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Glukokortikoide bei nichtendokrinen Erkrankungen, bei Kortisolmangel und bei endogenem Exzess – der Einfluss therapeutischer Strategien auf das kindliche Wachstum. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-019-0697-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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2
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Filippidou M, Petropoulou T, Botsa E, Vasilakis IA, Smyrnaki P, Orfanou I, Kaditis A, Kanaka-Gantenbein C. ROHHAD syndrome - A still unrecognized cause of childhood obesity: report of three cases. J Pediatr Endocrinol Metab 2020; 33:1341-1348. [PMID: 32990648 DOI: 10.1515/jpem-2020-0111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 07/09/2020] [Indexed: 11/15/2022]
Abstract
Objectives Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is a rare, potentially fatal, pediatric syndrome. Case presentations We describe three cases of ROHHAD-syndrome in Greece. The main and earliest symptom was the excessive and rapid weight gain at 5, 2, and 3 years of age. Years after the onset of obesity, the patients developed hypothalamic dysfunction with various endocrinological abnormalities (at 9, 8, and 6.8 years, respectively), autonomic dysregulation and finally, alveolar hypoventilation (at 14.6, 8, and 7.8 years, respectively), leading to the diagnosis of ROHHAD-syndrome. Conclusions The rarity of the syndrome, the variable symptoms' presentation, and the lack of specific diagnostic tests could explain why no previous cases have been reported from our country. The rapid onset of obesity was underestimated, and the patients were misdiagnosed with other more common obesity syndromes. Therefore, we propose a questionnaire to help physicians identify patients with ROHHAD-syndrome.
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Affiliation(s)
- Maria Filippidou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
| | - Theoni Petropoulou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
| | - Evanthia Botsa
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
| | - Ioannis-Anargyros Vasilakis
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
| | - Penelope Smyrnaki
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
| | - Irene Orfanou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
| | - Athanasios Kaditis
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, «Aghia Sophia» Children's Hospital, Athens, Greece
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Peng JX, Yang L, Huang GL, Liu Y, Zhang SC, Pan J, Qi ST. Development of a novel score to predict probability of growth without growth hormone after resection of paediatric craniopharyngiomas: relative to tumour growth pattern. J Endocrinol Invest 2020; 43:737-747. [PMID: 31853886 DOI: 10.1007/s40618-019-01154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Some patients with paediatric craniopharyngiomas (PCs) showed normal growth despite growth hormone deficiency, which is known as growth without GH (GWGH); however, its mechanism remains unclear. We aimed to develop a novel clinical score to predict the probability of GWGH in PCs. METHODS A total of 708 PC patients were prospectively enrolled from six hospitals, among which 431 patients were finally included. Data from four of the six hospitals (n = 325) were used to develop the innovative clinical score (ICS), which was further validated using the data from the other two hospitals (n = 106). To establish and validate the ICS, sequential logistic regression was used to analyse the clinical characteristics including tumour growth pattern and tumour size and so on. Furthermore, C-statistic was employed to calibrate the discriminatory ability of the established clinical score, while a calibration plot was adopted for further assessment. RESULTS The overall incidence of GWGH was 16.9% (73/431). The ICS ranged from 2 to 23, with an optimism-corrected C-statistic of 0.820, Furthermore, the optimism-corrected C-statistic of external validation was 0.835, indicating good discriminatory power and robustness of the clinical score. Additionally, no apparent overestimation or underestimation was observed in the calibration plots, which showed excellent calibration power of the clinical score. CONCLUSIONS Based on tumour growth patterns and PC patients' clinical characteristics, individualized surgical strategies were promising to achieve long-term effective management of PC patients. The ICS is valuable for the evaluation of probability of developing postoperative GWGH. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov ID: NCT00949156.
