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Kordonouri O, Pankowska E, Rami B, Kapellen T, Coutant R, Hartmann R, Lange K, Remus K, Bläsig S, Marquardt E, Danne T. Ergebnisse der multizentrischen Pädiatrischen ONSET-Studie zur sensorunterstützten Pumpentherapie bei Typ 1 Diabetes im ersten Jahr der Erkrankung. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lange K, Danne T, Coutant R, Kapellen T, Pankowska E, Rami B, Krug N, Aschemeier B, Remus K, Bläsig S, Marquardt E, Hartmann R, Kordonouri O. Gute kindliche Lebensqualität und psychisches Wohlbefinden der Mütter: 12 Monatsdaten der ONSET-Studie zur sensorunterstützten Insulinpumpentherapie. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lange K, Coutant R, Danne T, Kapellen T, Pankowska E, Rami B, Aschemeier B, Bläsig S, Hartmann R, Krug N, Marquardt E, Walte K, Kordonouri O. Diabetesdiagnose bei Kindern: Beeinträchtigung der kindlichen Lebensqualität und affektive Anpassungsstörungen ihrer Mütter zu Beginn der Paediatric ONSET-Studie. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kapellen T, Wolf J, Rosenbauer J, Stachow R, Ziegler R, Szczepanski R, Holl R. Changes in the Use of Analogue Insulins in 37 206 Children and Adolescents with Type 1 Diabetes in 275 German and Austrian Centers during the Last Twelve Years. Exp Clin Endocrinol Diabetes 2009; 117:329-35. [DOI: 10.1055/s-0028-1103289] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Berghaeuser MA, Kapellen T, Heidtmann B, Haberland H, Klinkert C, Holl RW. Continuous subcutaneous insulin infusion in toddlers starting at diagnosis of type 1 diabetes mellitus. A multicenter analysis of 104 patients from 63 centres in Germany and Austria. Pediatr Diabetes 2008; 9:590-5. [PMID: 18503495 DOI: 10.1111/j.1399-5448.2008.00416.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Schmidt F, Herbst A, Wolf J, Kapellen T, Hofer S, Rabl W, Holl RW. Diabetes mellitus im Rahmen von genetischen Syndromen im Kindes- und Jugendalter – eine DPV-Wiss-Analyse. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lange K, Kleine T, Dunstheimer D, Etspüler J, Paape D, Lauterborn R, Jorch N, Kapellen T, Petersen M, Ludwig KH, Neu A, Danne T. Gute Lebensqualität von Kindern mit Typ 1 Diabetes und hohe Belastung der Eltern im ersten Jahr nach Diabetesdiagnose: Ergebnisse einer multizentrischen prospektiven Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heidtmann B, Hilgard D, Kapellen T, Schumacher A, Lepler R, Schober E, Holl R. Die Insulinpumpentherapie bei kleinen Kindern bis zum 6. Lebensjahr: Vergleich der Stoffwechselparameter vor und 6 bzw. 12 Monate nach CSII-Beginn. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-960522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wolf J, Kapellen T, Stachow R, Ziegler R, Szczepanski R, Holl RW. Die Anwendung von Analoginsulinen in der Pädiatrie – eine Bestandsaufnahme. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Galler A, Gelbrich G, Kratzsch J, Noack N, Kapellen T, Körner A, Kiess W. Erhöhte Adiponektinkonzentrationen im Serum bei Kindern und Jugendlichen mit Diabetes mellitus Typ 1. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kratzsch J, Knerr I, Galler A, Kapellen T, Raile K, Körner A, Thiery J, Dötsch J, Kiess W. Metabolic decompensation in children with type 1 diabetes mellitus associated with increased serum levels of the soluble leptin receptor. Eur J Endocrinol 2006; 155:609-14. [PMID: 16990661 DOI: 10.1530/eje.1.02261] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Type 1 diabetes mellitus (T1DM) leads to increased serum levels of the soluble leptin receptor (sOB-R) by an as yet unknown cellular mechanism. The aim of our study was to investigate potential metabolic factors that may be associated with the induction of the sOB-R release from its membrane receptor. MATERIALS AND METHODS Twenty-five children (aged between 1.5 and 17.0 years) were studied at the onset of T1DM. Blood samples were collected before (n = 25), during the first 18 h (mean +/- S.D. 11.1 +/- 4.3 h, n = 16) and 92 h (47.5 +/- 22.5 h; n = 14) after beginning insulin therapy. Serum sOB-R and leptin levels were determined by in-house immunoassays. RESULTS The sOBR-level and the molar sOB-R/leptin ratio were significantly higher before than after starting insulin treatment (P < 0.05). In contrast, leptin levels were significantly lower (P < 0.05) before insulin therapy. The correlation between sOB-R and blood glucose (r = 0.49; P < 0.05), as well as sOB-R with parameters of ketoacidosis, such as pH (r = -0.72), base excess (r = -0.70), and bicarbonate (r = -0.69) (P < 0.0001) at diagnosis of T1DM remained significant during the first 18 h of insulin treatment. Multiple regression analysis revealed that base excess predicted 41.0% (P < 0.001), age 16.4% (P < 0.05), and height SDS 13.9% (P < 0.01) of the sOB-R variance. CONCLUSIONS Metabolic decompensation in children with new onset T1DM is associated with dramatic changes of the leptin axis; serum levels of sOB-R are elevated and of leptin are reduced. The molar excess of sOB-R over leptin (median 11.3) in this condition may contribute to leptin insensitivity. Upregulation of the soluble leptin receptor appears to be a basic mechanism to compensate for intracellular substrate deficiency and energy-deprivation state.
