Chapters authored
Central Nervous System Findings on Magnetic Resonance Imaging in Children with Epilepsy
Part of the book: Neuroimaging
Prevalence of Metabolic Syndrome in Obese Pediatric Population: Relation to Serum Leptin Concentrations
Childhood obesity represents the most relevant nutritional disorder in our environment. This study examines the prevalence of metabolic syndrome in an obese pediatric population and its relation to serum leptin concentrations. A cross-sectional clinical and metabolic study was accomplished in a group of 106 obese children (47 males and 59 females). Patients were classified into prepubertal group (Tanner stage I) and pubertal group (Tanner stages II–V). Prevalence of insulin resistance [homeostasis model assessment (HOMA)], hypertriglyceridemia, low high-density lipoprotein (HDL) and arterial hypertension (HTA) was 38.7, 45.3, 28.3 and 33.8%, respectively. Metabolic syndrome prevalence (30.2%) was significantly higher in the pubertal group (38%) than the prepubertal group (23.2%). There was a positive correlation between leptin and body mass index (BMI) (r = 0.529), leptin and HOMA indexes (r = 0.562) and leptin and triglycerides (r = 0.314). In addition, there was a positive correlation between HOMA indexes and triglycerides (r = 0.596). Clinical and metabolic disorders associated with obesity and related to the so-called metabolic syndrome are already present in pediatric population. Leptin could play an important role in the etiopathogenesis of the metabolic syndrome.
Part of the book: Adiposity
Amino Acid Plasma Concentrations and Urinary Excretion in Young Diabetics
The aim of this study is to analyze amino acid plasma profile in a group of young diabetics and to evaluate its application as markers of metabolic control of the disease, as well as to analyze the urinary excretion of amino acids in these patients. A clinical assessment and metabolic study (amino acid serum concentrations and urinary excretion of amino acids) was accomplished in a group of 49 children diagnosed with diabetes, and a group of 48 healthy children (control group). The plasma levels of total amino acids as well as branchedchain, glucogenic and ketogenic amino acids were significantly higher (p < 0.05) in the diabetic group with respect to the control group. Total as well as branched-chain, glucogenic and ketogenic amino acids urinary levels were significantly lower (p < 0.05) in the diabetic group compared to the control group. The study of the amino acid plasma in the young diabetic reflect disturbances in protein/amino acid metabolism and, consequently, in metabolic control of the disease. The study of amino acid urinary excretion might have interest not only in the context of diabetic nephropathy, but also in the revealing of partial aspects of amino acid metabolism and, probably, in the metabolic control of the disease.
Part of the book: Diabetes and Its Complications
Vitamin D Deficiency in Children
In addition to its contribution to bone metabolism, vitamin D seems to fulfill a broad spectrum of biological functions which justifies the interest in monitoring its body content. The aim of this study is to analyze the prevalence of hypovitaminosis D and associated factors in schoolchildren and adolescents living in a region of northern Spain. A cross-sectional clinical and analytical study (calcium, phosphorus, calcidiol, and parathyroid hormone) was accomplished in a group of 602 Caucasian individuals (aged 3.1–15.4 years). Gender, age, body mass index, residence, and season of the year were recorded, and their association with vitamin D deficiency was analyzed by multiple regression. Vitamin D status was defined according to the US Endocrine Society criteria. The prevalence of hypovitaminosis D was 60.4% (insufficiency: 44.6%; deficiency: 15.8%). The female sex, adolescence, season of blood sample collection (autumn, winter, and spring), an urban residence, and severe obesity showed an association with an increased risk of hypovitaminosis D.