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Affiliation(s)
- J X Peng
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - L Yang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - G L Huang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Y Liu
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - S C Zhang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - J Pan
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - S T Qi
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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El Kholy M, Elsedfy H, Perin L, Abi Habid W, Thibaud N, Bozzola M, Rossignol S, Leneuve P, Godeau F, Chantot-Bastaraud S, Netchine I, Le Bouc Y. Normal Growth despite Combined Pituitary Hormone Deficiency. Horm Res Paediatr 2020; 92:133-142. [PMID: 31022718 DOI: 10.1159/000499318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 02/27/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The paradox of normal growth despite a lack of growth hormone (GH) is an unexplained phenomenon described in some pathological (sellar, suprasellar, and hypothalamic disorders) and overgrowth syndromes. It has been suggested that the paradoxical growth is due to other GH variants, GH-like moieties, prolactin, insulin, insulin-like growth factors (IGFs), and unidentified serum factors or growth mechanisms. The objective of this study was to determine the mechanism underlying this normal growth without GH. CASE DESCRIPTION We describe here growth, hormonal, and genetic analyses for an adolescent boy with panhypopituitarism who achieved an adult height above his genetic potential. RESULTS Normal growth was observed despite low serum GH, IGF-I, IGF-II, IGF binding protein 3 (IGFBP-3) and acid labile subunit (ALS) concentrations, but the IGF-II/IGFBP-3 molar ratio was slightly high. Panhypopituitarism was associated with a heterozygous missense mutation of HESX1, with variable penetrance in heterozygous relatives. Exome analysis detected heterozygous missense mutations of various genes involved in intracellular signaling pathways. The growth-promoting activity of the patient's serum was unable to induce AKT phosphorylation in the MCF-7 cell line. CONCLUSION The high IGF-II/IGFBP-3 molar ratio was not the cause of the sustained high growth velocity, due to the low affinity of IGF-II for IGF type 1 receptor. The key finding was the HESX1 mutation, as similar cases have been described before, suggesting a common mechanism for growth without GH. However, the variable penetrance of this variant in heterozygous relatives suggests that modifier genes or mechanisms involving combinations with mutations of other genes involved in intracellular signaling pathways might be responsible.
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Affiliation(s)
| | - Heba Elsedfy
- Department of Pediatrics, Ain Shams University, Cairo, Egypt
| | - Laurence Perin
- Explorations Fonctionnelles et génétique endocriniennes, Hôpital Armand-Trousseau, AP-HP, Paris, France
| | - Walid Abi Habid
- Unité Mixe Recherche Scientifique 938, Centre de Recherche St-Antoine (CRSA), Institut National de la Santé et de la Recherche Médicale, Université Pierre et Marie Curie Paris 6, Sorbonne Université, Paris, France
| | - Nathalie Thibaud
- Explorations Fonctionnelles et génétique endocriniennes, Hôpital Armand-Trousseau, AP-HP, Paris, France
| | - Mauro Bozzola
- Unit of Pediatrics and Adolescentology, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Sylvie Rossignol
- Explorations Fonctionnelles et génétique endocriniennes, Hôpital Armand-Trousseau, AP-HP, Paris, France.,Unité Mixe Recherche Scientifique 938, Centre de Recherche St-Antoine (CRSA), Institut National de la Santé et de la Recherche Médicale, Université Pierre et Marie Curie Paris 6, Sorbonne Université, Paris, France
| | - Patricia Leneuve
- Unité Mixe Recherche Scientifique 938, Centre de Recherche St-Antoine (CRSA), Institut National de la Santé et de la Recherche Médicale, Université Pierre et Marie Curie Paris 6, Sorbonne Université, Paris, France
| | - François Godeau
- Unité Mixe Recherche Scientifique 938, Centre de Recherche St-Antoine (CRSA), Institut National de la Santé et de la Recherche Médicale, Université Pierre et Marie Curie Paris 6, Sorbonne Université, Paris, France
| | | | - Irène Netchine
- Explorations Fonctionnelles et génétique endocriniennes, Hôpital Armand-Trousseau, AP-HP, Paris, France.,Unité Mixe Recherche Scientifique 938, Centre de Recherche St-Antoine (CRSA), Institut National de la Santé et de la Recherche Médicale, Université Pierre et Marie Curie Paris 6, Sorbonne Université, Paris, France
