1.A developmental perspective on the origins of obesity and metabolic syndrome.
Journal of the Korean Medical Association 2014;57(3):234-240
Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, glucose intolerance, and insulin resistance. Children sometimes develop metabolic syndrome, and it is strongly associated with the same syndrome in adulthood. Recently, there is evidence that obesity and metabolic syndrome originate from fetal life. Possible explanations of fetal and developmental origin of metabolic syndrome are the thrifty genotype and thrifty phenotype hypothesis, which together confer insulin resistance on developing fetus. Poor nutrition in utero as well as extrauterine growth restriction of preterm infants are important triggers of this hypothesis. Like metabolic syndrome in adulthood, the high levels of inflammatory cytokines and adipokines are certainly characteristic in pediatric patients. Increased fat mass was also observed in these patients, although their birth weight was lower than average. The mitochondrial genome is responsible for the inheritance of obesity from the maternal line. This can be a key as to why the phenotypes of obesity and metabolic syndrome start in fetal life with an association with poor maternal nutrition. In such circumstances, catch-up growth with an over-nutrition strategy can aggravate those features, suggesting that rapid catch-up growth in early infancy should not be encouraged.
Adipokines
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Birth Weight
;
Child
;
Cytokines
;
Dyslipidemias
;
Fetal Nutrition Disorders
;
Fetus
;
Genome, Mitochondrial
;
Genotype
;
Glucose Intolerance
;
Humans
;
Hypertension
;
Infant, Newborn
;
Infant, Premature
;
Insulin Resistance
;
Obesity*
;
Obesity, Abdominal
;
Pediatric Obesity
;
Phenotype
;
Wills
2.Fetal malnutrition assessment program.
Xiao-Yu LIN ; Jian-Bing LIU ; Xiu-Ping DU ; Han-Zhou GUAN ; Wei-Bing ZHANG ; Wen-Long LI ; Xiang-Bo XU ; Li LI ; Ming LIU
Chinese Journal of Contemporary Pediatrics 2020;22(12):1273-1278
OBJECTIVE:
To study the application of ponderal index (PI), body mass index (BMI), mid-arm circumference/head circumference (MAC/HC), and Clinical Assessment of Nutritional Status (CANS) score in assessing the nutritional status of neonates at birth, and to find a simple and reliable scheme for the assessment of fetal nutritional status.
METHODS:
PI, BMI, MAC/HC, and CANS were used to assess the nutritional status of full-term infants and preterm infants shortly after birth. The assessment results of these methods were analyzed.
RESULTS:
Among the 678 full-term infants, 61, 102, 47, and 131 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. Among the 140 preterm infants, 30, 87, 9, and 112 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. The combination of BMI and CANS had a detection rate of 99.3% in full-term infants and 100% in preterm infants. Compared with the single method, the combination significantly improved the detection rate of malnutrition (
CONCLUSIONS
The combination of BMI+CANS can reduce the rate of missed diagnosis of fetal malnutrition. It is therefore a simple and reliable method for the assessment of fetal malnutrition.
Body Mass Index
;
Fetal Nutrition Disorders/diagnosis*
;
Humans
;
Infant, Newborn
;
Infant, Premature
;
Nutrition Assessment
;
Nutritional Status
3.Sporadic Nonfamilial Hypophosphatemic Osteomalacia
Young Kee SHONG ; Joong Yeol PARK ; Ghi Su KIM ; You Sook CHO ; Goo Yeong CHO ; Sang Wook KIM ; Jung Sik PARK ; Ki Up LEE
Journal of Korean Society of Endocrinology 1994;9(1):25-31
Chronic hypophosphatemia caused by decreased intestinal absorption or increased renal clearance, may lead to rickets or osteomalacia independently of other predisposing abnormalities. The conditions commonly associated with increased renal clearance of phosphate are X-linked hypophosphatemic rickets, tumor associated rickets/osteomalacia, RTA and Fanconi syndrome. Recently we experienced 3 men with adult-onset, histologically proven osteomalacia associated with increased renal clearance of phosphate. None of them had a family history of bone disease, tumors or other tubular defects. All of these had remarkable biochemical and clinical improvement with medical treatment such as 1, 25-dihydroxyvitamin D and phosphate supplementation. Although we did not find tumors yet, we could not rule out the possibility of tumor-associated osteomalcia since it often takes several years to make a diagnosis because of small size, benign nature and unusual location of tumors. Thus, careful long-term follow up for tumor occurrence will be maintained in these patients with sporadic nonfamilial hypophosphatemic osteomalacia.
Bone Diseases
;
Diagnosis
;
Familial Hypophosphatemic Rickets
;
Fanconi Syndrome
;
Follow-Up Studies
;
Humans
;
Hypophosphatemia
;
Intestinal Absorption
;
Male
;
Osteomalacia
;
Rickets
4.Percent of Body Fat by Bioelectrical Impedance Analysis in Healthy Children.