Part of the book: Vitamin D Deficiency
Characteristics of Catch-Up Growth in Very Low Birth Weight Infants (<1500 g)
Features of catch-up growth are not well established in very low birth weight infants (VLBW). The aim of this study is to analyze the catch-up growth in height and some factors associated in a cohort of VLBW (<1500 g) from birth to age 14 years. Retrospective registration of weight and height at birth and ages 0.5, 1, 2, 3, 4, 6, 8, 10, 12 and 14 years in a cohort of 170 VLBW have been recorded Anthropometric variables were compared with those from a control group. Sixty-nine (40.6%) were small for gestational age (SGA subgroup) and 101 (59.4%) were appropriate for gestational age (AGA subgroup). Thirty-seven (21.8%) were extremely low birth weight (ELBW), and 32 (18.8%) extremely preterm (EPT). At age 2, 4 and 10 years, 49.4%, 78.9% and 87.1% VLBW, respectively, did reach normal height. Between 4 and 10 years of age, only 8.2% of VLBW reached normal height. At 10 years of age, 7% of VLBW (1000–1500 g) and 35% of ELBW (<1500 g) showed short stature (p = 0.001). Almost the entire sample of VLBW with normal height at age 2, 4 and 10 have reached an adequate catch-up growth in weight in the previous evaluations. ELBW, SGA and EPT were found to be independent predictors for inadequate catch-up growth in height at 2, 4, and 10 years of age. The growth pattern of children born preterm has particular features: they have a lower rate and/or slowness in the catch-up growth in height with respect to that described in full-term small-for-gestational-age infants. Catch-up in weight appears to be a decisive factor for catch-up in height, and, on this basis, we recommend a rigorous nutritional follow-up in these individuals. If these measures do not help improve catch-up in height, they may be eligible for the establishment of rhGH therapy.
Part of the book: Current Topics in Caesarean Section
Vitamin D Deficiency in Childhood Obesity: Behavioral Factors or Altered Metabolism?
Obesity childhood is related to vitamin D deficiency, but the mechanisms for this association still remain questionable. We hypothesized that behavioral factors would be decisive in reducing the body content of vitamin D in patients with obesity. A cross-sectional clinical and analytical study (calcium, phosphorus, calcidiol, and parathyroid hormone) was carried out in a group of 377 patients with obesity (BMI-DS >2.0), 348 patients with severe obesity (BMI-DS >3.0), and 411 healthy children. The place of residence was categorized as urban or rural. Vitamin D status was defined according to the US Endocrine Society criteria. The prevalence of vitamin D deficiency was significantly higher (p < 0.001) in severe obesity (48.6%) and obesity groups (36.1%) than in the control group (12.5%). Vitamin D deficiency was more frequent in severe obesity and obesity groups living in urban areas than in those living in rural areas (not in the control group). The patients with obesity living in urban residence did not present significant seasonal variations in vitamin D deficiency throughout the year in contrast to those patients with obesity living in rural residence. These findings suggest that the most probable mechanism for vitamin D deficiency in children and adolescents with obesity, rather than altered metabolic, is the behavioral factors (sedentary lifestyle and lack of adequate sunlight exposure).
Part of the book: Vitamin D Deficiency
Sexual Dimorphism of the Fat Mass Index and the Fat-Free Mass Index in Healthy Adolescents
View all chaptersBody mass index (BMI) does not allow to discriminate the composition of the different body compartments. This study points to the formulation of reference values of fat mass index (FMI) and fat-free mass index (FFMI) in healthy adolescents by means of anthropometric techniques, and the subsequent availability in clinical practice as reference charts. The following is a cross-sectional study in a group of 1040 healthy Caucasian adolescents (470 boys and 570 girls), aged 10.1 to 14.9 years. Weight, height and skinfold thickness were registered, and BMI, percentage of total body fat, FMI and FFMI, and FMI and FFMI percentiles were calculated. Boys show a significant increase in FFMI and a decline in body fat and FMI. By contrast, girls show an increase in body fat, FMI and FFMI. Except for the 10 years, FMI was higher (p < 0.05) in girls in all ages and FFMI was higher (p < 0.05) in boys in all ages. There were no significant differences in the values of BMI between sexes in all ages. The availability of reference values for FMI and FFMI in daily clinical practice would be helpful in the diagnosis and assessment of changes in body composition during the treatment of childhood obesity.
Part of the book: Body Mass Index