10 years (55.4%, P = 8.2 x 10-4) and 11-15 years (56.1%, P = 7.1 x 10-4). In the older subjects the frequency of the two alleles was almost the same (A allele frequency = 49.5%), while in children ≤ 5 years the T allele was even more frequent than the A allele (44.0%), similarly to a group of lean controls.
Conclusions: Our preliminary results seem to confirm that the effect of the FTO rs9939609 A variant is age-dependent. It may be speculated that the effects of the FTO gene variants predominate in the age groups which escape control of food intake, either by the parents (≤5 years) or self-control (≥16 years). This is in line with the theory that FTO exerts its effect by an action on feeding behavior
Results of early reevaluation of growth hormone secretion in short children with apparent growth hormone deficiency.
No full textRelationship between Cortisol and Components of the Metabolic Syndrome in Obese Children and Adolescents
No full textBackground. A relationship between serum cortisol (F) and insulin resistance has been shown in obese adults and children, suggesting a role for F in the development of the metabolic syndrome (MS). In this regard, F could be an important predictor factor for MS. Objective. The aim of this study was to evaluate the relationship between F and components of MS in obese children and adolescents. Subjects and Methods. This is a retrospective study in 1027 obese children and adolescents (BMI-SDS 2.62±0.51) referred to our endocrine unit in the last 8 y. Waist circumference (WC), systolic and diastolic blood pressure (SP, DP), morning serum concentrations of F, glucose (Glyc), cholesterol HDL, tryglicerides (TG) and HOMA (Glyc(mmol/L)xInsulin(mU/L)/22.5) were evaluated in all subjects. MS was defined according to the IDF criteria (1). Patients were subdivided into 3 age groups: 6-10, 10-16 and >16 y. Results. In univariate regression analysis including the entire cohort, F was weakly associated with SP (r=0.17, P<0.001), DP (r=0.13 P<0.001), Glyc (r=0.16 P<0.001) and HOMA (r=0.15, P<10-5), also when adjusted for age, gender, puberty and BMI-SDS. 14/372 patients aged 10-16 y had MS. Univariate regression analysis in these 372 subjects showed that F was associated with SP (r=0.11, P=0.047), DP (r=0.16 P=0.003) and Glyc (r=0.21 P<0.0001) but not with HOMA. When adjusted for age, gender, puberty and BMI-SDS, F was no longer correlated with SP but was weakly correlated with HOMA (r=0.12, P=0.02). In multivariate regression analysis including age, sex, puberty, BMI-SDS and F as independent variables and one of the component of the MS as the dependent variable, the only models where F was a weak predictor of the variability were one with DP (B=0.02, P=0.009, adjusted R2=0.13) and one with Glyc (B=0.03, P=0.003, adjusted R2=0.12) as dependent variables. Patients were then subdivided into 4 groups according to the WC centile: WC<90, WC>90, WC>90 and 1 of the other components of the MS, WC>90 and 2 of the other components of the MS. Mean F concentrations in the 4 groups was significantly different (F=7.12, P=0.0001), even adjusted for age, gender, puberty and BMI-SDS (F=4.53, P=0.004). Patients with one or more components of the MS had higher F concentrations. Conclusions. In this cohort of obese children and adolescents, F was weakly associated with components of the MS. These findings suggest that F has a minor role, if any, in the development of MS.
(1)Zimmet et al., Pediatric Diabetes 2007; 8:299–306
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