| | - Yves Le Bouc
- Explorations Fonctionnelles et génétique endocriniennes, Hôpital Armand-Trousseau, AP-HP, Paris, France, .,Unité Mixe Recherche Scientifique 938, Centre de Recherche St-Antoine (CRSA), Institut National de la Santé et de la Recherche Médicale, Université Pierre et Marie Curie Paris 6, Sorbonne Université, Paris, France,
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Yu T, Chang G, Cheng Q, Yao R, Li J, Xu Y, Li G, Ding Y, Qing Y, Li N, Shen Y, Wang X, Wang J. Increased transactivation and impaired repression of β-catenin-mediated transcription associated with a novel SOX3 missense mutation in an X-linked hypopituitarism pedigree with modest growth failure. Mol Cell Endocrinol 2018; 478:133-140. [PMID: 30125608 DOI: 10.1016/j.mce.2018.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/14/2018] [Accepted: 08/15/2018] [Indexed: 01/01/2023]
Abstract
SOX3, a transcription factor of the SRY-related high mobility group box family, has been implicated in the etiology of X-linked hypopituitarism. Here, we report a Chinese pedigree of X-linked hypopituitarism with variable phenotypes. Despite the complete growth hormone deficiency, the growth failure of the patients was relatively modest. A rare point variant of SOX3 (c.424C > A; p. P142T) was identified in the pedigree via target panel sequencing. An in vitro study showed that both the expression and nuclear targeting of SOX3 remained unaffected by the variant. However, increased transcriptional activation and impaired repression of β-catenin-mediated transcription were noticed as a result of the SOX3 variant. This is the first study to report that the rare SOX3 missense variant associated with hypopituitarism possibly due to increased activation of SOX3 target genes and disregulation of β-catenin target genes. In addition, we have expanded the phenotypic spectrum associated with SOX3 mutations.
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Affiliation(s)
- Tingting Yu
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guoying Chang
- Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qing Cheng
- Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruen Yao
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Juan Li
- Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yufei Xu
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guoqiang Li
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Ding
- Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanrong Qing
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Niu Li
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiping Shen
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China; Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA
| | - Xiumin Wang
- Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Jian Wang
- Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Lee SS, Han AL, Ahn MB, Kim SH, Cho WK, Cho KS, Park SH, Jung MH, Suh BK. Growth without growth hormone in combined pituitary hormone deficiency caused by pituitary stalk interruption syndrome. Ann Pediatr Endocrinol Metab 2017; 22:55-59. [PMID: 28443260 PMCID: PMC5401823 DOI: 10.6065/apem.2017.22.1.55] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/21/2016] [Accepted: 11/09/2016] [Indexed: 01/13/2023] Open
Abstract
Growth hormone (GH) is an essential element for normal growth. However, reports of normal growth without GH have been made in patients who have undergone brain surgery for craniopharyngioma. Normal growth without GH can be explained by hyperinsulinemia, hyperprolactinemia, elevated leptin levels, and GH variants; however, its exact mechanism has not been elucidated yet. We diagnosed a female patient aged 13 with combined pituitary hormone deficiency (CPHD) caused by pituitary stalk interruption syndrome (PSIS). The patient has experienced recurrent hypoglycemic seizures since birth, but reached the height of 160 cm at the age of 13, showing normal growth. She grew another 8 cm for 3 years after the diagnosis, and she reached her final adult height of 168 cm which was greater than the midparental height, at the age of 16. The patient's blood GH and insulin-like growth factor-I levels were consistently subnormal, although her insulin levels were normal. Her physical examination conducted at the age of 15 showed truncal obesity, dyslipidemia, and osteoporosis, which are metabolic features of GH deficiency (GHD). Herein, we report a case in which a PSIS-induced CPHD patient attained her final height above mid parental height despite a severe GHD.
