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Evaluation of Growth Status Using Serum IGF-I and IGFBP-3 in Children with Subclinical Hypothyroidism.

Jae Wook BAE ; Byung Ok KWAK ; Sochung CHUNG

Journal of Korean Society of Pediatric Endocrinology.2011;16(1):31-37. doi:10.6065/jkspe.2011.16.1.31

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

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The Effect of IGFBP-3 on Adipokines and Gene Expression in Differentiated 3T3-L1 Adipocytes.

Hae Soon KIM

Journal of Korean Society of Pediatric Endocrinology.2011;16(1):24-30. doi:10.6065/jkspe.2011.16.1.24

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

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Serum IGF-1 and IGFBP-3 Levels in Central Precocious Puberty Girls Treated with Gonadotropin Releasing Hormone Agonist (GnRHa).

Kyung Hee YI

Journal of Korean Society of Pediatric Endocrinology.2011;16(1):20-23. doi:10.6065/jkspe.2011.16.1.20

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

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Analysis of Cytokines in Sera from Type 1 Diabetic Patients at Diagnosis.

In Suk YOON ; Choong Ho SHIN ; Sei Won YANG

Journal of Korean Society of Pediatric Endocrinology.2011;16(1):13-19. doi:10.6065/jkspe.2011.16.1.13

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

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Drug Delivery Systems - associated with Pediatric Endocrinology.

Ji Eun LEE

Journal of Korean Society of Pediatric Endocrinology.2011;16(1):7-12. doi:10.6065/jkspe.2011.16.1.7

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

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Reassessment of GH Status and GH Therapy in Adults with Childhood-onset GHD: Transitional Care from Adolescence to Adulthood.

Jin Ho CHOI ; Han Wook YOO

Journal of Korean Society of Pediatric Endocrinology.2011;16(1):1-6. doi:10.6065/jkspe.2011.16.1.1

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

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A Case of Fulminant Type 1 Diabetes Mellitus with Peripheral Neuropathy in a Korean Child.

Min Sun KIM ; Ka Young YU ; Soo Yeon LEE ; Sun Young KIM ; Sun Jun KIM ; Pyoung Han HWANG ; Dae Yeol LEE

Journal of Korean Society of Pediatric Endocrinology.2009;14(1):82-84.

Type 1 diabetes is an insulin-deficient status due to severe destruction of pancreatic beta cells, and is classified into two subtypes, type 1A and type 1B. Type 1A diabetes is autoimmune and type 1B is idiopathic diabetes. Recently fulminant type 1 diabetes has been identified as a new subtype of idiopathic diabetes. It develops rapidly without any evidence of autoimmunity. This subtype of type 1 diabetes was firstly introduced by Imagawa et al. in 2000, and exclusively reported in Japan. Nonetheless, there has been no case reported in Korea till now. Here, we report a case of fulminant type 1 diabetes in 14-year-old girl. She had acute symptoms for short duration, negative islet-related autoantibodies, elevated serum levels of pancreatic exocrine enzymes (amylase, lipase), high blood glucose level and peripheral neuropathy. But HbA1c level was in normal range. Treatment with insulin was successful, acute symptoms were improved and abnormal laboratory data normalized. Her recent HbA1c level showed only a mild elevation.
Adolescent ; Autoantibodies ; Autoimmunity ; Blood Glucose ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetic Neuropathies ; Humans ; Insulin ; Insulin-Secreting Cells ; Japan ; Korea ; Peripheral Nervous System Diseases ; Reference Values

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A Case of 8 Year-old Boy with Testicular Microlithiasis Showing Bilateral Testicular Enlargement.

Seung Hoon HAHN ; Min Ho JUNG ; Byung Kyu SUH

Journal of Korean Society of Pediatric Endocrinology.2009;14(1):78-81.

Testicular microlithiasis is a rare cause of testicular enlargement. An 8.5-year-old boy presented with bilateral testicular enlargement accompanied by no other pubertal signs. His bone age was 8.5 years and serum levels of luteinizing hormone and follicle-stimulating hormone after gonadotropin-releasing hormone stimulation were within prepubertal limits. Scrotal ultrasonography showed multiple echogenic microcalcifications that are indicative of microlithiasis in both testes. During 2-year follow-up, he developed clinical manifestations of early puberty between 9.5 and 10.5 years of age. Testicular microlithiasis should be considered when boys show bilateral testicular enlargement without other findings of puberty.
Calculi ; Follicle Stimulating Hormone ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Hypertrophy ; Luteinizing Hormone ; Puberty ; Testicular Diseases ; Testis

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Hyperglycemic Hyperosmolar State in Children with Type 2 Diabetes Mellitus: A Report of Two Cases.

Tae Yeon KIM ; Jung AHN ; Hae Soon KIM

Journal of Korean Society of Pediatric Endocrinology.2009;14(1):73-77.

Hyperglycemic hyperosmolar state (HHS) is usually associated with type 2 diabetes mellitus (T2DM) with signigicant mortality and morbidity and is rare in pediatric population. The incidence of obesity and T2DM in children and adolescents is increasing at an alarming rate. With increasing rates of T2DM, the incidence of HHS may increase in pediatric population. HHS is characterized by severe hyperglycemia, a marked increase in serum osmolarity and clinical evidence of dehydration. The significance of HHS in children and adolescents remains largely unappreciated. We describe two obese adolescents with hyperglycemic hyperosmolar state at the onset of T2DM.
Adolescent ; Child ; Dehydration ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Hyperglycemic Hyperosmolar Nonketotic Coma ; Incidence ; Obesity ; Osmolar Concentration

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Hypogonadotropic Hypogonadism and Abnormal Olfactory Bulb Development in CHARGE Syndrome with CHD7 Mutation.

Sun Hyang LEE ; Yong Wha LEE ; Young Lim SHIN

Journal of Korean Society of Pediatric Endocrinology.2009;14(1):68-72.

CHARGE syndrome is a congenital malformation disorder that includes Coloboma, Heart defect, Atresia of the choanae, Retarded growth and development, Genital hypoplasia, and Ear abnormalities. Recently hypogonadotropic hypogonadism and abnormal olfactory bulb development are occasionally described in CHARGE syndrome with chromodomain helicase DNA-binding protein 7 (CHD7) gene mutation. We report the case of Korean female patient with CHARGE syndrome and CHD7 mutation who had hypogonadotropic hypogonadism and abnormal olfactory bulb as manifested by delayed puberty and growth retardation at 13 years of age. She had both optic nerve coloboma, external ear abnormalities and bilateral agenesis of the semicircular canals. She had severe mental retardation and autistic-like behavior. We identified a heterozygous nonsense mutation at exon 20 of the CHD7 gene (c.4601G>A; Trp1534X).
CHARGE Syndrome ; Codon, Nonsense ; Coloboma ; Ear ; Ear, External ; Exons ; Fees and Charges ; Female ; Growth and Development ; Heart ; Humans ; Hypogonadism ; Intellectual Disability ; Nasopharynx ; Olfactory Bulb ; Optic Nerve ; Puberty, Delayed ; Semicircular Canals

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