Part of the book: Neuroimaging
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
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
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
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: Caesarean Section