Il Tae WHANG ; Kyung Ha RYU ; Kyung Hyo KIM ; Young Mi HONG ; Gyung Hee KIM ; Keun LEE
Journal of the Korean Pediatric Society 1999;42(9):1207-1214
PURPOSE: Obesity is a frequent nutritional disorder in children and adolescent and its prevalence is increasing. Bioelectrical impedance analysis is a simple, rapid, non-invasive and reproducible technique. The aim of this study was to measure percent of body fat using bioelectrical impedance in healthy children. METHODS: We measured height, weight and bioelectrical impedance in 1035 children aged 7-18 years(496 males and 539 females). RESULTS: Percent of body fat was decreased in male children, but it was increased during the pubertal period in female. 95th percentiles of percent of body fat by bioelectrical impedance was 32.9% in 7 year olds, 31.6% in 8, 34.7% in 9, 35.1% in 10, 35.8% in 11, 33.1% in 12, 36.1% in 13, 38.2% in 14, 33.3% in 15, 28.3% in 16, 32.8% in 17 and 32.2% in 18 year olds for males. 95th percentiles of percent of body fat by bioelectrical impedance was 25.1% in 7 year olds, 29.6% in 8, 30.5% in 9, 35.6% in 10, 34.5% in 11, 36.5% in 12, 39.1% in 13, 34.1% in 14, 33.7% in 15, 32.8% in 16, 34.5% in 17 and 35.1% in 18 year olds for females. Intraobserver reliability coefficient of bioelectrical impedance analysis was 0.995 and intraobserver reliability of BI(Bioelectrical impedance) analysis was significantly high. CONCLUSION: To measure body fat percentage using bioelectrical impedance analysis in healthy children provides objective data in diagnosing obesity.
Adipose Tissue*
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Adolescent
;
Child*
;
Electric Impedance*
;
Female
;
Humans
;
Male
;
Nutrition Disorders
;
Obesity
;
Pediatric Obesity
;
Prevalence
5.Leptin Levels and Obesity in Childhood.
Journal of Korean Society of Pediatric Endocrinology 1999;4(2):211-218
PURPOSE: Leptin is a hormone involved in the regulation of energy balance. Serum leptin levels are correlated with body fat. It provide information to hypothalamus on the amount of energy stored in the adipose tissue. Certain endocrine disease presents obesity in childhood, such as growth hormone deficiency, Prader- Willi syndrome and Turner syndrome. The purpose of this study is to evaluate leptin levels in obese children and to know whether it is a useful marker to differentiate the underlying cause of obesity. METHODS: One hundred sixty six obese children were included in this study. Height, weight, HTSDS, WTSDS, adjusted WTSDS to height age and BMI were measured. Serum leptin levels were measured. RESULTS :Leptin levels in simple obesity, growth hormone deficiency, Prader-Willi syndrome, Turner syndrome and control were 12.3+/-6.3ng/ml, 6.4+/-2.0ng/ml, 19.9+/-11.2ng/ml, 8.9+/-5.3ng/ml, 5.7+/-3.7ng/ml respectively. Leptin levels were significantly high in obese children, especially in Prader-Willi syndrome, simple obesity and Turner syndrome. Leptin concentration were correlated with BMI and WTSDS. CONCLUSION: Leptin can be used as an indicator of obesity but, not suitable as a differential diagnostic factor for obesity.
Adipose Tissue
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Child
;
Endocrine System Diseases
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Growth Hormone
;
Humans
;
Hypothalamus
;
Leptin*
;
Obesity*
;
Pediatric Obesity*
;
Prader-Willi Syndrome
;
Turner Syndrome
6.Relationship between skeletal muscle mass index and metabolic phenotypes of obesity in adolescents.
Ling-Ling TONG ; Xiao-Yan MA ; Mei TIAN ; Wen-Qing DING
Chinese Journal of Contemporary Pediatrics 2023;25(5):457-462
OBJECTIVES:
To study the relationship between skeletal muscle mass index (SMI) and metabolic phenotypes of obesity in adolescents, and to provide a basis for the prevention and control of adolescent obesity and related metabolic diseases.
METHODS:
A total of 1 352 adolescents aged 12 to 18 years were randomly selected by stratified cluster sampling in Yinchuan City from October 2017 to September 2020, and they were surveyed using questionnaires, physical measurements, body composition measurements, and laboratory tests. According to the diagnostic criteria for metabolic abnormalities and the definition of obesity based on the body mass index, the subjects were divided into four metabolic phenotypes: metabolically healthy normal weight, metabolically healthy obesity, metabolically unhealthy normal weight, and metabolically unhealthy obesity. The association between SMI and the metabolic phenotypes was analyzed using multivariate logistic regression.
RESULTS:
The SMI level in the metabolically unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity groups was lower than that in the metabolically healthy normal weight group (P<0.001). Multivariate logistic regression analysis showed that after adjusting for gender and age, a higher SMI level was a protective factors for adolescents to develop metabolic unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity phenotypes (OR=0.74, 0.60, and 0.54, respectively; P<0.001).
CONCLUSIONS
Increasing SMI can reduce the risk of the development of metabolic unhealthy/obesity.
Adolescent
;
Humans
;
Body Mass Index
;
Metabolic Syndrome/metabolism*
;
Muscle, Skeletal/metabolism*
;
Obesity, Metabolically Benign/diagnosis*
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Pediatric Obesity
;
Phenotype
;
Risk Factors
;
Child
7.Fetal origin of some chronic diseases associated with nutrition
Journal of Medical and Pharmaceutical Information 2003;0(6):6-8
The theory on establishment of programmed in the fetal period and chronic diseases haven’t still given out anything clearly but in most of studies, they showed that there is a relation between fetal growing with cardiovascular diseases, hypertension and metabolic syndrome. Its establishment of programmed in fetal period doesn’t replace other risk factors but adding more the environmental factor to these diseases. Currently, the important of fetal nutrition and mother nutrition in pregnancy period are paid attention as well as other nutrition issue in the transition period.
Nutrition Therapy
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Cardiovascular Diseases
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Chronic Disease
;
Fetal Nutrition Disorders
8.Value of serum fibroblast growth factor 23 in diagnosis of hypophosphatemic rickets in children.
Sha-Sha DONG ; Ruo-Chen CHE ; Bi-Xia ZHENG ; Ai-Hua ZHANG ; Chun-Li WANG ; Mi BAI ; Ying CHEN
Chinese Journal of Contemporary Pediatrics 2023;25(7):705-710
OBJECTIVES:
To study the value of serum fibroblast growth factor 23 (FGF23) in the diagnosis of hypophosphatemic rickets in children.
METHODS:
A total of 28 children who were diagnosed with hypophosphatemic rickets in Children's Hospital of Nanjing Medical University from January 2016 to June 2021 were included as the rickets group. Forty healthy children, matched for sex and age, who attended the Department of Child Healthcare of the hospital were included as the healthy control group. The serum level of FGF23 was compared between the two groups, and the correlations of the serum FGF23 level with clinical characteristics and laboratory test results were analyzed. The value of serum FGF23 in the diagnosis of hypophosphatemic rickets was assessed.
RESULTS:
The rickets group had a significantly higher serum level of FGF23 than the healthy control group (P<0.05). In the rickets group, the serum FGF23 level was positively correlated with the serum alkaline phosphatase level (rs=0.38, P<0.05) and was negatively correlated with maximum renal tubular phosphorus uptake/glomerular filtration rate (rs=-0.64, P<0.05), while it was not correlated with age, height Z-score, sex, and parathyroid hormone (P>0.05). Serum FGF23 had a sensitivity of 0.821, a specificity of 0.925, an optimal cut-off value of 55.77 pg/mL, and an area under the curve of 0.874 in the diagnosis of hypophosphatemic rickets (P<0.05).
CONCLUSIONS
Serum FGF23 is of valuable in the diagnosis of hypophosphatemic rickets in children, which providing a theoretical basis for early diagnosis of this disease in clinical practice.
Child
;
Humans
;
Fibroblast Growth Factor-23
;
Fibroblast Growth Factors
;
Familial Hypophosphatemic Rickets/diagnosis*
;
Rickets, Hypophosphatemic/diagnosis*
9.Actuality of malnutrition control in children
Journal of Medical and Pharmaceutical Information 2000;(4):1-7
There are 3 kinds of malnutrition in the community: underweight, stunting and wasting malnutrition. There were many diseases related with malnutrition such as diarrhea, pneumonia, and growth retardation of physical and psychological aspects. The children with ages of from 4 months to 2 year olds had a high risk of malnutrition. The malnutrition control involved the breast feeding, complementary diet, use of Vitamin A, rational nutrition during and after disease free, iron/folic supplement for pregnant women and iodine containing salt using
Malnutrition
;
Nutrition Disorders
;
child
10.Study on preparation of the product Vilacid, soluble powder utilized in the treatment of malnutrition
Pharmaceutical Journal 2001;305(9):21-22
Soluble powder of vilacid was prepared by direct drying spray and addition of inactive components and aromatic compounds. This powder contains high essential total aminoacids and packaged in the suitable dosage
Malnutrition
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Nutrition Disorders