1
|
Fitch AK, Malhotra S, Conroy R. Differentiating monogenic and syndromic obesities from polygenic obesity: Assessment, diagnosis, and management. OBESITY PILLARS 2024; 11:100110. [PMID: 38766314 PMCID: PMC11101890 DOI: 10.1016/j.obpill.2024.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/18/2024] [Accepted: 04/18/2024] [Indexed: 05/22/2024]
Abstract
Background Obesity is a multifactorial neurohormonal disease that results from dysfunction within energy regulation pathways and is associated with increased morbidity, mortality, and reduced quality of life. The most common form is polygenic obesity, which results from interactions between multiple gene variants and environmental factors. Highly penetrant monogenic and syndromic obesities result from rare genetic variants with minimal environmental influence and can be differentiated from polygenic obesity depending on key symptoms, including hyperphagia; early-onset, severe obesity; and suboptimal responses to nontargeted therapies. Timely diagnosis of monogenic or syndromic obesity is critical to inform management strategies and reduce disease burden. We outline the physiology of weight regulation, role of genetics in obesity, and differentiating characteristics between polygenic and rare genetic obesity to facilitate diagnosis and transition toward targeted therapies. Methods In this narrative review, we focused on case reports, case studies, and natural history studies of patients with monogenic and syndromic obesities and clinical trials examining the efficacy, safety, and quality of life impact of nontargeted and targeted therapies in these populations. We also provide comprehensive algorithms for diagnosis of patients with suspected rare genetic causes of obesity. Results Patients with monogenic and syndromic obesities commonly present with hyperphagia (ie, pathologic, insatiable hunger) and early-onset, severe obesity, and the presence of hallmark characteristics can inform genetic testing and diagnostic approach. Following diagnosis, specialized care teams can address complex symptoms, and hyperphagia is managed behaviorally. Various pharmacotherapies show promise in these patient populations, including setmelanotide and glucagon-like peptide-1 receptor agonists. Conclusion Understanding the pathophysiology and differentiating characteristics of monogenic and syndromic obesities can facilitate diagnosis and management and has led to development of targeted pharmacotherapies with demonstrated efficacy for reducing body weight and hunger in the affected populations.
Collapse
Affiliation(s)
| | - Sonali Malhotra
- Harvard Medical School, Boston, MA, USA
- Rhythm Pharmaceuticals, Inc., Boston, MA, USA
- Massachussetts General Hospital, Boston, MA, USA
| | | |
Collapse
|
2
|
Kleinendorst L, Abawi O, Vos N, van der Valk ES, Maas SM, Morgan AT, Hildebrand MS, Da Silva JD, Florijn RJ, Lauffer P, Visser JA, van Rossum EFC, van den Akker ELT, van Haelst MM. GNB1 and obesity: Evidence for a correlation between haploinsufficiency and syndromic obesity. Clin Obes 2024; 14:e12661. [PMID: 38596856 DOI: 10.1111/cob.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Most patients with GNB1 encephalopathy have developmental delay and/or intellectual disability, brain anomalies and seizures. Recently, two cases with GNB1 encephalopathy caused by haploinsufficiency have been reported that also show a Prader-Willi-like phenotype of childhood hypotonia and severe obesity. Here we present three new cases from our expert centre for genetic obesity in which GNB1 truncating and splice variants, probably leading to haploinsufficiency, were identified. They all have obesity, hyperphagia and intellectual deficit. The clinical cases and their weight courses are presented, together with a review of all 68 published cases with GNB1 encephalopathy. Information on weight was not mentioned in most of these articles, so we contacted authors for additional clinical information on weight status and hyperphagia. Of the 42 patients whose weight status we could determine, obesity was present in 8 patients (19%). Obesity is significantly over-represented in the group with truncating and splicing variants. In this group, we see an obesity prevalence of 75%. Since GNB1 has been linked to several key genes in the hypothalamic leptin-melanocortin pathway, which regulates satiety and energy expenditure, our data support the potential association between GNB1 haploinsufficiency and genetic obesity. We also suggest GNB1 is a candidate gene for the known obesity phenotype of the 1p36 microdeletion syndrome given this chromosomal region includes the GNB1 gene. Knowledge of an additional obesity phenotype is important for prognosis, early interventions against obesity and awareness when prescribing weight-inducing medication.
Collapse
Affiliation(s)
- Lotte Kleinendorst
- Department of Human Genetics, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ozair Abawi
- Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Niels Vos
- Department of Human Genetics, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Eline S van der Valk
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Saskia M Maas
- Department of Human Genetics, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Michael S Hildebrand
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - Jorge D Da Silva
- Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto & Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ralph J Florijn
- Department of Human Genetics, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Peter Lauffer
- Department of Human Genetics, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jenny A Visser
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Erica L T van den Akker
- Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mieke M van Haelst
- Department of Human Genetics, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
3
|
Bomberg EM, Clark J, Rudser KD, Gross AC, Kelly AS, Fox CK. Effectiveness and predictors of weight loss response to phentermine plus lifestyle modifications among youth in a paediatric weight management clinical setting. Pediatr Obes 2024; 19:e13143. [PMID: 38886982 PMCID: PMC11239309 DOI: 10.1111/ijpo.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 05/12/2024] [Accepted: 05/17/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Anti-obesity medications (AOMs) are promising lifestyle modification (LSM) adjuncts for obesity treatment, and phentermine is commonly prescribed in paediatric weight management clinics. Determining 'real-world' AOM effectiveness and characteristics predicting response is important. OBJECTIVES We sought to describe phentermine plus LSM effectiveness and identify baseline characteristics predicting response. METHODS This was a retrospective cohort study among youth seen in a US academic-based weight management clinic from 2012 to 2020. Baseline characteristics (e.g., body mass index (BMI), liver transaminases, eating-related behaviours) and outcomes (%BMI of 95th percentile (%BMIp95), BMI, %BMI change, weight) were determined through electronic health records and intake surveys. RESULTS Among 91 youth prescribed phentermine plus LSM over 8 years (mean %BMIp95 150%), %BMIp95 was statistically significantly reduced at 1.5, 3, 6 and 12 months (peak reduction 10.9 percentage points at 6 months; p < 0.001). Considering multiple comparisons, the presence of baseline elevated alanine aminotransferase was associated with statistically significant smaller 1.5-month %BMIp95 reductions (p = 0.001) and higher food responsiveness with smaller 3- (p = 0.001) and 6-month (p < 0.001) reductions. CONCLUSIONS Phentermine plus LSM reduced %BMIp95 among youth in a weight management clinic, and baseline characteristics may help determine those more or less likely to respond. Prospective studies are needed to further characterize effectiveness and confirm response predictors.
Collapse
Affiliation(s)
- Eric M Bomberg
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Justin Clark
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kyle D Rudser
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Amy C Gross
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Aaron S Kelly
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Claudia K Fox
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
4
|
Welling MS, Mohseni M, Meeusen REH, de Groot CJ, Boon MR, Kleinendorst L, Visser JA, van Haelst MM, van den Akker ELT, van Rossum EFC. Clinical phenotypes of adults with monogenic and syndromic genetic obesity. Obesity (Silver Spring) 2024; 32:1257-1267. [PMID: 38807300 DOI: 10.1002/oby.24047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/14/2024] [Accepted: 03/24/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE Considering limited evidence on diagnostics of genetic obesity in adults, we evaluated phenotypes of adults with genetic obesity. Additionally, we assessed the applicability of Endocrine Society (ES) recommendations for genetic testing in pediatric obesity. METHODS We compared clinical features, including age of onset of obesity and appetite, between adults with non-syndromic monogenic obesity (MO), adults with syndromic obesity (SO), and adults with common obesity (CO) as control patients. RESULTS A total of 79 adults with genetic obesity (32 with MO, 47 with SO) were compared with 186 control patients with CO. Median BMI was similar among the groups: 41.2, 39.5, and 38.7 kg/m2 for patients with MO, SO, and CO, respectively. Median age of onset of obesity was 3 (IQR: 1-6) years in patients with MO, 9 (IQR: 4-13) years in patients with SO, and 21 (IQR: 13-33) years in patients with CO (p < 0.001). Patients with genetic obesity more often reported increased appetite: 65.6%, 68.1%, and 33.9% in patients with MO, SO, and CO, respectively (p < 0.001). Intellectual deficit and autism spectrum disorder were more prevalent in patients with SO (53.2% and 21.3%) compared with those with MO (3.1% and 6.3%) and CO (both 0.0%). The ES recommendations were fulfilled in 56.3%, 29.8%, and 2.7% of patients with MO, SO, and CO, respectively (p < 0.001). CONCLUSIONS We found distinct phenotypes in adult genetic obesity. Additionally, we demonstrated low sensitivity for detecting genetic obesity in adults using pediatric ES recommendations, necessitating specific genetic testing recommendations in adult obesity care.
Collapse
Affiliation(s)
- Mila S Welling
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mostafa Mohseni
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Renate E H Meeusen
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Cornelis J de Groot
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mariëtte R Boon
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lotte Kleinendorst
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jenny A Visser
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mieke M van Haelst
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Erica L T van den Akker
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
5
|
De Visser HS, Dufault B, Brunton N N, McGavock J. Early life adversity and obesity risk in adolescence: a 9-year population-based prospective cohort study. Pediatr Res 2024; 96:216-222. [PMID: 38267708 DOI: 10.1038/s41390-024-03040-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND There are few prospective studies of factors that mediate the association between exposure to adverse childhood experiences (ACEs) and obesity in adolescence. Our aim was to address this limitation. METHODS We used prospective data from the Growing up in Ireland cohort study, with measurements at 9, 13, and 18 years old. The exposures were 14 adverse experiences before age 9. The main outcome was body mass index (BMI) at 18 years. Mediators were daily activity, diet quality, self-image and behavioural difficulties at 13 years. RESULTS Among the 4561 adolescents in the final cohort, 77.2% experienced any adversity, 50.5% were female and 26.7% were overweight/obese at 18 years. BMI Z was higher at ages 9 (0.54 vs 0.43, p < 0.05, 95% CI of difference: -0.22, -0.01) and 13 years (0.50 vs 0.35, p < 0.05, 95% CI of difference: -0.25, -0.06), in those exposed to an ACE, compared to those unexposed. Structural equation models revealed that behavioural difficulties (β = 0.01; 95% CI: 0.007-0.018, p < 0.001) and self-concept (β = 0.0027; 95% CI: 0.0004-0.0050, p = 0.026) indirectly mediate the association between exposure to ACEs and BMI at 18 years. CONCLUSIONS The association between ACEs and BMI in adolescence is mediated by behavioural difficulties and self-concept. IMPACT In a previous study, we found modest associations between exposure to a range of adverse childhood experiences and weight gain at 13 years of age. The strength of the association between adverse childhood experiences and weight gain was lower at 18 years of age compared to the association observed at 13 years and was no longer significant after controlling for confounding and including possible mediators. The association between adverse childhood experiences and BMI in adolescence is indirectly mediated by behavioural difficulties and self-concept.
Collapse
Affiliation(s)
- Hannah Steiman De Visser
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme of the Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Brenden Dufault
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - Nicole Brunton N
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme of the Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
- The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme of the Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada.
| |
Collapse
|
6
|
Tian C, Xu M, Lai H, Sun M, Lu Y, Wang Y, Tong B, Wang Y, Na F, Wang J, Li Q, Ge L. Management for children and adolescents with overweight and obesity: a recommendations mapping. Pediatr Res 2024:10.1038/s41390-024-03357-3. [PMID: 38914759 DOI: 10.1038/s41390-024-03357-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Childhood obesity is a global public health issue, and the status of clinical practice guidelines (CPGs) as instruction manuals for the management of childhood obesity remains unclear. This study aims to identify and apprise the methodological and reporting quality of CPGs focused on childhood obesity and provide an overview of key recommendations. METHODS Databases and websites reporting guidelines were searched from January, 2018 to September, 2023. The methodological quality was graded using the AGREE II, and RIGHT was used to assess the reporting completeness. RESULTS Among the six included CPGs, two were rated as high quality and considered "Recommended" and three were reported no less than 80%. CPGs included 184 recommendations cover diagnosis, assessment and management of complications, interventions and prevention. The diagnostic criteria for children with obesity over 2 years of age are based on normative BMI percentiles, depending on sex and age. CPGs recommended the delivery of multi-component behavior-changed interventions included controlling diet and increasing physical activity. Pharmacological interventions and bariatric surgery are considered as complementary therapies. CONCLUSION CPGs for childhood obesity should emphasize the impact of psychological factors and consider the provision of interventions from multiple settings, and could consider the role of complementary alternative therapies. IMPACT Six guidelines have been published in the past 5 years focusing children obesity. Recommendations covered diagnosis, multiple intervention and prevention. Guidelines should focus on the role of complementary alternative therapies. Guidelines should emphasize the impact of psychological factors. Guidelines should consider the provision of interventions from multiple settings.
Collapse
Affiliation(s)
- Chen Tian
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
| | - Meng Xu
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
| | - Honghao Lai
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Mingyao Sun
- Evidence-Based Nursing Research Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yao Lu
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yong Wang
- First Clinical School of Medicine, Lanzhou University, Lanzhou, China
| | - Bo Tong
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yiyun Wang
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Feiyang Na
- Department of Pediatric, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Jing Wang
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
| | - Qiong Li
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, China.
| | - Long Ge
- Evidence-Based Social Sciences Research Centre, Lanzhou University, Lanzhou, China.
- Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou, China.
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China.
| |
Collapse
|
7
|
Gupta A, Choudhary N, Gupta N. Prediabetes in children and adolescents: A ticking bomb! World J Clin Pediatr 2024; 13:92127. [PMID: 38947990 PMCID: PMC11212763 DOI: 10.5409/wjcp.v13.i2.92127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/12/2024] [Accepted: 04/25/2024] [Indexed: 06/07/2024] Open
Abstract
Prediabetes in children and adolescents is on the rise which has drawn significant attention over the past decade. It is an early warning sign of the underlying pathophysiological changes which in due course of time might compound into type II diabetes mellitus. The incidence of prediabetes in adolescents ranges from 4%-23% which is alarmingly high and requires active intervention from the system. We have discussed early identification of high-risk patients, prompt screening and active intervention to manage this growing problem.
Collapse
Affiliation(s)
- Anju Gupta
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Science, New Delhi 110076, India
| | - Nitin Choudhary
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Science, New Delhi 110076, India
| | - Nishkarsh Gupta
- Department of Onco-Anesthesiology and Palliative Medicine, All India Institute of Medical Science, New Delhi 110029, India
| |
Collapse
|
8
|
McCoy J, Miller MR, Watson M, Crowley E, Woolfson JP. Paediatric obesity and Crohn's disease: a descriptive review of disease phenotype and clinical course. Paediatr Child Health 2024; 29:158-162. [PMID: 38827375 PMCID: PMC11141610 DOI: 10.1093/pch/pxad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/16/2023] [Indexed: 06/04/2024] Open
Abstract
Objectives In an era of increasing paediatric obesity and inflammatory bowel disease (IBD), this study evaluates the disease phenotype and clinical course of Crohn's disease (CD) in paediatric patients who are obese or overweight. Methods This is a retrospective, single-center, descriptive observational study from January 2010 to May 2020. Participants were included if they were: aged 2 to 18 years at the time of diagnosis, had a confirmed diagnosis of CD, and met WHO criteria for overweight or obesity at the time of diagnosis or within one year before diagnosis. Results A total of 345 patient charts with CD were screened during the study period, with 16 patients meeting inclusion criteria. Median age of patients was 15.5 years (IQR = 13.6, 16.1). Of the 15 patients over 10 years of age, median anthropometrics at diagnosis included body mass index (BMI) of 27.2 (IQR = 24.9, 29.4) and BMI for age z-score of 1.82 (IQR = 1.58, 2.19). Presenting symptoms included abdominal pain (80.0%), diarrhea (66.7%), hematochezia (66.7%), and weight loss (26.7%). Five patients (33.3%) had obesity-related complications. Median time from symptom onset to diagnosis was 146 days (IQR = 31, 367), and median time from diagnosis to remission was 229 days (IQR = 101.8, 496.3). Conclusions Patients with elevated BMI and CD present with typical symptoms of IBD, although weight loss was a less common presenting symptom. Time to disease remission is delayed, and obesity-related complications are common. Primary care providers must have a high degree of clinical suspicion in patients to prevent delays to gastroenterology referral and to improve time to disease remission.
Collapse
Affiliation(s)
- Jacob McCoy
- Department of Paediatrics, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Michael R Miller
- Department of Paediatrics, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
| | - Melanie Watson
- Department of Paediatrics, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
- Division of Paediatric Gastroenterology, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Eileen Crowley
- Department of Paediatrics, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
- Division of Paediatric Gastroenterology, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Jessica P Woolfson
- Department of Paediatrics, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
- Division of Paediatric Gastroenterology, Children’s Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada
| |
Collapse
|
9
|
Zuccaro MV, LeDuc CA, Thaker VV. Updates on Rare Genetic Variants, Genetic Testing, and Gene Therapy in Individuals With Obesity. Curr Obes Rep 2024:10.1007/s13679-024-00567-y. [PMID: 38822963 DOI: 10.1007/s13679-024-00567-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 06/03/2024]
Abstract
PURPOSE OF REVIEW The goal of this paper is to aggregate information on monogenic contributions to obesity in the past five years and to provide guidance for genetic testing in clinical care. RECENT FINDINGS Advances in sequencing technologies, increasing awareness, access to testing, and new treatments have increased the utilization of genetics in clinical care. There is increasing recognition of the prevalence of rare genetic obesity from variants with mean allele frequency < 5% -new variants in known genes as well as identification of novel genes- causing monogenic obesity. While most of these genes are in the leptin melanocortin pathway, those in adipocytes may also contribute. Common variants may contribute either to higher lifetime tendency for weight gain or provide protection from monogenic obesity. While specific genetic mutations are rare, these segregate in individuals with early-onset severe obesity; thus, collectively genetic etiologies are not as rare. Some genetic conditions are amenable to targeted treatment. Research into the discovery of novel genetic causes as well as targeted treatment is growing over time. The utility of therapeutic strategies based on the genetic risk of obesity is an advancing frontier.
Collapse
Affiliation(s)
- Michael V Zuccaro
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, United States
| | - Charles A LeDuc
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Irving Medical Center, 1150, St. Nicholas Avenue, NY 10032, United States
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, United States
| | - Vidhu V Thaker
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Irving Medical Center, 1150, St. Nicholas Avenue, NY 10032, United States.
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, United States.
- Division of Pediatric Endocrinology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, 10032, United States.
| |
Collapse
|
10
|
Kühnen P, Argente J, Clément K, Dollfus H, Dubern B, Farooqi S, de Groot C, Grüters A, Holm JC, Hopkins M, Kleinendorst L, Körner A, Meeker D, Rydén M, von Schnurbein J, Tschöp M, Yeo GSH, Zorn S, Wabitsch M. IMPROVE 2022 International Meeting on Pathway-Related Obesity: Vision of Excellence. Clin Obes 2024; 14:e12659. [PMID: 38602039 DOI: 10.1111/cob.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 04/12/2024]
Abstract
Nearly 90 clinicians and researchers from around the world attended the first IMPROVE 2022 International Meeting on Pathway-Related Obesity. Delegates attended in person or online from across Europe, Argentina and Israel to hear the latest scientific and clinical developments in hyperphagia and severe, early-onset obesity, and set out a vision of excellence for the future for improving the diagnosis, treatment, and care of patients with melanocortin-4 receptor (MC4R) pathway-related obesity. The meeting co-chair Peter Kühnen, Charité Universitätsmedizin Berlin, Germany, indicated that change was needed with the rapidly increasing prevalence of obesity and the associated complications to improve the understanding of the underlying mechanisms and acknowledge that monogenic forms of obesity can play an important role, providing insights that can be applied to a wider group of patients with obesity. World-leading experts presented the latest research and led discussions on the underlying science of obesity, diagnosis (including clinical and genetic approaches such as the role of defective MC4R signalling), and emerging clinical data and research with targeted pharmacological approaches. The aim of the meeting was to agree on the questions that needed to be addressed in future research and to ensure that optimised diagnostic work-up was used with new genetic testing tools becoming available. This should aid the planning of new evidence-based treatment strategies for the future, as explained by co-chair Martin Wabitsch, Ulm University Medical Center, Germany.
Collapse
Affiliation(s)
- Peter Kühnen
- Department of Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jesús Argente
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Karine Clément
- Assistance Publique-Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, Paris, France
| | - Hélène Dollfus
- CARGO and Department of Medical Genetics, University of Strasbourg, Strasbourg, France
| | - Béatrice Dubern
- INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, Paris, France
- Sorbonne Université, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sadaf Farooqi
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Corjan de Groot
- Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annette Grüters
- Department of Pediatric Endocrinology and Diabetes, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jens-Christian Holm
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Copenhagen, Denmark
| | - Mark Hopkins
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Lotte Kleinendorst
- Department of Clinical Genetics, Amsterdam UMC, Amsterdam, The Netherlands
| | - Antje Körner
- Center for Pediatric Research, Department of Pediatrics, LIFE Research Center for Civilization Diseases, University Hospital Leipzig, Leipzig, Germany
| | - David Meeker
- Rhythm Pharmaceuticals, Boston, Massachusetts, USA
| | - Mikael Rydén
- Department of Medicine H7, Karolinska Institute, Stockholm, Sweden
- Department of Endocrinology and Metabolism, Karolinska University Hospital, Stockholm, Sweden
| | - Julia von Schnurbein
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Matthias Tschöp
- Institute for Diabetes and Obesity, Helmholtz Zentrum, Munich, Germany
| | - Giles S H Yeo
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Stefanie Zorn
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| |
Collapse
|
11
|
Zhou Y, Zhao L, Zhang Z, Meng X, Cai QJ, Zhao XL, Wang LP, Hu AH, Zhou XL. Sex difference in nocturnal blood pressure dipping in adolescents with varying degrees of adiposity. BMC Pediatr 2024; 24:353. [PMID: 38778302 PMCID: PMC11110230 DOI: 10.1186/s12887-024-04804-0] [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: 02/21/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND For adolescents, abnormal dipping patterns in blood pressure (BP) are associated with early-onset organ damage and a higher risk of cardiovascular disorders in adulthood. Obesity is one of the most common reasons for abnormal BP dipping in young people. However, it is unknown whether the severity of obesity is associated with BP dipping status and whether this association is sex-dependent. METHODS 499 participants between 12 and 17 years old with overweight or obesity underwent ambulatory blood pressure monitoring (ABPM) between April 2018 and January 2019 in Beijing and Baoding. Participants were grouped by body mass index (BMI) into overweight (BMI 85th-95th percentile), obese (BMI ≥ 95th percentile) and severely obese (BMI ≥ 120% of 95th percentile or ≥ 35 kg/m2) groups. Non-dipping was defined as a < 10% reduction in BP from day to night. The interaction effect between sex and obesity degree was also analyzed. RESULTS 326 boys and 173 girls were included, of whom 130 were overweight, 189 were obese, and 180 were severely obese. Girls with severe obesity had a higher prevalence of non-dipping, but boys showed no significant differences in BP dipping status between obesity categories. In addition, as obesity severity went up, a more evident increase in night-time SBP was observed in girls than in boys. CONCLUSIONS Severely obese is associated with a higher prevalence of non-BP dipping patterns in girls than in boys, which suggests that the relationship between the severity of obesity and BP dipping status might be sex-specific.
Collapse
Affiliation(s)
- Yi Zhou
- Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Lin Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
- National Integrated Traditional and Western Medicine Center for Cardiovascular Disease, China-Japan Friendship Hospital, Beijing, China
| | - Zenglei Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xu Meng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Qiu-Jing Cai
- Department of Non-communicable Disease Management, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Xiao-Lei Zhao
- Department of Non-communicable Disease Management, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Lin-Ping Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
| | - Ai-Hua Hu
- Department of Non-communicable Disease Management, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.
| | - Xian-Liang Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
| |
Collapse
|
12
|
Viana RS, Nascimento-Ferreira MV, Schaan BD, Bloch KV, de Carvalho KMB, Cureau FV, De Moraes ACF. Prevalence of the Double Burden of Malnutrition among Adolescents: Associations with Lifestyle Behaviors and Clusters of Social Determinants. CHILDREN (BASEL, SWITZERLAND) 2024; 11:620. [PMID: 38929200 PMCID: PMC11201642 DOI: 10.3390/children11060620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m2) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21-29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9-8.9) was revealed. A percentage of 19.2% (95% CI: 17.0-21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8-10.1) were obese. A total of 41.5% (95% CI: 38.7-44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4-28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20-7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study.
Collapse
Affiliation(s)
- Raytta Silva Viana
- Postgraduate Program in Public Health, Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
- YCARE Research Group (Youth/Child Cardiovascular Risk Environmental Research Group), Faculdade de Medicina, University of São Paulo, São Paulo 01246-903, Brazil
| | - Marcus Vinicius Nascimento-Ferreira
- YCARE Research Group (Youth/Child Cardiovascular Risk Environmental Research Group), Faculdade de Medicina, University of São Paulo, São Paulo 01246-903, Brazil
- Research Group on Health, Physical Activity and Behavior (HEALTHY-BRA), Federal University of Tocantins, Miracema do Tocantins 77650-000, Brazil
| | - Beatriz D. Schaan
- Faculty of Medicine, Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
- Faculty of Medicine, Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035003, Brazil
| | - Katia Vergetti Bloch
- Institute of Studies in Public Health, Federal University of Rio de Janeiro, Rio de Janeiro 21941-592, Brazil
| | | | - Felipe Vogt Cureau
- Faculty of Medicine, Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
| | - Augusto César Ferreira De Moraes
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Department of Epidemiology, Michael & Susan Dell Center for Healthy Living, Texas Physical Activity Research Collaborative (Texas PARC) 1836 San Jacinto Blvd., Ste. 510, Austin, TX 78701, USA
| |
Collapse
|
13
|
Ocariza LM, Leong GM, Gandham S, Poulton A, Liu A, Bhurawala H. Paediatric obesity diagnosis and intervention practices in Australian hospitals - Australia-wide survey. J Paediatr Child Health 2024. [PMID: 38766842 DOI: 10.1111/jpc.16564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 11/09/2023] [Accepted: 05/04/2024] [Indexed: 05/22/2024]
Abstract
AIM Previous studies suggest a lack of a unified approach in identifying and addressing children with obesity while being inpatients in individual Australian hospitals. Our study aimed to describe current clinical practice across Australia and identify discrepancies that can aid in developing a more unified response to children identified with obesity as hospital inpatients. METHODS A cross-sectional exploratory online survey was distributed to major paediatric in-patient departments in Australia, with a response rate of 68%. Questions focused on education, identification, interventions and attitudes towards a national protocol. RESULTS Twenty percent of respondents indicated that staff in their department regularly record body mass index, 66% address weight issues and only 8% consistently refer to appropriate outpatient services. Although 88% of respondents believe that a national protocol for addressing paediatric obesity would be beneficial, respondents emphasised concerns regarding their local resources. CONCLUSION Our study can inform the development of a guideline for a unified response to opportunistically identify children with overweight and obesity as inpatients.
Collapse
Affiliation(s)
| | - Gary M Leong
- The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Paediatrics, Nepean Blue Mountains Metabolic Health Service, Nepean Hospital, Sydney, New South Wales, Australia
| | - Sowmya Gandham
- Paediatric Department, Nepean Hospital, Sydney, New South Wales, Australia
- Blue Mountains Hospital, Katoomba, New South Wales, Australia
| | - Alison Poulton
- Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Anthony Liu
- Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Habib Bhurawala
- Paediatric Department, Nepean Hospital, Sydney, New South Wales, Australia
- Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Paediatrics, School of Medicine, The University of Notre Dame, Australia, Sydney, New South Wales, Australia
| |
Collapse
|
14
|
Gavryutina I, Bochner R, Chin V, Bargman R. A Cross-Sectional Pilot Study of Parental Outdoor Play Preferences and Association With Child Overweight and Obesity. Clin Pediatr (Phila) 2024; 63:466-473. [PMID: 37246752 DOI: 10.1177/00099228231176350] [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] [Indexed: 05/30/2023]
Abstract
Childhood obesity is highly prevalent among certain populations of New York. This cross-sectional pilot study examined the associations between parental attitudes about outdoor activities and body mass index (BMI). A questionnaire was distributed among parents of 1 to 13 aged children at ambulatory pediatric clinics. Of 104 children included in the study 57 were of normal weight and 47 were overweight or obese. Most parents of children with BMI <85% reported frequent playground utilization, considered longer hours to spend outside on weekdays, reported a larger total temperature range for outdoor playground utilization and a lower tolerable minimum temperature compared to parents of children with BMI ≥85%, p < .05. Only having a parent born outside of the United States remained a significant predictor of overweight and obesity in the final model. Parents of children with BMI < 85% are more willing to spend time outdoors, regardless of weather. Immigrant parents are protective against overweight.
Collapse
Affiliation(s)
- Irina Gavryutina
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Risa Bochner
- Department of Pediatrics, New York City Health and Hospitals Harlem Hospital, New York, NY, USA
| | - Vivian Chin
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Renee Bargman
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
- Department of Pediatrics, New York City Health and Hospitals Kings County Hospital, Brooklyn, NY, USA
- Department of Pediatrics, New York City Health and Hospital South Brooklyn Health, Brooklyn, NY, USA
| |
Collapse
|
15
|
Ogawa M, Uchizawa A, Tamai S, Momma R, Hoshi D, Kondo E, Sagayama H, Watanabe K. Evaluation of Energy Balance Estimated From Total Energy Expenditure and Body Composition Changes in Junior Sumo Wrestlers: An Observational Study Over Six Months. Cureus 2024; 16:e61158. [PMID: 38933620 PMCID: PMC11200937 DOI: 10.7759/cureus.61158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Background Sumo is a sport that requires wrestlers to develop their physique from childhood for athletic advantage. However, the energy expenditure and energy balance required for the growth of junior Sumo wrestlers remain unclear. This study aimed to determine the energy balance of junior Sumo wrestlers over six months using doubly labeled water (DLW) and bioelectrical impedance analysis (BIA). Methodology A total of 12 male Sumo wrestlers were affiliated with a local Sumo club (average age = 15 ± 1 years). The total energy expenditure (TEE) was measured using DLW, whereas body composition was evaluated using BIA. Daily physical activity was quantified using a tri-accelerometer (Active style Pro HJA-750C). Results The TEE was 4,194 ± 734 kcal/day, while daily physical activity without training was 786 ± 50 minutes. Within six months, the body weight increased by 2.0 ± 3.2 kg, fat-free mass (FFM) was augmented by 2.1 kg, while fat mass did not change significantly. The surplus energy accumulated was 5.6 ± 213 kcal/day. Conclusions The excess energy of junior Sumo wrestlers predominantly increases their FFM. To increase their physical prowess, wrestlers adhere to a lifestyle characterized by high-intensity training and attenuated daily physical activity.
Collapse
Affiliation(s)
- Miori Ogawa
- Institutes of Health and Sports Sciences, University of Tsukuba, Tsukuba, JPN
- Pediatrics, Japanese Red Cross Nasu Hospital, Otawara, JPN
| | - Akiko Uchizawa
- Institutes of Health and Sports Sciences, University of Tsukuba, Tsukuba, JPN
- Research, Japan Society for the Promotion of Science, Tokyo, JPN
| | - Shinsuke Tamai
- Department of Sports Science and Research, Japan Institute of Sports Sciences, Tokyo, JPN
| | - Reiko Momma
- Department of Sports Science and Research, Japan Institute of Sports Sciences, Tokyo, JPN
| | - Daisuke Hoshi
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, JPN
| | - Emi Kondo
- Department of Health and Sport Sciences, Osaka University of Health and Sport Sciences, Osaka, JPN
| | - Hiroyuki Sagayama
- Institutes of Health and Sports Sciences, University of Tsukuba, Tsukuba, JPN
| | - Koichi Watanabe
- Institutes of Health and Sports Sciences, University of Tsukuba, Tsukuba, JPN
| |
Collapse
|
16
|
Bai L, Wang X, Niu R, Zhao M, Zhao Z, Jia P, Sun S. Association between body mass index and tic disorders in school-age children. BMC Pediatr 2024; 24:261. [PMID: 38643075 PMCID: PMC11031855 DOI: 10.1186/s12887-024-04592-7] [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: 11/21/2023] [Accepted: 01/25/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE To explore the relationship between body mass index (BMI ) and the severity of tic disorders (TDs) in children 6-14 years old. METHODS A total of 86 children diagnosed with TDs in a hospital between Jan. 2023 and Sept. 2023 were collected by convenient sampling method, and the general data and TD-specific data were collected and analyzed. RESULTS Univariate analysis showed that patients with different Yale Global Tic Severity Scale (YGTSS) grades had statistically significant differences in age, BMI, residence, snacking pattern, weekly physical exercise frequency, weekly physical exercise time, and proportion of cesarean birth. Multiple linear regression analysis showed that the YGTSS score grades were related to BMI, snacking pattern, and cesarean birth of the patients. Correlation analysis revealed a positive correlation between BMI grades and the YGTSS score grades, with a higher BMI indicating more severe TDs. Predictive value evaluation showed that BMI, snacking pattern, and cesarean birth had predictive values for TD severity, and the highest value was found in the combined prediction. CONCLUSION BMI, snacking pattern, and cesarean birth are of predictive values for the severity of TDs. In addition, BMI is positively correlated with the severity of TDs, and a higher BMI suggests more severe TDs.
Collapse
Affiliation(s)
- Lu Bai
- Hebei Medical University, Shijiazhuang, 050017, China
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Xia Wang
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Ruijie Niu
- Hebei Medical University, Shijiazhuang, 050017, China
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Mengchuan Zhao
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Ziwei Zhao
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Pengyu Jia
- Hebei Medical University, Shijiazhuang, 050017, China
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China
| | - Suzhen Sun
- Hebei Medical University, Shijiazhuang, 050017, China.
- Department of Pediatric Neurology, Children's Hospital of Hebei Province, Hebei Medical University, No. 133 of Jianhuanan Street, YuhuaDistrict, Shijiazhuang, 050031, China.
| |
Collapse
|
17
|
Burhanuddin K, Mohammed A, Badhan RKS. The Impact of Paediatric Obesity on Drug Pharmacokinetics: A Virtual Clinical Trials Case Study with Amlodipine. Pharmaceutics 2024; 16:489. [PMID: 38675150 PMCID: PMC11053426 DOI: 10.3390/pharmaceutics16040489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
The incidence of paediatric obesity continues to rise worldwide and contributes to a range of diseases including cardiovascular disease. Obesity in children has been shown to impact upon the plasma concentrations of various compounds, including amlodipine. Nonetheless, information on the influence of obesity on amlodipine pharmacokinetics and the need for dose adjustment has not been studied previously. This study applied the physiologically based pharmacokinetic modelling and established a paediatric obesity population to assess the impact of obesity on amlodipine pharmacokinetics in children and explore the possible dose adjustments required to reach the same plasma concentration as non-obese paediatrics. The difference in predicted maximum concentration (Cmax) and area under the curve (AUC) were significant between children with and without obesity across the age group 2 to 18 years old when a fixed-dose regimen was used. On the contrary, a weight-based dose regimen showed no difference in Cmax between obese and non-obese from 2 to 9 years old. Thus, when a fixed-dose regimen is to be administered, a 1.25- to 1.5-fold increase in dose is required in obese children to achieve the same Cmax concentration as non-obese children, specifically for children aged 5 years and above.
Collapse
Affiliation(s)
| | | | - Raj K. S. Badhan
- School of Pharmacy, College of Health and Life Science, Aston University, Birmingham B4 7ET, UK; (K.B.); (A.M.)
| |
Collapse
|
18
|
Chimatapu SN, Mittelman SD, Habib M, Osuna-Garcia A, Vidmar AP. Wearable Devices Beyond Activity Trackers in Youth With Obesity: Summary of Options. Child Obes 2024; 20:208-218. [PMID: 37023409 PMCID: PMC10979694 DOI: 10.1089/chi.2023.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Background: Current treatment protocols to prevent and treat pediatric obesity focus on prescriptive lifestyle interventions. However, treatment outcomes are modest due to poor adherence and heterogeneity in responses. Wearable technologies offer a unique solution as they provide real-time biofeedback that could improve adherence to and sustainability of lifestyle interventions. To date, all reviews on wearable devices in pediatric obesity cohorts have only explored biofeedback from physical activity trackers. Hence, we conducted a scoping review to (1) catalog other biofeedback wearable devices available in this cohort, (2) document various metrics collected from these devices, and (3) assess safety and adherence to these devices. Methods: This scoping review was conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Fifteen eligible studies examined the use of biofeedback wearable devices beyond activity trackers in pediatric cohorts, with an emphasis on feasibility of these devices. Results: Included studies varied in sample sizes (15-203) and in ages 6-21 years. Wearable devices are being used to capture various metrics of multicomponent weight loss interventions to provide more insights about glycemic variability, cardiometabolic function, sleep, nutrition, and body fat percentage. High safety and adherence rates were reported among these devices. Conclusions: Available evidence suggests that wearable devices have several applications aside from activity tracking, which could modify health behaviors through real-time biofeedback. Overall, these devices appear to be safe and feasible so as to be employed in various settings in the pediatric age group to prevent and treat obesity.
Collapse
Affiliation(s)
- Sri Nikhita Chimatapu
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven D. Mittelman
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Manal Habib
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Antonia Osuna-Garcia
- Department of Health and Life Sciences Librarian, Nursing, Biomedical Library, University of California Los Angeles, Los Angeles, CA, USA
| | - Alaina P. Vidmar
- Center for Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
19
|
Mainieri F, La Bella S, Rinaldi M, Chiarelli F. Rare genetic forms of obesity in childhood and adolescence: A narrative review of the main treatment options with a focus on innovative pharmacological therapies. Eur J Pediatr 2024; 183:1499-1508. [PMID: 38227053 DOI: 10.1007/s00431-024-05427-4] [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: 07/26/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
The prevalence of obesity in children and adolescents is increasing, and it is recognised as a complex disorder that often begins in early childhood and persists throughout life. Both polygenic and monogenic obesity are influenced by a combination of genetic predisposition and environmental factors. Rare genetic obesity forms are caused by specific pathogenic variants in single genes that have a significant impact on weight regulation, particularly genes involved in the leptin-melanocortin pathway. Genetic testing is recommended for patients who exhibit rapid weight gain in infancy and show additional clinical features suggestive of monogenic obesity as an early identification allows for appropriate treatment, preventing the development of obesity-related complications, avoiding the failure of traditional treatment approaches. In the past, the primary recommendations for managing obesity in children and teenagers have been focused on making multiple lifestyle changes that address diet, physical activity, and behaviour, with the goal of maintaining these changes long-term. However, achieving substantial and lasting weight loss and improvements in body mass index (BMI) through lifestyle interventions alone is rare. Recently the progress made in genetic analysis has paved the way for innovative pharmacological treatments for different forms of genetic obesity. By understanding the molecular pathways that contribute to the development of obesity, it is now feasible to identify specific patients who can benefit from targeted treatments based on their unique genetic mechanisms. Conclusion: However, additional preclinical research and studies in the paediatric population are required, both to develop more personalised prevention and therapeutic programs, particularly for the early implementation of innovative and beneficial management options, and to enable the translation of these novel therapy approaches into clinical practice. What is Known: • The prevalence of obesity in the paediatric population is increasing, and it is considered as a multifaceted condition that often begins in early childhood and persists in the adult life. Particularly, rare genetic forms of obesity are influenced by a combination of genetic predisposition and environmental factors and are caused by specific pathogenic variants in single genes showing a remarkable impact on weight regulation, particularly genes involved in the leptin-melanocortin pathway. • Patients who present with rapid weight gain in infancy and show additional clinical characteristics indicative of monogenic obesity should undergo genetic testing, which, by enabling a correct diagnosis, can prevent the development of obesity-related consequences through the identification for appropriate treatment. What is New: • In recent years, advances made in genetic analysis has made it possible to develop innovative pharmacological treatments for various forms of genetic obesity. In fact, it is now achievable to identify specific patients who can benefit from targeted treatments based on their unique genetic mechanisms by understanding the molecular pathways involved in the development of obesity. • As demonstrated over the last years, two drugs, setmelanotide and metreleptin, have been identified as potentially effective interventions in the treatment of certain rare forms of monogenic obesity caused by loss-of-function mutations in genes involved in the leptin-melanocortin pathway. Recent advancements have led to the development of novel treatments, including liraglutide, semaglutide and retatrutide, that have the potential to prevent the progression of metabolic abnormalities and improve the prognosis of individuals with these rare and severe forms of obesity. However, extensive preclinical research and, specifically, additional studies in the paediatric population are necessary to facilitate the translation of these innovative treatment techniques into clinical practice.
Collapse
Affiliation(s)
| | | | - Marta Rinaldi
- Paediatric Department, Stoke Mandeville Hospital - Thames Valley Deanery, Oxford, UK
| | | |
Collapse
|
20
|
Shoemaker A. Bardet-Biedl syndrome: A clinical overview focusing on diagnosis, outcomes and best-practice management. Diabetes Obes Metab 2024; 26 Suppl 2:25-33. [PMID: 38383825 DOI: 10.1111/dom.15494] [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: 12/08/2023] [Revised: 01/16/2024] [Accepted: 01/27/2024] [Indexed: 02/23/2024]
Abstract
Bardet-Biedl syndrome (BBS) is a genetic disorder characterized by early-onset obesity, polydactyly, genital and kidney anomalies, developmental delay and vision loss due to rod-cone dystrophy. BBS is an autosomal recessive disorder with >20 implicated genes. The genotype-phenotype relationship in BBS is not clear, and there may be additional modifying factors. The underlying mechanism is dysfunction of primary cilia. In BBS, receptor trafficking in and out of the cilia is compromised, affecting multiple organ systems. Along with early-onset obesity, hyperphagia is a prominent symptom and contributes significantly to clinical morbidity and caregiver burden. While there is no cure for BBS, setmelanotide is a new pharmacotherapy approved for treatment of obesity in BBS. The differential diagnosis for BBS includes other ciliopathies, such as Alstrom syndrome, and other genetic obesity syndromes, such as Prader-Willi syndrome. Careful clinical history and genetic testing can help determine the diagnosis and a multidisciplinary team is necessary to guide clinical management.
Collapse
Affiliation(s)
- Ashley Shoemaker
- Division of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
21
|
Kang E, Hong YH, Kim J, Chung S, Kim KK, Haam JH, Kim BT, Kim EM, Park JH, Rhee SY, Kang JH, Rhie YJ. Obesity in Children and Adolescents: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity. J Obes Metab Syndr 2024; 33:11-19. [PMID: 38193204 PMCID: PMC11000513 DOI: 10.7570/jomes23060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/12/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
The prevalence of obesity in children and adolescents has been gradually increasing in recent years and has become a major health problem. Childhood obesity can readily progress to adult obesity. It is associated with obesity-related comorbidities, such as type 2 diabetes mellitus, hypertension, obstructive sleep apnea, non-alcoholic fatty liver disease, and the risk factor for cardiovascular disease. It is important to make an accurate assessment of overweight and obesity in children and adolescents with consideration of growth and development. Childhood obesity can then be prevented and treated using an appropriate treatment goal and safe and effective treatment strategies. This article summarizes the clinical practice guidelines for obesity in children and adolescents that are included in the 8th edition of the Clinical Practice Guidelines for Obesity of the Korean Society for the Study of Obesity.
Collapse
Affiliation(s)
- Eungu Kang
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Yong Hee Hong
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jaehyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Ji-Hee Haam
- Deptartment of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bom Taeck Kim
- Department of Family Practice & Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| |
Collapse
|
22
|
Melendez-Montañez JM, De Jesus-Rojas W. The Tip of the Iceberg: Genotype of Puerto Rican Pediatric Obesity. Genes (Basel) 2024; 15:394. [PMID: 38674329 PMCID: PMC11049160 DOI: 10.3390/genes15040394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
Childhood obesity is a significant public health concern, particularly among Hispanic populations. This study aimed to elucidate the genetic predisposition to obesity in Puerto Rican children of Hispanic descent, addressing a notable gap in existing research. A cohort of 103 children with obesity and hyperphagia underwent genetic screening for rare obesity-related variants. Clinical assessments and family history evaluations were conducted to characterize the demographic and clinical characteristics of the cohort. Genetic testing revealed a high prevalence of variants, with 73% of subjects having at least one reported variant. Pathogenic variants, predominantly associated with obesity-related ciliopathies, were identified in 7% of cases. Additionally, 90% of cases had variants of uncertain significance, highlighting the complexity of genetic contributions to obesity. This study emphasizes the critical need for further investigation into the genetic foundations of obesity, particularly within Hispanic communities. The findings emphasize the importance of early medical evaluation, vigilant monitoring for hyperphagia onset, and targeted interventions tailored to the unique genetic landscape of Puerto Rican children. This research provides a foundational framework for future studies to mitigate the impact of genetic obesity within this population.
Collapse
Affiliation(s)
| | - Wilfredo De Jesus-Rojas
- Department of Pediatrics and Basic Science, Ponce Health Sciences University, Ponce, PR 00716, USA;
| |
Collapse
|
23
|
Calcaterra V, Rossi V, Magenes VC, Baldassarre P, Grazi R, Loiodice M, Fabiano V, Zuccotti G. Dietary habits, depression and obesity: an intricate relationship to explore in pediatric preventive strategies. Front Pediatr 2024; 12:1368283. [PMID: 38523835 PMCID: PMC10957686 DOI: 10.3389/fped.2024.1368283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
Obesity and depression represent major health problems due to their high prevalence and morbidity rates. Numerous evidences elucidated the connections between dietary habits and the incidence or severity of depression. This overview aims to investigate the intricate relationship between dietary patterns and depression with the objective of elaborating preventive strategies for childhood obesity. Literature data recognized that there is a link between mood and food choices, with certain foods selected for their impact on the brain's reward centers. This behavior parallels the one observed in substance addiction, suggesting a specific neural mechanism for food addiction that contributes to overeating and obesity. It is important to note the significant correlation between obesity and depression, indicating a shared biological pathway influencing these conditions. Stress substantially affects also eating behaviors, often leading to increased consumption of pleasurable and rewarding foods. This can trigger a cycle of overeating, weight gain, and psychological distress, exacerbating mood disorders and obesity. In addition, consumption of certain types of foods, especially "comfort foods" high in fat and calories, may provide temporary relief from symptoms of depression, but can lead to long-term obesity and further mental health problems. Understanding these complex interactions is critical to developing preventive strategies focusing on dietary, emotional, and environmental factors, thereby reducing the risk of obesity and mood disorders.
Collapse
Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | | | - Paola Baldassarre
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Roberta Grazi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Martina Loiodice
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Valentina Fabiano
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Science, Università Degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Science, Università Degli Studi di Milano, Milan, Italy
| |
Collapse
|
24
|
Roebroek YGM, Paulus GF, Talib A, van Mil EGAH, Vreugdenhil ACE, Winkens B, Stehouwer CDA, Greve JWM, Bouvy ND, van Heurn LWE. Weight Loss and Glycemic Control After Bariatric Surgery in Adolescents With Severe Obesity: A Randomized Controlled Trial. J Adolesc Health 2024; 74:597-604. [PMID: 38069930 DOI: 10.1016/j.jadohealth.2023.10.024] [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: 05/05/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE Bariatric surgery is regarded as a valuable treatment option for adolescents with severe obesity. However, high-quality evidence of its superiority over prolonged conservative treatment with multidisciplinary lifestyle intervention (MLI) is limited. This study investigated the efficacy and safety of bariatric surgery in adolescents without sufficient weight loss after MLI for severe obesity. METHODS A two-group randomized controlled trial was designed to assess one-year health effects of bariatric surgery in adolescents with severe obesity. The participants were referred by pediatricians after completing MLI without sufficient effects. Eligible for participation were adolescents aged 14-16 years with severe obesity (age- and sex-adjusted body mass index (BMI) using the International Obesity Task Force cutoffs: BMI ≥40 kg/m2, or ≥35 kg/m2 in combination with comorbidity). Participants were assigned to MLI combined with laparoscopic adjustable gastric banding (n = 29) versus only MLI (n = 30). Participants were included from 2011 to 2019. Main outcomes were weight change and sex- and age-specific BMI loss. Additionaly, glucose metabolism, blood pressure and lipid profile were analysed. RESULTS 53 patients completed the 12-months follow-up (89.8%). Mean (±standard deviation [SD]) weight loss in the surgery group was 11.2 ± 7.8% after 12 months, compared to a weight gain of 1.7 ± 8.1% in the control group. The fasting insulin, insulin resistance score and lipid profile improved significantly in the surgery group. DISCUSSION Bariatric surgery was associated with substantial weight loss and improvements in glucose and lipid metabolism after 12 months compared to conservative treatment in adolescents with severe obesity.
Collapse
Affiliation(s)
- Yvonne G M Roebroek
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
| | - Givan F Paulus
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Ali Talib
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Edgar G A H van Mil
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; Department of Pediatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Anita C E Vreugdenhil
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics and CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan-Willem M Greve
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; Department of General Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - L W Ernest van Heurn
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands; AG&M Amsterdam Gastroenterology and Metabolism, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| |
Collapse
|
25
|
Cuda S. Special considerations for the adolescent with obesity: An obesity medicine association (OMA) clinical practice statement (CPS) 2024. OBESITY PILLARS (ONLINE) 2024; 9:100096. [PMID: 38186667 PMCID: PMC10770754 DOI: 10.1016/j.obpill.2023.100096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details special considerations for the management of the adolescent with obesity. The information in this CPS is based on scientific evidence, supported by medical literature, and derived from the clinical experiences of members of the OMA. Methods The scientific information and clinical guidance in this CPS are based on scientific evidence, supported by the medical literature, and derived from the clinical perspectives of the authors. Results This OMA Clinical Practice Statement addresses special considerations in the management and treatment of adolescents with overweight and obesity. Conclusions This OMA Clinical Practice Statement on the adolescent with obesity is an overview of current recommendations. These recommendations provide a roadmap to the improvement of the health of adolescents with obesity, especially those with metabolic, physiological, and psychological complications. This CPS also addresses treatment recommendations and is designed to help the provider with clinical decision making.
Collapse
Affiliation(s)
- Suzanne Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
| |
Collapse
|
26
|
Tastemel Ozturk T, Düzova A, Oygar PD, Baltu D, Ozcilingir Hakverdi P, Lacinel Gurlevik S, Kurt-Sukur ED, Aykan HH, Ozen S, Ertugrul I, Kesici S, Gulhan B, Ozaltin F, Ozsurekci Y, Cengiz AB, Topaloglu R. Acute kidney injury in children with moderate-severe COVID-19 and multisystem inflammatory syndrome in children: a referral center experience. Pediatr Nephrol 2024; 39:867-877. [PMID: 37676500 DOI: 10.1007/s00467-023-06125-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Data on the characteristics of acute kidney injury (AKI) in pediatric COVID-19 and MIS-C are limited. We aimed to define the frequency, associated factors and early outcome of AKI in moderate, severe or critical COVID-19 and MIS-C; and to present a tertiary referral center experience from Türkiye. METHODS Hospitalized patients ≤ 18 years of age with confirmed COVID-19 or MIS-C at İhsan Doğramacı Children's Hospital, Hacettepe University, between March 2020-December 2021 were enrolled. The characteristics of AKI in the COVID-19 group were investigated in moderate, severe and critically ill patients; patients with mild COVID-19 were excluded. RESULTS The median (Q1-Q3) age in the COVID-19 (n = 66) and MIS-C (n = 111) groups was 10.7 years (3.9-15.2) and 8.7 years (4.5-12.7), respectively. The frequency of AKI was 22.7% (15/66) in COVID-19 and 15.3% (17/111) in MIS-C; all MIS-C patients with AKI and 73.3% (11/15) of COVID-19 patients with AKI had AKI at the time of admission. Multivariate analyses revealed need for vasoactive/inotropic agents [Odds ratio (OR) 19.233, p = 0.002] and presence of vomiting and/or diarrhea (OR 4.465, p = 0.036) as independent risk factors of AKI in COVID-19 patients; and need for vasoactive/inotropic agents (OR 22.542, p = 0.020), procalcitonin and ferritin levels as independent risk factors of AKI in the MIS-C group. Age was correlated with lymphocyte count (r = -0.513, p < 0.001) and troponin level (r = 0.518, p < 0.001) in MIS-C patients. Length of hospital stay was significantly longer in both groups with AKI, compared to those without AKI. Mortality was 9.1% in the COVID-19 group; and was associated with AKI (p = 0.021). There was no mortality in MIS-C patients. AKI recovery at discharge was 63.6% in COVID-19 survivors and 100% in MIS-C patients. CONCLUSIONS Independent risk factors for AKI were need for vasoactive/inotropic agents and vomiting/diarrhea in moderate, severe or critical COVID-19 patients; and need for vasoactive/inotropic agents and severe inflammation in MIS-C patients. Our findings suggest that inflammation and cardiac dysfunction are associated with AKI in MIS-C patients; and the association with age in this group merits further studies in larger groups. Early outcome is favorable; long-term follow-up for kidney functions is needed.
Collapse
Affiliation(s)
- Tugba Tastemel Ozturk
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Ali Düzova
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.
| | - Pembe Derin Oygar
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Demet Baltu
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | | | - Sibel Lacinel Gurlevik
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Eda Didem Kurt-Sukur
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Hayrettin Hakan Aykan
- Division of Pediatric Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
- Life Support Center, Hacettepe University, Ankara, Türkiye
| | - Seza Ozen
- Division of Pediatric Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Ilker Ertugrul
- Division of Pediatric Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Selman Kesici
- Life Support Center, Hacettepe University, Ankara, Türkiye
- Division of Pediatric Intensive Care, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Bora Gulhan
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Fatih Ozaltin
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Yasemin Ozsurekci
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Ali Bulent Cengiz
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Rezan Topaloglu
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| |
Collapse
|
27
|
Tsumori M, Itonaga T, Oyake M, Hirano N, Oyama N, Ihara K. Infantile Hypothalamic Hamartoma: A Rare Presentation of Isolated Obesity. JCEM CASE REPORTS 2024; 2:luae033. [PMID: 38505090 PMCID: PMC10948354 DOI: 10.1210/jcemcr/luae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Indexed: 03/21/2024]
Abstract
Hypothalamic hamartomas (HHs) are rare, benign brain tumors or lesions of the hypothalamus that are predominantly identified in cases of epilepsy and central precocious puberty (CPP), whereas isolated manifestations of infantile obesity are atypical. We herein report an 8-month-old boy with severe obesity (Kaup index 26.4 [>100th percentile]) and uncontrollable hyperphagia. His growth chart demonstrated remarkable weight gain that exceeded the length gain in magnitude. Brain magnetic resonance imaging identified a lesion consistent with HH. There were no episodes or clinical findings of epilepsy, CPP, or Cushing disease. Hypothalamic obesity should be considered in the diagnosis even in infants with excessive weight gain due to overeating.
Collapse
Affiliation(s)
- Mika Tsumori
- Department of Pediatrics, Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Tomoyo Itonaga
- Department of Pediatrics, Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Momoko Oyake
- Department of Pediatrics, Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Naoki Hirano
- Department of Pediatrics, Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Noriko Oyama
- Department of Pediatrics, Oita Prefectural Hospital, Oita, Oita 870-0855, Japan
| | - Kenji Ihara
- Department of Pediatrics, Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan
| |
Collapse
|
28
|
Shreve MD, Scott A, Davis RL. Reexamining the complex issue of obesity in childhood: A new guideline and patient-focused approach. Nurse Pract 2024; 49:20-28. [PMID: 38386469 DOI: 10.1097/01.npr.0000000000000150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
ABSTRACT Obesity in childhood is a complex, multifaceted condition with various contributors, including genetic, environmental, socioeconomic, and physiologic factors. The latest guidelines recommend annual evaluation beginning at age 2 years. Treatment strategies should be family focused and should target nutrition, physical activity, and behavior.
Collapse
|
29
|
Bomberg EM, Kyle TK, Stanford FC. The need for increasing pediatric obesity advocacy. Complement Ther Med 2024; 80:103012. [PMID: 38161055 PMCID: PMC10908360 DOI: 10.1016/j.ctim.2023.103012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Eric M Bomberg
- Center for Pediatric Obesity Medicine, Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota Medical School, 717 Delaware Street SE, Room 370, Minneapolis, MN 55414, USA.
| | - Theodore K Kyle
- ConscienHealth, 2270 Country Club Drive, Pittsburgh, PA 15421, USA.
| | - Fatima C Stanford
- Massachusetts General Hospital, Department of Medicine - Division of Endocrinology -Neuroendocrine, Department of Pediatrics - Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, 4th Floor Weight Center, 50 Staniford Street, Boston, MA 02114, USA.
| |
Collapse
|
30
|
Muth ND, Bolling C, Hannon T, Sharifi M. The Role of the Pediatrician in the Promotion of Healthy, Active Living. Pediatrics 2024; 153:e2023065480. [PMID: 38404207 PMCID: PMC11042797 DOI: 10.1542/peds.2023-065480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
Few children and adolescents meet federal nutrition or physical activity recommendations, and many experience poor or inadequate sleep and negative health effects from screen use and social media. These lifestyle factors exacerbate physical and mental health risks for children and adolescents. This clinical report provides guidance to help pediatricians address the nutritional, physical activity, sleep, media and screen use, and social-emotional factors that affect child and adolescent health and wellness. The recommendations in this clinical report aim to promote health and wellness practices for infants, children, and adolescents across several domains of influence, including the individual, interpersonal, institutional, community, and public policy levels.
Collapse
Affiliation(s)
- Natalie D. Muth
- Children’s Primary Care Medical Group, Carlsbad, Californiaand Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California
| | - Christopher Bolling
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tamara Hannon
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics, Indiana University School of Medicine, Bloomington, Indiana
| | - Mona Sharifi
- Departments of Pediatrics and Biostatistics, Yale School of Medicine, New Haven, Connecticut
| | | | | |
Collapse
|
31
|
Lawton RI, Stanford FC. The Role of Racism in Childhood Obesity. Curr Obes Rep 2024; 13:98-106. [PMID: 38172479 PMCID: PMC10939728 DOI: 10.1007/s13679-023-00538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Obesity rates continue to rise among children and have shown persistent racial disparities. Racism plays a potentially essential and actionable role in these disparities. This report reviews some mechanisms through which racism may shape childhood obesity. RECENT FINDINGS From the youngest ages, disparities in childhood obesity prevalence are already present. Racism may shape intergenerational and prenatal factors that affect obesity and various stressors and environments where children grow up. The relationships between clinicians and patients may also be shaped by everyday racism and legacies of past racism, which may affect obesity prevalence and treatment efficacy. Comprehensive data on the extent to which racism shapes childhood obesity is limited. However, compelling evidence suggests many ways through which racism ultimately does affect childhood obesity. Interventions to address racism at multiple points where it shapes childhood obesity, including intergenerational and prenatal mechanisms, may help to close disparities.
Collapse
Affiliation(s)
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA, USA.
- MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Massachusetts General Hospital, Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, 02114, USA.
- Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, USA.
| |
Collapse
|
32
|
Tocan V, Nakamura-Utsunomiya A, Sonoda Y, Matsuoka W, Mizuguchi S, Muto Y, Hijioka T, Nogami M, Sasaoka D, Nagamatsu F, Oba U, Kawakubo N, Hamada H, Mushimoto Y, Chong PF, Kaku N, Koga Y, Sakai Y, Oda Y, Tajiri T, Ohga S. High-Titer Anti-ZSCAN1 Antibodies in a Toddler Clinically Diagnosed with Apparent Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation Syndrome. Int J Mol Sci 2024; 25:2820. [PMID: 38474067 DOI: 10.3390/ijms25052820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/24/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024] Open
Abstract
Severe obesity in young children prompts for a differential diagnosis that includes syndromic conditions. Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) syndrome is a potentially fatal disorder characterized by rapid-onset obesity associated with hypoventilation, neural crest tumors, and endocrine and behavioral abnormalities. The etiology of ROHHAD syndrome remains to be established, but recent research has been focusing on autoimmunity. We report on a 2-year-old girl with rapid-onset obesity during the first year of life who progressed to hypoventilation and encephalitis in less than four months since the start of accelerated weight gain. The patient had a high titer of anti-ZSCAN1 antibodies (348; reference range < 40), and the increased values did not decline after acute phase treatment. Other encephalitis-related antibodies, such as the anti-NDMA antibody, were not detected. The rapid progression from obesity onset to central hypoventilation with encephalitis warns about the severe consequences of early-onset ROHHAD syndrome. These data indicate that serial measurements of anti-ZSCAN1 antibodies might be useful for the diagnosis and estimation of disease severity. Further research is needed to determine whether it can predict the clinical course of ROHHAD syndrome and whether there is any difference in antibody production between patients with and without tumors.
Collapse
Affiliation(s)
- Vlad Tocan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Akari Nakamura-Utsunomiya
- Department of Genetic Medicine/Pediatrics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8511, Japan
- Department of Pediatrics, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima 731-0293, Japan
- Division of Neonatal Screening, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Yuri Sonoda
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Wakato Matsuoka
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Soichi Mizuguchi
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Yuichiro Muto
- Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto 861-8520, Japan
| | - Takaaki Hijioka
- Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto 861-8520, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Masao Nogami
- Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto 861-8520, Japan
| | - Daiki Sasaoka
- Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Fusa Nagamatsu
- Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Utako Oba
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Naonori Kawakubo
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Hiroshi Hamada
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yuichi Mushimoto
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Pin Fee Chong
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Noriyuki Kaku
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Yuhki Koga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Tatsuro Tajiri
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| |
Collapse
|
33
|
Porri D, Morabito LA, Cavallaro P, La Rosa E, Li Pomi A, Pepe G, Wasniewska M. Time to act on childhood obesity: the use of technology. Front Pediatr 2024; 12:1359484. [PMID: 38434727 PMCID: PMC10904600 DOI: 10.3389/fped.2024.1359484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Childhood obesity is rapidly increasing worldwide and there is an urgent need to implement treatment and prevention programs. Over the last decade, in addition to increasing rates of childhood obesity, we have also observed rapid technological and digital development. The Covid-19 pandemic has largely contributed to both expansions but has also allowed an opening towards a broader vision of medicine, through new therapeutic opportunities such as mobile healthcare. The digital and technological delivery of obesity prevention and treatment programs can represent an innovative tool to support children and families to overcome some limitations and barriers such as the accessibility of programs that prevent them from adopting healthy lifestyle changes. This review aimed to summarize the impact of different digital interventions for children and adolescent affected by obesity.
Collapse
Affiliation(s)
| | | | - Paola Cavallaro
- Unit of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | | | | | | | | |
Collapse
|
34
|
Martínez-Triana MA, Zavala-Rodríguez M, Villaseñor-López K, Martínez-Tovilla Y, Peña-Vélez R. Knowledge of the recommendations for the diagnosis and treatment of childhood obesity among a group of medical students in Mexico. NUTR HOSP 2024; 41:266-269. [PMID: 38047413 DOI: 10.20960/nh.04921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Introduction
Collapse
Affiliation(s)
| | | | | | | | - Rubén Peña-Vélez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition. Hospital General de Puebla Dr. Eduardo Vázquez Navarro
| |
Collapse
|
35
|
Gilardini L, Croci M, Cavaggioni L, Pasqualinotto L, Bertoli S. Sex differences in cardiometabolic risk factors and in response to lifestyle intervention in prepubertal and pubertal subjects with obesity. Front Pediatr 2024; 12:1304451. [PMID: 38410765 PMCID: PMC10895017 DOI: 10.3389/fped.2024.1304451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
Objectives Childhood obesity is a growing health problem and requires a tailored treatment. This study explored the sex differences in cardiovascular risk factors in children/adolescents with obesity and in response to a weight loss intervention. Methods Five hundred and thirty-three children/adolescents with obesity and their parents underwent to a 3-months lifestyle intervention program. Tanner criteria were used to assess the pubertal stage. Before and after 3 months, anthropometric measurements, blood pressure (BP), and biochemical measurements were assessed. Results Four hundred and forty five participants completed the treatment (age 12.4 ± 2.7 years, males 45.8%, prepubertal 29.2%, BMI z score 2.3 ± 0.2). In comparison to boys, prepubertal girls had higher values of BMI z score (2.4 ± 02 vs. 2.3 ± 0.2, p < 0.05), waist circumference z score (2.2 ± 0.3 vs. 2.0 ± 0.3, p < 0.05), HOMA-IR [2.9 (2.1-4.9) vs. 2.3(1.5-3.6), p < 0.01], prevalence of hypertransaminasemia (41.3% vs. 17.7%, p < 0.05) and lower levels of HDL cholesterol (46.2 ± 9.8 vs. 51.2 ± 10.5 mg/dl, p < 0.05). In the pubertal stage, boys had worse cardiometabolic risk profile than girls, including unfavourable measure of systolic BP (z score: 0.6 ± 1.0 vs. 0.3 ± 1.0, p < 0.01), fasting glucose (87.2 ± 6.1 vs. 84.8 ± 7.7 mg/dl, p < 0.01), ALT (26.9 ± 21.5 vs. 20.2 ± 10.6 U/L, p < 0.001) and uric acid (6.1 ± 1.9 vs. 5.0 ± 1.0 mg/dl, p < 0.001). After the lifestyle intervention, changes in BMI z score (p < 0.05) were higher in pubertal boys than pubertal girls. The systolic blood pressure decrease was greater in pubertal boys than in their female counterpart (Δ systolic BP: -7.2 mmHg in boys vs. -3.6 mmHg in girls, p < 0.05; Δ systolic BP z score: -0.6 in boys vs. -0.3 in girls, p < 0.05). LDL cholesterol showed an improvement only in boys, and ALT in the whole group. Conclusion Our study showed that a short-term lifestyle intervention is more effective in reducing BMI z score and cardiovascular risk factors in pubertal boys than in their female counterparts. Further investigation is needed to deepen this gender difference, especially to develop a tailor-made intervention.
Collapse
Affiliation(s)
- Luisa Gilardini
- Obesity Unit—Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marina Croci
- Obesity Unit—Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Luca Cavaggioni
- Obesity Unit—Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Lucia Pasqualinotto
- Obesity Unit—Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Simona Bertoli
- Obesity Unit—Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
| |
Collapse
|
36
|
Luppino G, Wasniewska M, Casto C, Ferraloro C, Li Pomi A, Pepe G, Morabito LA, Alibrandi A, Corica D, Aversa T. Treating Children and Adolescents with Obesity: Predictors of Early Dropout in Pediatric Weight-Management Programs. CHILDREN (BASEL, SWITZERLAND) 2024; 11:205. [PMID: 38397317 PMCID: PMC10887674 DOI: 10.3390/children11020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Possible therapeutic failure of pediatric obesity is influenced by the high dropout rate. The aim of this study was to evaluate the rate of dropout and the rate of weight loss over the 24 months of follow-up. METHODS The retrospective, single-center study, involved 489 patients followed for obesity in the period 2016-2020. Patients' auxological data and blood samples were collected during the first (V1) and last visit (V2). Dropout was defined as a follow-up of less than 12 months and/or including less than one visit every 6 months. Patients were divided into two groups and compared: Group A of dropout (297 patients) and Group B of non-dropout (192 patients). RESULTS In the follow-up period, which had a mean duration of 24 months, the dropout rate was 60.7%. In Group A, the percentage of patients with BMI ≥ 3 SD at V2 was significantly higher than that in Group B. In Group B, the percentage of patients with pathological HOMA-IR and with fasting glucose >100 mg/dL was higher than group A. The probability of dropout was positively associated with pubertal stage and negatively with impaired fasting glycemia and pathological insulinemia at V1. CONCLUSION The study demonstrated a high dropout rate during follow-up, mainly among adolescents and patients with no glucometabolic alterations.
Collapse
Affiliation(s)
- Giovanni Luppino
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Pediatric Unit, AOU Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Celeste Casto
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Chiara Ferraloro
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Alessandra Li Pomi
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Giorgia Pepe
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Pediatric Unit, AOU Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Letteria Anna Morabito
- Pediatric Unit, AOU Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Angela Alibrandi
- Department of Economics, University of Messina, 98125 Messina, Italy
| | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Pediatric Unit, AOU Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Tommaso Aversa
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Pediatric Unit, AOU Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy
| |
Collapse
|
37
|
Iacopetta D, Catalano A, Ceramella J, Pellegrino M, Marra M, Scali E, Sinicropi MS, Aquaro S. The Ongoing Impact of COVID-19 on Pediatric Obesity. Pediatr Rep 2024; 16:135-150. [PMID: 38391001 PMCID: PMC10885050 DOI: 10.3390/pediatric16010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
In the developed world, pediatric obesity (PO) has been a major health concern since the last century, and this condition may lead to detrimental life-long physical and mental comorbidities. Currently, its prevalence has increased in low- and middle-income countries and in many high-income countries. Thus, the provision of effective and tailored care for children and their families has become vital. The social consequences of the COVID-19 pandemic are known everywhere, and among these, it has been argued that the COVID-19 pandemic has had a major impact on PO. Overall, the growth of PO over the last decade has been enhanced by the pandemic. During the COVID-19 pandemic, children, adolescents and young adults gained weight as the pediatric population dealt with sedentary lifestyles and changes in food habits. In this review, we want to highlight the impact that the COVID-19 pandemic had on PO.
Collapse
Affiliation(s)
- Domenico Iacopetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70126 Bari, Italy
| | - Jessica Ceramella
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Michele Pellegrino
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Maria Marra
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Elisabetta Scali
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Maria Stefania Sinicropi
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| |
Collapse
|
38
|
Umekar S, Joshi A. Obesity and Preventive Intervention Among Children: A Narrative Review. Cureus 2024; 16:e54520. [PMID: 38516445 PMCID: PMC10955407 DOI: 10.7759/cureus.54520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
Childhood obesity has become a major public health concern around the world, with a rise in prevalence over the last few decades. This abstract provides an overview of pediatric obesity, including its causes, implications, and potential treatments. Childhood obesity is caused by a complex combination of environmental, genetic, and behavioral variables. A child's likelihood of developing obesity is influenced by factors, such as socioeconomic status, family dynamics, and cultural norms. Childhood obesity leads to extensive repercussions, elevating the risk of chronic conditions, such as diabetes, cardiovascular diseases, and mental health challenges. Furthermore, children dealing with obesity often face social stigmatization, diminished self-esteem, and academic struggles. Efforts to prevent and manage childhood obesity should employ a comprehensive and multi-tiered approach. This involves enacting policies geared toward enhancing nutrition in schools and communities, advocating for increased physical activity (PA), and curbing sedentary behaviors.
Collapse
Affiliation(s)
- Sayali Umekar
- School of Epidermology and Public Health, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Abhishek Joshi
- Community Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
39
|
Henes ST, Stotz SA, Riggs SE, Yang HM. eHealth, family-based interventions, and multilevel approaches to pediatric weight management: a scoping review. Nutr Rev 2024:nuad160. [PMID: 38269577 DOI: 10.1093/nutrit/nuad160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE This scoping review examines the current literature on technology-based, eHealth interventions that integrate community and clinical approaches for family-based pediatric weight management. BACKGROUND Telehealth and eHealth interventions for weight management are increasingly commonplace; however, it is unclear in the current literature how family-based, pediatric, healthy-weight interventions integrate technology. Additionally, multilevel approaches to address childhood obesity, including working with clinical and community partners, are currently considered best practice and within the socioecological framework for sustainability of outcomes. Little is known how current family based pediatric healthy weight interventions integrate eHealth and multi-level approaches. METHODS Guided by Arksey and O'Malley's scoping review framework, a scoping literature review was conducted. Four databases were searched to identify studies conducted between 2010 and 2022 that addressed multilevel, family-based, pediatric weight management interventions that also integrated technology. Studies were excluded that did not include at least 2 of the 4 components and that did not include technology to some degree. RESULTS A total of 15 articles were included in the scoping review. All articles included some type of technology in the intervention. Twelve articles included a family-based approach, and only 1 article fully used a holistic approach to family-based, pediatric weight management that included technology and integrated clinical and community approaches to address the complexity of childhood obesity. CONCLUSIONS There are several family-based, pediatric weight management interventions that incorporate an eHealth component. There is a gap in the literature about programs that use both technology and integrate multilevel clinical and community approaches for treatment. Additionally, gaps exist in information about adolescent, family-based, weight management interventions, and there are opportunities for nutrition and dietetic professionals to become more involved with technological and multilevel approaches in family-based pediatric weight management.
Collapse
Affiliation(s)
- Sarah T Henes
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Sarah A Stotz
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Sandra E Riggs
- University Libraries, Research and Instruction, University of Georgia, Athens, GA, USA
| | - Hsuan-Mein Yang
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| |
Collapse
|
40
|
Chatzidaki E, Chioti V, Mourtou L, Papavasileiou G, Kitani RA, Kalafatis E, Mitsis K, Athanasiou M, Zarkogianni K, Nikita K, Kanaka-Gantenbein C, Pervanidou P. Parenting Styles and Psychosocial Factors of Mother-Child Dyads Participating in the ENDORSE Digital Weight Management Program for Children and Adolescents during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2024; 11:107. [PMID: 38255420 PMCID: PMC10814028 DOI: 10.3390/children11010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Childhood obesity is a complex disease with multiple biological and psychosocial risk factors. Recently, novel digital programs were developed with growing evidence for their effectiveness in pediatric weight management studies. The ENDORSE platform consists of mobile applications, wearables, and serious games for the remote management of childhood obesity. The pilot studies included 50 mothers and their children aged 6-14 years and resulted in a clinically significant BMI z-score reduction over 4 to 5 months. This secondary analysis of the ENDORSE study focuses on parenting styles and psychosocial factors. METHODOLOGY Semi-structured clinical interviews were conducted with all participating mothers pre-and post-intervention. The Parenting Styles and Dimensions Questionnaire (PSDQ) evaluated the mothers' parenting styles. The psychosocial functioning of the participating children was assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). The relationship between parenting styles, psychosocial parameters, and weight outcomes was investigated using a linear regression analysis. RESULTS Weight-related stigma at school (56%), body image concerns (66%), and difficulties in family relationships (48%) were the main concerns documented during the initial psychological interviews. According to the SDQ, there was a significant decrease in children's conduct problems during the study's initial phase (pre-pilot group). A decrease in maternal demandingness (i.e., strict parenting style) was associated with a decrease in BMI z-score (beta coefficient = 0.314, p-value = 0.003). CONCLUSION Decreasing parental demandingness was associated with better weight outcomes, highlighting the importance of assessing parenting factors in pediatric weight management programs.
Collapse
Affiliation(s)
- Evi Chatzidaki
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
| | - Vassiliki Chioti
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
| | - Lidia Mourtou
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Georgia Papavasileiou
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Rosa-Anna Kitani
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Eleftherios Kalafatis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Kostas Mitsis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Maria Athanasiou
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Konstantia Zarkogianni
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
- Department of Advanced Computing Sciences, Faculty of Sciences and Engineering, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Konstantina Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Panagiota Pervanidou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| |
Collapse
|
41
|
Chamay Weber C, Gal-Duding C, Maggio AB. Family based behavioral treatment in adolescents suffering from obesity: evolution through adulthood. BMC Pediatr 2024; 24:33. [PMID: 38200412 PMCID: PMC10777574 DOI: 10.1186/s12887-023-04497-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Family Based Behavioral Treatments (FBBT) are reported to have a favorable impact on the short and mid-term evolution on the body mass index (BMI) of adolescents suffering from obesity. This study investigated the long-term BMI z-score evolution, as well as variables associated with favorable or unfavorable evolution in adolescents who beneficiated from FBBT group therapy treatment for obesity. METHODS This was a prospective study including adolescents who participated in FBBT group therapy for obesity sessions (n = 131). All adolescents were invited for a study's clinical interview 4 years after the therapy, during which their weight and height were measured, and they answered a questionnaire on some life habits. Anthropometric measurements at the time of therapy as well as socio-demographic data were retrospectively extracted from the electronic medical record. RESULTS Seventy-six subjects (57% of the sample) accepted to participate in the study. At the study's clinical interview (mean 5.5 years after FBBT), 52.6% of the adolescents showed a favorable evolution of their weight status defined as a decrease (>-0.2) or stabilization (between - 0.2 and + 0.2) of their BMI z-score. 32% were engaged in a daily physical activity and 40.6% monitored their weight at least once a week or more. Only these 2 variables were associated with a favorable evolution (p = 0.009 and p = 0.001, respectively). Less than half of the sample (45.9%) have maintained a medical weight-management follow up, of which 67% had a BMI equal or more than 30. CONCLUSIONS Long-term evolution of the BMI z-score was favorable for most of the adolescents, emphasizing the potential benefits of FBBT treatment on the long term for adolescents suffering from obesity. This study highlighted the difficulty for long-term weight management follow up in this population at risk of numerous medical comorbidities, confirming the need to improve adherence to weight management treatment at this age of transition of care. Prospective observational study registered.
Collapse
Affiliation(s)
- Catherine Chamay Weber
- Health and Movement Consultation, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- Adolescent Health Unit, Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
| | - Claudine Gal-Duding
- Health and Movement Consultation, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Adolescent Health Unit, Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Albane Br Maggio
- Health and Movement Consultation, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| |
Collapse
|
42
|
Roberts KJ, Chaves E, Ariza AJ, Thaker VV, Cho CC, Binns HJ. Exploring Genetic Testing for Rare Disorders of Obesity: Experience and Perspectives of Pediatric Weight Management Providers. Child Obes 2024. [PMID: 38227789 DOI: 10.1089/chi.2023.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Background: This study describes experiences and perspectives of pediatric weight management (PWM) providers on the implementation of genetic testing for rare causes of obesity. Methods: Purposive and snowball sampling recruited PWM providers via email to complete a 23-question survey with multiple choice and open-ended questions. Analyses include descriptive statistics, Fisher's exact test, one-way ANOVA with Tukey's post hoc test, and qualitative analysis. Results: Of the 55 respondents, 80% reported ordering genetic testing. Respondents were primarily physicians (82.8%) in practice for 11-20 years (42%), identified as female (80%), White (76.4%), and non-Hispanic (92.7%) and provided PWM care 1-4 half day sessions per week. Frequently reported patient characteristics that prompted testing did not vary by provider years of experience (YOE). These included obesity onset before age 6, hyperphagia, dysmorphic facies, and developmental delays. The number of patient characteristics that prompted testing varied by YOE (p = 0.03); respondents with 6-10 YOE indicated more patient characteristics than respondents with >20 YOE (mean 10.3 vs. mean 6.2). The reported primary benefit of testing was health information for patients/families; the primary drawback was the high number of indeterminate tests. Ethical concerns expressed were fear of increasing weight stigma, discrimination, and impact on insurance coverage. Respondents (42%) desired training and guidance on interpreting results and counseling patients and families. Conclusions: Most PWM providers reported genetic testing as an option for patient management. Provider training in genetics/genomics and research into provider and family attitudes on the genetics of obesity and the value of genetic testing are next steps to consider.
Collapse
Affiliation(s)
- Karyn J Roberts
- School of Nursing, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Eileen Chaves
- Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Adolfo J Ariza
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Vidhu V Thaker
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Chi C Cho
- School of Nursing, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Helen J Binns
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| |
Collapse
|
43
|
Prabhakar PK. Combination Therapy: A New Tool for the Management of Obesity. Endocr Metab Immune Disord Drug Targets 2024; 24:402-417. [PMID: 37641995 DOI: 10.2174/1871530323666230825140808] [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: 01/20/2023] [Revised: 06/19/2023] [Accepted: 07/20/2023] [Indexed: 08/31/2023]
Abstract
Obesity is a chronic lifestyle issue with devastating results. Behavioral changes are one of the initial lines of management strategies for obesity, but they are not very efficient management strategies. Many people also use surgical intervention to maintain a healthy weight, now considered to be the most common and effective obesity management. Chemically synthesized medicines fill the gap between lifestyle interventions and minimally invasive surgical management of obesity. The most common issue associated with monotherapy without side effects is its moderate effectiveness and higher dose requirement. Combination therapy is already used for many serious and complicated disease treatments and management and has shown efficacy as well. Generally, we use two or more medicines with different mechanisms of action for a better effect. The commonly used combination therapy for obesity management includes low-dose phentermine and prolonged and slow-releasing mechanism topiramate; naltrexone, and bupropion. Phentermine with inhibitors of Na-glucose cotransporter-2 or glucagon-like peptide-1 (GLP-1) agonists with gastric hormone or Na-glucose cotransporter-2 are two more viable combo therapy. This combination strategy aims to achieve success in bariatric surgery and the scientific community is working in this direction.
Collapse
Affiliation(s)
- Pranav Kumar Prabhakar
- Department of Research Impact and Outcome, Lovely Professional University, Punjab, 144411, India
| |
Collapse
|
44
|
Concepción-Zavaleta MJ, Quiroz-Aldave JE, Durand-Vásquez MDC, Gamarra-Osorio ER, Valencia de la Cruz JDC, Barrueto-Callirgos CM, Puelles-León SL, Alvarado-León EDJ, Leiva-Cabrera F, Zavaleta-Gutiérrez FE, Concepción-Urteaga LA, Paz-Ibarra J. A comprehensive review of genetic causes of obesity. World J Pediatr 2024; 20:26-39. [PMID: 37725322 DOI: 10.1007/s12519-023-00757-z] [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: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Obesity is a multifactorial chronic disease with a high, increasing worldwide prevalence. Genetic causes account for 7% of the cases in children with extreme obesity. DATA SOURCES This narrative review was conducted by searching for papers published in the PubMed/MEDLINE, Embase and SciELO databases and included 161 articles. The search used the following search terms: "obesity", "obesity and genetics", "leptin", "Prader-Willi syndrome", and "melanocortins". The types of studies included were systematic reviews, clinical trials, prospective cohort studies, cross-sectional and prospective studies, narrative reviews, and case reports. RESULTS The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body weight. However, several important aspects of the pathophysiology of obesity remain unknown. Genetic causes of obesity can be grouped into syndromic, monogenic, and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years, hyperphagia, or a family history of extreme obesity. A microarray study, an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this purpose. There are three therapeutic levels: lifestyle modifications, pharmacological treatment, and bariatric surgery. CONCLUSIONS Genetic study technologies are in constant development; however, we are still far from having a personalized approach to genetic causes of obesity. A significant proportion of the affected individuals are associated with genetic causes; however, there are still barriers to its approach, as it continues to be underdiagnosed. Video Abstract (MP4 1041807 KB).
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - José Paz-Ibarra
- Department of Medicine, School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| |
Collapse
|
45
|
Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
Collapse
Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
| |
Collapse
|
46
|
ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Ekhlaspour L, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 14. Children and Adolescents: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S258-S281. [PMID: 38078582 PMCID: PMC10725814 DOI: 10.2337/dc24-s014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
47
|
Juszli S, Stamm R, Karas D. Implementation of Provider-Focused Education to Improve Laboratory Screening for Pediatric Patients With Elevated Body Mass Index in Primary Care: A Quality Improvement Project. J Pediatr Health Care 2024; 38:39-51. [PMID: 37943209 DOI: 10.1016/j.pedhc.2023.09.002] [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: 04/12/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Children with elevated body mass index (BMI) do not consistently receive recommended laboratory screenings. This project aimed to increase provider screening rates and knowledge of screening guidelines for this population. METHOD This project utilized the Rosswurm and Larrabee evidence-based practice model. Providers completed education with pretest and posttest design. Laboratory screening rates were measured with retrospective chart reviews, and a project satisfaction survey was conducted. RESULTS Nine (82%) of 11 providers showed an increase in knowledge of screening for children with elevated BMI. Laboratory screening increased (27% to 39%) above the preintervention median (25%) for children with obesity and was above the median (22%) for one month of the project (15% to 26%) for children with overweight. CONCLUSIONS Project results suggest education improved knowledge and compliance with guidelines for laboratory screening of children with an elevated BMI. Asynchronous education and sharing of compliance rates are adaptable to similar quality improvement projects.
Collapse
|
48
|
Wang L, Liu W, Bi S, Zhou L, Li L. Association between minerals intake and childhood obesity: A cross-sectional study of the NHANES database in 2007-2014. PLoS One 2023; 18:e0295765. [PMID: 38150411 PMCID: PMC10752540 DOI: 10.1371/journal.pone.0295765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The roles of minerals in obesity received increasing attention recently due to its oxidant or antioxidant functions and effects on insulin and glucose metabolism that may be associated with obesity. Herein, this study aims to explore the association between minerals and obesity and body mass index (BMI) in children with different ages, and hope to provide some references for prevention and management in children with high-risk of obesity. METHODS Data of children aged 2-17 years old were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2007-2014 in this cross-sectional study. Weighted univariate and multivariate logistic regression and liner regression analyses were used to screen covariates, and explore the association between minerals [including calcium (Ca), phosphorus (P), magnesium (Mg), iron (Fe), zinc (Zn), copper (Cu), sodium (Na), potassium (K) and selenium (Se)] and childhood obesity and BMI. The evaluation indexes were β, odds ratios (ORs) and 95% confidence intervals (CIs). These relationships were also investigated in age subgroups. RESULTS Among 10,450 eligible children, 1,988 (19.02%) had obesity. After adjusting for covariates, we found the highest quartile of dietary Fe [OR = 0.74, 95%CI: (0.58, 0.95)] and Zn [OR = 0.70, 95%CI: (0.54, 0.92)] intakes were associated with low odds of childhood obesity, while that of dietary Na intake seemed to be positively linked to childhood obesity [OR = 1.35, 95%CI: (1.05, 1.74)]. High dietary intakes of Ca, Na and K were positively associated with children's BMI, on the contrary, dietary Fe and Zn consumptions had a negative one (all P<0.05). Additionally, these associations were also found in children with different age (all P<0.05). CONCLUSION Dietary Fe and Zn intakes played positive roles in reducing childhood obesity or BMI, while the intakes of Na should be controlled suitably.
Collapse
Affiliation(s)
- Lu Wang
- Department of pediatrics, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, P.R. China
| | - Wei Liu
- Department of pediatrics, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, P.R. China
| | - Sitong Bi
- Department of pediatrics, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, P.R. China
| | - Li Zhou
- Department of pediatrics, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, P.R. China
| | - Lihua Li
- Department of pediatrics, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, P.R. China
| |
Collapse
|
49
|
Kitani RA, Nicolaides NC, Mantzou A, Chatzidaki E, