[Show abstract][Hide abstract] ABSTRACT: In this study, we have investigated the role of leptin, soluble leptin receptor(sOb-R), resistin, and insulin secretory dynamics in the development of hypothalamic obesity.
Children who had hypothalamo-pituitary tumor were divided into two groups. First group included obese-overweight (hypothalamic obese = HOB group, n = 23) and second group included non-obese children (hypothalamic non-obese = HNOB group, n = 16). Exogenously obese-overweight children (OB group, n = 22) were included as controls. Basal and second-hour serum glucose and insulin in oral glucose tolerance test (OGTT), basal serum leptin, sOb-R, resistin levels, and homeostasis model assessment (HOMA) indexes were compared between the groups.
Age, sex, and pubertal status were similar in study groups. Median and interquartile ranges of body mass index (BMI) z scores were similar in HOB and OB groups (2.0 (1.5-2.1) and 2.1 (1.8-2.3), respectively). Serum leptin levels corrected for BMI were highest and total leptin/sOb-R ratios (free leptin index (FLI)) tended to be higher in HOB than HNOB and OB groups, indicating leptin resistance (leptin/BMI, 4.0 (1.6-5.2), 1.5 (0.8-3.1), and 2.5 (1.8-3.5); FLI, 2.0 (0.8-3.5), 0.6 (0.3-1.2), and 1.5 (1-2.3) in HOB, HNOB, and OB groups; respectively). Serum resistin levels were similar in groups (2.6 (1.9-3.1), 2.8 (1.7-3.4), and 3.0 (2.2-3.5) ng/ml in HOB, HNOB, and OB groups, respectively). Basal serum glucose, basal and second-hour insulin levels in OGTT, and HOMA index were higher in OB group than the HOB and HNOB groups, indicating insulin resistance in simple obesity; however, increment of insulin to same glycemic load in OGTT was highest in the HOB group indicating insulin dysregulation (p < 0.05).
Hypothalamic obesity seems to be related to both dysregulated afferent (leptin) and efferent (insulin) neural outputs through the autonomic nervous system resulting in energy storage as fat.
European Journal of Pediatrics 12/2008; 168(9):1043-8. DOI:10.1007/s00431-008-0876-x · 1.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Chickenpox is a common infectious disease of the pediatric age group with rare complications such as hemorrhagic varicella and arterial thrombotic purpura. Medical support is the mainstay of treatment in such cases but for the rescue of necrotic tissues, hyperbaric oxygen (HBO) therapy should be applied in addition to anticoagulant intervention. We report an infant with acute arterial thrombotic purpura which developed after varicella eruption and who made full recovery with the help of HBO as an adjunctive treatment modality. Fresh frozen plasma and low molecular weight heparin were given for prolonged prothrombin time and thromboemboli on the 2nd-4th digits of his right foot. Protein C, protein S and factor V levels were found to be normal in our patient. Necrotic lesions on the toes regressed with repeated HBO treatment and amputation was not needed.
The Turkish journal of pediatrics 46(3):256-8. · 0.43 Impact Factor