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Kapellen T. Fistel nach Gallensteinperforation in das Duodenum. Dtsch Med Wochenschr 2006. [DOI: 10.1055/s-2006-941756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kapellen T. Manifestation eines Morbus Addison im Sinne eines Autoimmun-Polyendokrinopathie-Syndroms Typ 2 (APS-Typ 2: Diabetes mellitus Typ 1, Autoimmunthyreoiditis, Morbus Addison). Dtsch Med Wochenschr 2006. [DOI: 10.1055/s-2006-941743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gundlach S, Würz J, Schmutzer G, Hiermann P, Kapellen T, Galler A, Wudy S, Hauschild M, Kiess W, Brähler E. Gesundheitsbezogene Lebensqualität von Geschwistern an Diabetes mellitus Typ 1 erkrankter Kinder und Jugendlicher. Dtsch Med Wochenschr 2006; 131:1143-8. [PMID: 16705535 DOI: 10.1055/s-2006-941741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND INFORMATION A chronic illness in childhood or adolescents constitutes a drastic event for the whole family, especially for the healthy siblings. This could impair their quality of life. PATIENTS AND METHODS We designed a case-control-study in three centres (Leipzig, Giessen and Augsburg) with questionaires sent to 72 diabetic children, 71 of their siblings and 63 children of neighbourhood (controls) aged between 8 and 16 years. KINDL-Questionnaire was used for the study of the health-related quality of life of children and adolescents, supplemented by other appropriate items. RESULTS The results indicate a positive health related quality of life of the healthy siblings of families with a child who has type 1 diabetes. Differences in the quality of life depend on factors such as age and gender of the children and relate to specific items of sibling relationship (e. g. "worried about sibling", "looked after sibling"). Generally, there was a great similarity with regard to the quality of life of healthy brothers and sisters from affected families compared with children of families without a child suffering from chronic illness. CONCLUSIONS The results indicate that the health related quality of life of healthy siblings of children with diabetes only differs insignificantly from brothers and sisters of "healthy" families.