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Affiliation(s)
- Sang Soo Lee
- Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
| | - A-Leum Han
- Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
| | - Moon Bae Ahn
- Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Shin Hee Kim
- Department of Pediatrics, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Won Kyoung Cho
- Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyoung Soon Cho
- Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
| | - So Hyun Park
- Department of Pediatrics, St. Vincent Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Min Ho Jung
- Department of Pediatrics, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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7
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Shtaif B, Dror N, Bar-Maisels M, Phillip M, Gat-Yablonski G. Growth without growth hormone: can growth and differentiation factor 5 be the mediator? Growth Factors 2015; 33:309-18. [PMID: 26393787 DOI: 10.3109/08977194.2015.1082557] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Growth without growth hormone (GH) is often observed in the setup of obesity; however, the missing link between adipocytes and linear growth was until now not identified. 3T3L1 cells were induced to differentiate into adipocytes and their conditioned medium (CM) (adipocytes CM, CMA) was added to metatarsals bone culture and compared to CM derived from undifferentiated cells. CMA significantly increased metatarsals bone elongation. Adipogenic differentiation increased the expression of growth and differentiation factor (GDF)-5, also found to be secreted into the CMA. GDF-5 significantly increased metatarsal length in culture; treatment of the CMA with anti-GDF-5 antibody significantly reduced the stimulatory effect on bone length. The presence of GDF-5 receptor (bone morphogenetic protein receptor; BMPR1) in metatarsal bone was confirmed by immunohistochemistry. Animal studies in rodents subjected to food restriction followed by re-feeding showed an increase in GDF-5 serum levels concomitant with nutritional induced catch up growth. These results show that adipocytes may stimulate bone growth and suggest an additional explanation to the growth without GH phenomenon.
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Affiliation(s)
- Biana Shtaif
- a Felsentein Medical Research Center , Petach Tikva , Israel
- b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel , and
| | - Nitzan Dror
- c The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petach Tikva , Israel
| | - Meytal Bar-Maisels
- a Felsentein Medical Research Center , Petach Tikva , Israel
- c The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petach Tikva , Israel
| | - Moshe Phillip
- a Felsentein Medical Research Center , Petach Tikva , Israel
- b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel , and
- c The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petach Tikva , Israel
| | - Galia Gat-Yablonski
- a Felsentein Medical Research Center , Petach Tikva , Israel
- b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel , and
- c The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petach Tikva , Israel
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8
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August GP, Caprio S, Fennoy I, Freemark M, Kaufman FR, Lustig RH, Silverstein JH, Speiser PW, Styne DM, Montori VM. Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab 2008; 93:4576-99. [PMID: 18782869 PMCID: PMC6048599 DOI: 10.1210/jc.2007-2458] [Citation(s) in RCA: 354] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 08/29/2008] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Our objective was to formulate practice guidelines for the treatment and prevention of pediatric obesity. CONCLUSIONS We recommend defining overweight as body mass index (BMI) in at least the 85th percentile but < the 95th percentile and obesity as BMI in at least the 95th percentile against routine endocrine studies unless the height velocity is attenuated or inappropriate for the family background or stage of puberty; referring patients to a geneticist if there is evidence of a genetic syndrome; evaluating for obesity-associated comorbidities in children with BMI in at least the 85th percentile; and prescribing and supporting intensive lifestyle (dietary, physical activity, and behavioral) modification as the prerequisite for any treatment. We suggest that pharmacotherapy (in combination with lifestyle modification) be considered in: 1) obese children only after failure of a formal program of intensive lifestyle modification; and 2) overweight children only if severe comorbidities persist despite intensive lifestyle modification, particularly in children with a strong family history of type 2 diabetes or premature cardiovascular disease. Pharmacotherapy should be provided only by clinicians who are experienced in the use of antiobesity agents and aware of the potential for adverse reactions. We suggest bariatric surgery for adolescents with BMI above 50 kg/m(2), or BMI above 40 kg/m(2) with severe comorbidities in whom lifestyle modifications and/or pharmacotherapy have failed. Candidates for surgery and their families must be psychologically stable and capable of adhering to lifestyle modifications. Access to experienced surgeons and sophisticated multidisciplinary teams who assess the benefits and risks of surgery is obligatory. We emphasize the prevention of obesity by recommending breast-feeding of infants for at least 6 months and advocating that schools provide for 60 min of moderate to vigorous daily exercise in all grades. We suggest that clinicians educate children and parents through anticipatory guidance about healthy dietary and activity habits, and we advocate for restricting the availability of unhealthy food choices in schools, policies to ban advertising unhealthy food choices to children, and community redesign to maximize opportunities for safe walking and bike riding to school, athletic activities, and neighborhood shopping.
