PURPOSE: The aim of this study was to evaluate growth status using the insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 (IGFBP-3) concentrations in children with subclinical hypothyroidism (SCH). METHODS: The study included 93 SCH patients (33 males and 60 females, age 8.1+/-1.9 years) and 94 healthy control subjects (31 males and 63 females, age 8.0+/-0.7 years). Patients' height and weight were measured, and their body mass index (BMI) and Z-scores were calculated. The relationship between growth parameters, including IGF-I and IGFBP-3 concentrations and thyroid functions (thyroid-stimulating hormone (TSH) and free thyroxine 4 (fT4) was explored. RESULTS: Although weight and BMI were greater in SCH patients, the Z-score of height, weight and BMI, and serum IGF-I and IGFBP-3 levels in SCH children were not significantly different compared to the control. In SCH patients, TSH showed a negative correlation with weight Z-scores (r=-0.23, P=0.028) and BMI Z-scores (r=-0.21, P=0.048). FT4 showed a positive correlation with IGFBP-3. CONCLUSION: The positive correlation of fT4 and IGFBP-3 and the negative relationship between TSH and weight and BMI Z-scores in SCH children suggest that subnormal thyroid functions could be related to growth impairment.
Body Mass Index ; Child ; Female ; Humans ; Hypothyroidism ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Male ; Thyroid Gland ; Thyroxine

PURPOSE: IGFBP-3 leads to the induction of insulin resistance in 3T3-L1 adipocytes. We carried out a series of experiments to elucidate the effects of IGFBP-3 on adipokines and gene expressions. METHODS: We treated fully-differentiated 3T3-L1 adipocytes with IGFBP-3 (0.5, 1, and 2 microg/mL) for one day and measured the mRNA levels of adiponectin, leptin, resistin, and TNF-alpha by RT-PCR, and adiponectin, leptin, resistin, and IL-6 protein levels in the culture supernatant were measured using multiplex adipokine assay ELISA Kits (Linco Research, St. Charles, Missouri). Gene expression in 3T3-L1 adipocyte cells using a microarray method was performed. RESULTS: IGFBP-3 inhibited the expression of adiponectin, leptin, resistin, and TNF-alpha mRNA. IGFBP-3 at 0.5 and 1 micro/mL decreased adiponectin release, but IL-6 release was increased at 2 micro/mL IGFBP-3. A dose-dependent inhibition of leptin was released by IGFBP-3 at 50%. Resistin release was decreased by 40%. The effect of IGFBP-3 on the gene expression in 3T3-L1 adipocyte cells using a microarray assay related to an increase of agouti-realted proteins (Agrp) and Janus kinase 2 (JAK2), and a decrease of the ras homolog gene family (Rhoq), acyl-CoA synthetase long-chain family member 6 (Acsl6), and the interleukin-1 receptor-associated kinase 1 (Irak1). CONCLUSION: IGFBP-3 regulates several adipokines gene expressions that are known to modulate insulin sensitivity, and this regulation may be attributable to the insulin resistance effect of IGFBP-3 on adipocytes.
Adipocytes ; Adipokines ; Adiponectin ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans ; Insulin Resistance ; Insulin-Like Growth Factor Binding Protein 3 ; Interleukin-1 Receptor-Associated Kinases ; Interleukin-6 ; Janus Kinase 2 ; Leptin ; Ligases ; Proteins ; Resistin ; RNA, Messenger ; Tumor Necrosis Factor-alpha

PURPOSE: The purpose of this test was to investigate the changes of serum IGF-1 and IGFBP-3 levels during a one-year gonadotropin releasing hormone agonist (GnRHa) treatment in central precocious puberty (CPP) girls. METHODS: From 2007 to 2009, 26 girls were enrolled in this study. They were diagnosed as having central precocious puberty and were treated with GnRHa (leuprolide actete) for one year. Their height, bone age, and serum IGF-1 and IGFBP-3 levels were evaluated every six months. RESULTS: At the time of diagnosis, their mean serum IGF-1 and IGFBP-3 levels were 302.90+/-102.54 ng/mL and 3,103.58+/-705.08 ng/mL, respectively. At six month after treatment, the serum IGF-1 and IGFBP-3 levels were slightly decreased. One year later, IGF-1 concentrations were higher than before treatment and IGFBP-3 levels were lower (P=NS). This result, however, was not statistically significant. CONCLUSION: Gonadal suppression with gonadotropin releasing hormones inversely influenced circulating IGF-1 and IGFBP-3 levels. However, the serum IGF-1 and IGFBP-3 levels were maintained at relatively steady levels, preserving a normal height velocity.
Gonadotropin-Releasing Hormone ; Gonadotropins ; Gonads ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Puberty, Precocious

PURPOSE: Diverse cytokines influence the pathogenesis of type 1 diabetes mellitus (T1DM) in different ways. We studied the profile of cytokines in sera from type 1 diabetic patients at diagnosis. METHODS: Serum levels of 11 cytokines (IL-1alpha, IL-1beta, IL-1Ra, IL-2, IL-4, IL-6, IL-10, IL-12 (p70), INF-gamma, and TNF-alpha) from 38 newly-diagnosed T1DM patents and 39 healthy controls were measured, using multiplex immunoanalytic xMAP. RESULTS: Patients showed significantly higher levels of IL-1beta (P < 0.01), IL-10 (P < 0.01), and TNF-alpha (P = 0.019), than the healthy controls. In 12 of 35 patients, the insulin autoantibody (IAA) was positive (34%) and the level of IAA was correlated with IL-10 (r = 0.454, P = 0.006), and TNF-alpha (r = 0.368, P = 0.030). CONCLUSION: These results suggest that IL-1beta, TNF-alpha, and IL-10 play a role in the pathogenesis of T1DM, and the level of the IAA is correlated with IL-10 and TNF-alpha.
Autoantibodies ; Cytokines ; Diabetes Mellitus, Type 1 ; Humans ; Insulin ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-10 ; Interleukin-12 ; Interleukin-1beta ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Tumor Necrosis Factor-alpha

As a result of recent advances in life science and technology, various therapeutic drugs have been developed and active research in the fields of medicine for the development of novel drugs are under progress. Among these researches, the Drug Delivery System (DDS) is an advanced technology that effectively delivers therapeutic drugs to desired targets and thereby reduces adverse effects and increases efficacy. The application of this technology in the industry is technology-intensive and high value-added and therefore suitable for Korea's condition which is poor of material resources while abundant of human resources. Therefore there are many efforts in developing DDS as a major fundamental industry in Korea. Therefore this technology has emerged as a new technology that has a substantial impact in the development and growth of biotechnology related industries in Korea. In this review, we introduce the basic concepts and principles of DDS, so that pediatric endocrinologists may obtain a more comprehensive understanding and may benefit in treating patients with this advanced technology.
Biological Science Disciplines ; Biotechnology ; Drug Delivery Systems ; Endocrinology ; Growth and Development ; Humans ; Korea

Adult growth hormone deficiency (GHD) is associated with increased morbidity and mortality and reduced quality of life. GH status should be reevaluated in the transitional age for continued treatment to complete somatic development. All children diagnosed with GHD should be retested by insulin provocative tests upon completion of skeletal growth. A low insulin-like growth factor (IGF)-I is a reliable diagnostic indicator of GHD in the presence of hypopituitarism, however, a normal IGF-I does not rule out GHD. When the diagnosis of adult GHD is established, continuation of GH therapy is strongly recommended. Continued GH treatment from adolescence into early adulthood may contribute to the attainment of a normal bone and muscle mass and contribute to a decrease of the cardiovascular risk of GHD adults. There is ongoing debate about nearly every aspect of GH therapy.
Adolescent ; Adult ; Child ; Growth Hormone ; Humans ; Hypopituitarism ; Insulin ; Insulin-Like Growth Factor I ; Muscles ; Quality of Life

Acute suppurative thyroiditis is an uncommon condition because the thyroid gland is remarkably resistant to infection. In children, anatomic defects, such as a left piriform sinus fistula, predispose subjects to this infection. It is very important yet difficult to differentiate acute thyroiditis with thyrotoxicosis from subacute thyroiditis; and if left untreated, acute suppurative thyroiditis can lead to thyroid abscess formation. Bacterial infections with staphylococcus and streptococcus species are the most common causes of acute suppurative thyroiditis. Occasionally, the thyroid gland can be infected with fungi, parasites, or mycobacterium. An 8-year-old boy presented with acute fever and tender neck swelling. The patient was admitted to the hospital and was diagnosed with acute suppurative thyroiditis. The culture result of the drained fluid revealed methicillin-resistant staphylococcus aureus (MRSA). The patient's condition improved after the use of antibiotics and drainage. There was no evidence of fistula formation between the thyroid and the pyriform sinus on a computed tomography (CT) scan. Here we describe rapidly progressive thyroid abscesses caused by MRSA in healthy children.
Abscess ; Anti-Bacterial Agents ; Bacterial Infections ; Child ; Drainage ; Fever ; Fistula ; Fungi ; Humans ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Mycobacterium ; Neck ; Parasites ; Pyriform Sinus ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Suppurative ; Thyrotoxicosis

PURPOSE: Most childhood diabetes mellitus (DM) is usually thought of as type 1 DM (T1DM), but the incidence of type 2 DM (T2DM) in childhood is increasing. Sometimes, it might not be easy to determine which type of DM a patient has and to choose the best treatment. The purpose of this study is to evaluate the usefulness of autoantibody test and clinical characteristics for the specific diagnosis of DM in childhood. METHODS: In this study, we retrospectively reviewed the medical records of 42 patients who were diagnosed with DM and followed at the department of pediatrics, Dankook University Hospital from January 2002 to October 2010. RESULTS: The patients were grouped as T1DM, T2DM, or T1.5DM (unclassified) according to the clinical and laboratory findings. T1DM had an earlier onset age compared to T2DM. Diabetic ketoacidosis (DKA) was the presenting symptom in 57% of T1DM, but there was no DKA in T2DM. Initial serum insulin and C-peptide levels were lower in T1DM than T2DM. Thirty nine percent and 70% of the patients had a family history of DM, respectively. The average body mass index (BMI) in T2DM was higher than that in T1DM. At least one of autoantibodies was positive in 80% of T1DM. But no antoantibody was detected in T2DM. During follow up, higher levels of HbA1c and more frequent microalbuminuria were detected in the female adolescents. CONCLUSION: We can confirm that the autoantibody test is very valuable in diagnosing specific types of DM. And adolescent period was thought as a very vulnerable period to manage the diabetes requiring more intensive emotional support including family cooperation.
Adolescent ; Age of Onset ; Autoantibodies ; Body Mass Index ; C-Peptide ; Child ; Diabetes Mellitus ; Diabetic Ketoacidosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Insulin ; Medical Records ; Pediatrics ; Retrospective Studies

PURPOSE: The aim of the study was to investigate postnatal changes in growth and insulin, leptin, IGF-I, adiponectin, and ghrelin, and to examine the relationship of these hormones with catch-up growth in full-term small for gestational age (SGA) infants. METHODS: SGA was defined as a birth weight less than the ten percentile. Weight and height were measured at birth, 1 month, 6 months, 1 year, and 2 years of age in 70 SGA infants (40 females and 30 males). The infants were subdivided according to their weight and height catch-up growth (CUG) at 2 years old. CUG is defined as reaching a standard deviation score (SDS) of > -2 SDS. Blood samples were serially taken for insulin, leptin, insulinlike growth factor (IGF)-I, adiponectin, and ghrelin. RESULTS: 1) Dramatic CUG for weight and height occurred during the first year of life; weight and height growth gain decreased thereafter. 2) Non-catch-up growth (NCUG) infants showed more decreased weight and height growth gain than CUG infants between the first and second year of life. 3) Weight CUG was 77.1% and height CUG was 75.8% in the SGA infants. 4) Weight CUG infants showed significantly higher leptin and ghrelin levels than in weight NCUG infants at the age of 1 year (P <0.05). 5) Height CUG infants showed significantly higher leptin and ghrelin levels than in height NCUG infants at the age of 1 year (P <0.05). CONCLUSION: CUG for weight and height occurred during the first year of life and growth velocity decreased thereafter. Significant corresponding changes occurred with regard to serum leptin and ghrelin.
Adiponectin ; Birth Weight ; Female ; Gestational Age ; Ghrelin ; Humans ; Infant ; Infant, Newborn ; Infant, Small for Gestational Age ; Insulin ; Insulin-Like Growth Factor I ; Leptin ; Parturition

PURPOSE: The objective of this study was to evaluate the effect of gonadotropin releasing hormone analog (GnRHa) treatment on bone mineral density (BMD) in girls with central precocious puberty (CPP). Further we investigated the differences in the effect on BMD by using the GnRHa leuprolide-acetate and triptorelin. METHODS: Sixty-one females with CPP were enrolled in the study, the lumbar spine BMD was measured by dual energy x-ray absorptiometry before treatment, after one year (n = 61) and after two years (n = 24) of treatment. Lumbar spine BMD standard deviation scores (SDS) were compared according to chronological age (CA) and bone age (BA) for the whole group, as well as for the group A, treated with leuprolide-acetate (n = 40), and the group B, treated with triptorelin (n = 21). RESULTS: All subjects showed significant increment in BMD during treatment (P < 0.05). Lumbar spine BMD SDS for CA and BA showed no significant changes before and during treatment. Group A and group B, within each group, showed no significant changes in lumbar spine BMD SDS for CA and BA during treatment. CONCLUSION: Our study suggests that lumbar spine BMD was not impaired in girls treated with GnRHa for CPP and both leuprolide-acetate and triptorelin showed comparable effects on lumbar spine BMD during treatment.
Absorptiometry, Photon ; Bone Density ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Leuprolide ; Piperazines ; Puberty, Precocious ; Spine ; Triptorelin Pamoate