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Würz J, Brähler E, Kapellen T, Galler A, Kiess W. Dyadisches Coping (paarbezogene Stressbewältigung) bei Eltern von Kindern und Jugendlichen mit Diabetes mellitus Typ 1. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lange K, Kleine T, Dunstheimer D, Etspüler J, Paape D, Lauterborn R, Jorch N, Kapellen T, Petersen M, Ludwig KH, Serra E, Danne T. Struktur und Ergebnisse der Initialschulung der Eltern von Kindern mit Typ 1 Diabetes: eine multizentrische Evaluation. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Würz J, Gundlach S, Hiermann P, Kapellen T, Galler A, Wudy S, Hauschild M, Brähler E, Kiess W. „Vergessene“ Geschwister? – Lebensqualität von Geschwistern von an Diabetes mellitus Typ 1 erkrankten Kindern und Jugendlichen. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Galler A, Kapellen T, Schulz M, Kiess W. Fallbericht: Hirnödem und Hirninfarkt der Arteria cerebri posterior bei Manifestation eines Diabetes mellitus Typ 1 bei einem 2½ Jahre altem Kleinkind. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kapellen T, Heidtmann B, Bachmann J, Ziegler R, Holl R. Die Insulinpumpe im Kindes- und Jugendalter: Unterschiede in den einzelnen Altersgruppen hinsichtlich der Therapieziele und deren Verwirklichung. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rohrer T, Grabert M, Holterhus PM, Kapellen T, Knerr I, Mix M, Holl R, Initiative DPV. Das Menarchealter ist abhängig von der relativen Diabetes-Dauer und der Qualität der Diabetes-Einstellung. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Heidtmann B, Hilgard D, Kapellen T, Schumacher A, Holl RW. Die Insulinpumpentherapie bei kleinen Kindern bis zum 6. Lebensjahr: Vergleich der Stoffwechselparameter vor und 12 Monate nach CSII-Beginn. Auswertung der DPV-Wiss-Daten für die Insulinpumpen-AG und die DPV-Wiss-Initiative. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Reinehr T, Andler W, Kapellen T, Kiess W, Richter-Unruh A, Schönau E, Seewi O, Heinze E, Wabitsch M. Clinical characteristics of type 2 diabetes mellitus in overweight European caucasian adolescents. Exp Clin Endocrinol Diabetes 2005; 113:167-70. [PMID: 15789276 DOI: 10.1055/s-2005-837522] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM To present the clinical features of Type 2 diabetes mellitus (T2DM) in overweight European Caucasian children and adolescents. METHODS We report the clinical characteristics of 16 non-syndromal overweight European Caucasian adolescents with T2DM (10 boys, 6 girls, SDS-BMI in median +2.8, range +1.6 to +3.4) treated in 5 specialised centres for obesity and diabetes. RESULTS None of the adolescents manifested with ketoacidosis. 13 were asymptomatic (3 adolescents with polyuria), 12 showed features of metabolic syndrome (dyslipidaemia or hypertension), 8 demonstrated acanthosis nigricans and 12 had relatives with T2DM. 11 adolescents were extremely obese and all patients were pubertal. Mean age at diagnosis was 14.2 years (range 11.0 - 16.9). Median insulin was 19 microU/ml, insulin resistance index (HOMA) 8.5, C-peptide 2.3 ng/ml, HbA1c 6.9 %, fasting blood glucose 176 mg/dl and blood glucose at 2 hours with the oGTT 229 mg/dl at manifestation. Fasting blood glucose and HBA1c were in the normal range in 4 and 6 adolescents respectively, while oGTT always fitted the diagnosis of T2DM. CONCLUSION Since T2DM occurred in Caucasian overweight adolescents and is frequently asymptomatic, it is essential that clinicians perform diagnostic procedures to identify T2DM in high-risk groups of overweight Caucasian adolescents (extreme obesity, features of metabolic syndrome, relatives with T2DM).
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Kratzsch J, Deimel A, Galler A, Kapellen T, Klinghammer A, Kiess W. Increased serum soluble leptin receptor levels in children and adolescents with type 1 diabetes mellitus. Eur J Endocrinol 2004; 151:475-81. [PMID: 15476448 DOI: 10.1530/eje.0.1510475] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We investigated whether or not serum levels of the soluble leptin receptor (sOB-R) and leptin are related to anthropometric and metabolic changes during pubertal development of children and adolescents with type 1 diabetes mellitus. DESIGN AND METHODS Blood levels of sOB-R, leptin and HbA1C, as well as body-mass index (BMI), diabetes duration and daily insulin doses, were determined in 212 (97 girls; 115 boys) children with type 1 diabetes mellitus and compared with the sOB-R serum levels in 526 healthy children and adolescents. RESULTS OB-R serum levels and parallel values of the molar ratio between sOB-R and leptin were significantly higher in children with diabetes than in normal children (P<0.05) in almost all investigated Tanner stages. Furthermore, in the entire group of patients, we demonstrated statistically significant correlations (P<0.02) between sOB-R and the duration of diabetes (r=0.30), HbA1c levels (r=0.32) and the insulin dose (r=0.18). Multiple-regression analysis revealed that HbA1c (12.4%), height (7.9%) and duration of diabetes (8.7%) contributed to 29% variance of sOB-R in diabetic children. CONCLUSIONS Our data suggest that poor glycemic control in diabetes may lead to increased serum levels of sOB-R. This regulation of sOB-R appears to be independent of leptin, but may have an impact on leptin action. The consequently developing molar excess of sOB-R related to leptin could reduce leptin sensitivity and may, therefore, influence leptin-related anthropometric and metabolic abnormalities.
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Kiess W, Böttner A, Raile K, Kapellen T, Müller G, Galler A, Paschke R, Wabitsch M. Type 2 diabetes mellitus in children and adolescents: a review from a European perspective. Horm Res Paediatr 2003; 59 Suppl 1:77-84. [PMID: 12566725 DOI: 10.1159/000067829] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Changes in food consumption and exercise are fueling a worldwide increase in obesity in children and adolescents. As a consequence of this dramatic development, an increasing rate of type 2 diabetes mellitus has been recorded in children and adolescents in the USA and, more recently, in many countries around the world. Both genetic and environmental factors contribute to the pathogenesis of type 2 diabetes. Lower susceptibility in white Caucasians and higher susceptibility in Asians, Hispanics and blacks have been noted. There is a high hidden prevalence and a lack of exact data on the epidemiology of the disease in Europe: in Germany only 70 patients below the age of 15 years were identified in the systematic, nationwide DPV (Diabetessoftware für prospektive Verlaufsdokumentation) diabetes survey, but our calculations suggest that more than 5000 young people in Germany at present would meet the diagnostic criteria of type 2 diabetes. In Australasia, the prevalence of type 2 diabetes is reportedly high in some ethnic groups and again is linked very closely to the obesity epidemic. No uniform and evidence-based treatment strategy is available: many groups use metformin, exercise programmes and nutritional education as a comprehensive approach to treat type 2 diabetes in childhood and adolescence. The lack of clear epidemiological data and a strong need for accepted treatment strategies point to the key role of preventive programmes. Prevention of obesity will help to counteract the emerging worldwide epidemic of type 2 diabetes in youth. Preventive programmes should focus on exercise training and reducing sedentary behaviour such as television viewing, encouraging healthy nutrition and supporting general education programmes since shorter school education is clearly associated with higher rates of obesity and hence the susceptibility of an individual to acquire type 2 diabetes.
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Kiess W, Galler A, Reich A, Müller G, Kapellen T, Deutscher J, Raile K, Kratzsch J. Clinical aspects of obesity in childhood and adolescence. Obes Rev 2001; 2:29-36. [PMID: 12119634 DOI: 10.1046/j.1467-789x.2001.00017.x] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The level of fatness of a child at which morbidity acutely and/or later in life increases is determined on an acturial basis. Direct measurements of body fat content, e.g. hydrodensitometry, bioimpedance, or DEXA, are useful tools in scientific studies. However, body mass index (BMI) is easy to calculate and is generally accepted now to be used to define obesity in children and adolescents clinically. An increased risk of death from cardiovascular disease in adults has been found in subjects whose BMI had been greater than the 75th percentile as adolescents. Childhood obesity seems to substantially increase the risk of subsequent morbidity whether or not obesity persists into adulthood. The genetic basis of childhood obesity has been elucidated to some extent through the discovery of leptin, the ob gene product, and the increasing knowledge on the role of neuropeptides such as POMC, neuropeptide Y (NPY) and the melanocyte concentrating hormone receptors (for example, MC4R). Environmental/exogenous factors largely contribute to the development of a high degree of body fatness early in life. Twin studies suggest that approximately 50% of the tendency toward obesity is inherited. There are numerous disorders including a number of endocrine disorders (Cushing's syndrome, hypothyroidism, etc.) and genetic syndromes (Prader-Labhard-Willi syndrome, Bardet Biedl syndrome, etc.) that can present with obesity. A simple diagnostic algorithm allows for the differentiation between primary or secondary obesity. Among the most common sequelae of primary childhood obesity are hypertension, dyslipidemia, back pain and psychosocial problems. Therapeutic strategies include psychological and family therapy, lifestyle/behaviour modification and nutrition education. The role of regular exercise and exercise programmes is emphasized. Surgical procedures and drugs used in adult obesity are still not generally recommended in children and adolescents with obesity. As obesity is the most common chronic disorder in industrialized societies, its impact on individual lives as well as on health economics has to be recognized more widely. This review is aimed towards defining the clinical problem of childhood obesity on the basis of current knowledge and towards outlining future research areas in the field of energy homoesostasis and food intake in relation to child health. Finally, one should aim to increase public awareness of the ever increasing health burden and economic dimension of the childhood obesity epidemic that is present around the globe.
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