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Affiliation(s)
- Gilbert P. August
- Professor Emeritus of Pediatrics, George Washington University School of Medicine (G.P.A.), Washington, D.C. 20037
| | - Sonia Caprio
- Yale University School of Medicine (S.C.), New Haven, Connecticut 06510
| | - Ilene Fennoy
- Columbia University (I.F.), New York, New York 10027
| | - Michael Freemark
- Duke University Medical Center (M.F.), Durham, North Carolina 27710
| | | | - Robert H. Lustig
- University of California San Francisco (R.H.L.), San Francisco, California 94143
| | | | | | - Dennis M. Styne
- University of California–Davis Medical Center (D.M.S.), Sacramento, California 95817
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Ben-Eliezer M, Phillip M, Gat-Yablonski G. Leptin regulates chondrogenic differentiation in ATDC5 cell-line through JAK/STAT and MAPK pathways. Endocrine 2007; 32:235-44. [PMID: 18080100 DOI: 10.1007/s12020-007-9025-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 07/23/2007] [Accepted: 09/12/2007] [Indexed: 12/19/2022]
Abstract
Leptin, the satiety hormone, has been found to affect growth-plate cartilage development. In the present study, some of the signal transduction pathways that mediate leptin signaling in the ATDC5 chondrogenic cell-line, a model for endochondral ossification, were analyzed. For this purpose, real-time PCR, Western blots and immunofluorescence techniques were used. It was found that leptin increased phosphorylation of ERK1/2, p38, and STAT3 in a time- and dose-dependent manner. Specific inhibition of STAT3 or ERK1/2, but not of P38, blocked the stimulatory effect of leptin on type X collagen mRNA levels. Moreover, leptin induced the translocation of ERK1/2 into the nucleus, as well as c-fos expression, indicating full activation of this cascade. Leptin-induced JNK phosphorylation was not observed, although leptin significantly and rapidly increased JNK protein levels and c-jun mRNA levels. In addition, ERK5 was identified in these cells, but there was no apparent effect of leptin on either its phosphorylation or protein level. The study indicates that the effects of leptin on growth-plate chondrocytes are specifically mediated through ERK1/2 and STAT3, while P38 is not essential for leptin-induced type X collagen expression. This is the first demonstration that these pathways are involved in leptin-induced growth.
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Affiliation(s)
- Miri Ben-Eliezer
- Felsenstein Medical Research Center, 14 Kaplan Street, Petach Tikva, 49202, Israel
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10
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Petraroli M, D'Alessio E, Ausili E, Barini A, Caradonna P, Riccardi R, Caldarelli M, Rossodivita A. Bone mineral density in survivors of childhood brain tumours. Childs Nerv Syst 2007; 23:59-65. [PMID: 17058089 DOI: 10.1007/s00381-006-0175-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Osteopenia has been reported in children surviving acute lymphoblastic leukaemia, apparently as consequence of therapy. Few studies have been published on bone mineral density (BMD) evaluation in children surviving from brain tumours. The endocrine system in these patients is frequently affected as consequence of therapeutic interventions such as cranial irradiation and anti-neoplastic agents: growth hormone deficiency is the most common adverse sequel. The pathogenesis of osteopenia in brain cancer survivors is multi-factorial but still uncertain. OBJECTIVE The aim of this study is to examine bone mass in 12 brain cancer survivors and its relationship with their hormonal status. RESULTS AND DISCUSSION We observed that most of the patients had a BMD that was lower than normal in both the lumbar column and in the femoral neck. Bone mass loss was higher in the lumbar region rather than in the femoral neck, due to spinal radiation therapy and to the effect of hormonal deficiencies. Particularly hypogonadism, but also multiple hormonal deficiencies, are associated with lower BMD values. Experience in clinical care of these patients suggests the importance of periodic evaluations of BMD, especially in those with secondary hormone deficiencies. Moreover, the periodic assessment of the hypothalamus-pituitary function is essential for an early diagnosis of hormonal insufficiency, primarily hypogonadism, to precociously detect bone mineral loss and to prevent pathological fractures, thus improving the quality of life.
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Affiliation(s)
- M Petraroli
- Department of Paediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
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11
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Ahmad T, Garcia-Filion P, Borchert M, Kaufman F, Burkett L, Geffner M. Endocrinological and auxological abnormalities in young children with optic nerve hypoplasia: a prospective study. J Pediatr 2006; 148:78-84. [PMID: 16423602 DOI: 10.1016/j.jpeds.2005.08.050] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2005] [Revised: 07/15/2005] [Accepted: 08/15/2005] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the prevalence of endocrinopathies, neuroradiographical findings, and growth derangements in young children with optic nerve hypoplasia (ONH). STUDY DESIGN A prospective observational study examined the prevalence of endocrinopathies at study enrollment and growth patterns in children with ONH. Subjects (n = 47, mean +/- SD 15.2 +/- 10.6 months) were followed until 59.0 +/- 6.2 months of age. RESULTS The prevalence of endocrinopathies was 71.7%: 64.1% of subjects had growth hormone (GH) axis abnormalities, 48.5% hyperprolactinemia, 34.9% hypothyroidism, 17.1% adrenal insufficiency, and 4.3% diabetes insipidus (DI). Endocrinopathies were not associated with ONH laterality, absence of the septum pellucidum, or pituitary abnormalities on neuroimaging. End height standard deviation score (SDS) was similar to start length SDS independent of GH surrogate status. A significant increase in end weight SDS was found for the cohort (p < .001). A body mass index (BMI) >85th percentile was noted in 44.4% of the cohort and in 52.1% of subjects with GH axis abnormalities. Initial hyperprolactinemia was positively associated with increased end BMI SDS (p = .004). CONCLUSIONS These prospective findings confirm the high prevalence of pituitary endocrinopathies in children with ONH reported in previous retrospective studies. Our data reveal that some of these children maintain normal height velocity despite GH axis abnormalities, and, as a group, they are at high risk for increased BMI.
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Affiliation(s)
- Tariq Ahmad
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, USC Keck School of Medicine and Childrens Hospital Los Angeles, Los Angeles, CA 90027, USA.
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Diaz-Casares A, Leon Y, de la Rosa EJ, Varela-Nieto I. Regulation of Vertebrate Sensory Organ Development: A Scenario for Growth Hormone and Insulin-Like Growth Factors Action. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2005; 567:221-42. [PMID: 16370141 DOI: 10.1007/0-387-26274-1_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Amelia Diaz-Casares
- Instituto de Investigaciones Biomedicas Alberto Sols, Consejo Superior de Investigaciones Cientificas-Universidad Autonoma de Madrid, Spain
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