ABSTRACT: Pediatric obesity continues to rise and has become a major health problem worldwide. Vitamin D deficiency has been increasing among obese non-Asian children and is associated with abnormal glucose homeostasis in obese adults. However, data on the vitamin D status and its association with glucose homeostasis in obese children residing in tropical Asian countries are unavailable.
To assess vitamin D status and glucose homeostasis in obese Thai children.
A total of 150 obese, and 29 healthy non-obese children and adolescents were enrolled. Weight, height, body mass index (BMI) and waist circumference were obtained. All obese children underwent an oral glucose tolerance test with glucose and insulin measurements. Plasma 25-hydroxyvitamin D (25-OHD) and calciotropic blood chemistries were measured in all participants. Insulin sensitivity indices were calculated from the measured glucose and insulin levels.
Approximately 25% of the obese children and adolescents had impaired glucose tolerance, impaired fasting plasma glucose (FPG) and diabetes. Seventeen out of 150 (11.3%) obese children and 3 out of 29 (10.3%) non-obese children had vitamin D deficiency, which was defined as a 25-OHD level of <50 nmol l(-1). Glucose tolerance and insulin sensitivity indices were comparable between obese children with sufficient vitamin D and those with vitamin D deficiency. There were no relationships among serum 25-OHD; weight, height, and BMI standard deviation scores; insulin sensitivity indices; FPG and insulin; and 2-h plasma glucose and insulin levels.
Vitamin D deficiency is not as prevalent in obese Thai children as in obese non-Asian children from high-latitude countries. Adiposity per se is unlikely to be a determinant of vitamin D status in these obese individuals. There was no association between vitamin D deficiency and abnormal glucose homeostasis.
International journal of obesity (2005) 01/2012; 36(4):491-5. · 4.34 Impact Factor
ABSTRACT: Traumatic brain injury (TBI)-mediated hypopituitarism is an increasingly recognised problem. Paediatric survivors of TBI may be vulnerable to the possible effects of pituitary deficits as pituitary hormones control normal growth and development. Research concerning pituitary dysfunction following childhood TBI is limited.
To identify pituitary dysfunction in paediatric survivors of severe TBI.
Of 1020 children who sustained a TBI and were admitted to the Royal Children's Hospital, Melbourne, Australia over 10 years, 117 were identified as survivors of severe TBI. 54 patients (31 males) were enrolled and administered questionnaires regarding quality of life and possible endocrine dysfunction. Where indicated, hormone testing was performed.
29 of the 54 patients underwent hormonal investigations, while 21 who had satisfactory questionnaires did not (four patients had already been diagnosed with pituitary deficiencies). In those 29 patients, TBI occurred at ages ranging from 0.25 to 16.80 years (median 9.7 years). Time from TBI to study ranged from 0.9 to 8.5 years (median 4.5 years). Of the 54 patients, nine had pituitary dysfunction, of whom four had multiple pituitary hormone deficiencies.
Our study that confirms that paediatric survivors of severe TBI may develop pituitary dysfunction. Pituitary function should therefore be determined in these patients.
Archives of Disease in Childhood 03/2008; 93(2):133-7. · 2.88 Impact Factor
ABSTRACT: Background/Aim: Children with β-thalassemia have chronic anemia and growth retardation. Impaired growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis function has been demonstrated. Growth improvement has been demonstrated following optimal blood transfusion. Whether correction of anemia by blood transfusion augments GH-IGF-1 axis function has not been established. Methods: Twenty children with thalassemia aged 11.7 years (5.3–16.3 years) were recruited. GH provocative tests were performed twice, before and 1 week after blood transfusion. IGF-1, IGF-binding protein-3 (IGFBP-3) and hematocrit were measured. Results: Median IGF-1 and IGFBP-3 concentrations were significantly increased at 1 week following transfusion: pre- versus posttransfused concentrations: 86.4 versus 143.5 ng/ml (p < 0.001) and 2.95 versus 3.75 mg/l (p < 0.001), respectively. However, median peak GH levels and areas under the curve of GH during GH testing between pre- and posttransfusion periods were not different. The pretransfused hematocrit level was correlated with pretransfused IGF-1 (r = 0.662, p < 0.001) and IGFBP-3 (r = 0.691, p < 0.001) levels. Conclusions: In thalassemics, correction of anemia by blood transfusion rapidly enhanced GH-mediated IGF-1 and IGFBP-3 secretion. This suggests thatanemia may be one of the factors causing partial GH insensitivity.
Hormone Research in Paediatrics 08/1970; 75(4):240-245.
ABSTRACT: A worldwide secular trend towards earlier onset of puberty in girls has been noted during recent years. However, the data on sexual maturation of boys are relatively scarce and normative data of sexual maturation in Thai boys are still lacking.
To determine the age of secondary sexual maturation in normal Thai boys.
Three hundred healthy urban boys aged 9-18 years were recruited during January 1997 to December 1999. Genital and pubic hair maturity staging was determined using the method of Marshall and Tanner. Testicular size was assessed by Prader orchidometer. Probit analysis was used to analyze the onset of puberty (gonadarche) and pubarche.
Median (range) ages of the onset of puberty and pubarche were 10.8 (9.5-12) and 12.4 (10.9-13.9) years, respectively.
The age of onset of genital development in boys living in Bangkok seems to be slightly earlier than that of boys in other countries. However, the onset of pubic hair development is comparable.
Journal of pediatric endocrinology & metabolism: JPEM 23(1-2):65-71. · 0.88 Impact Factor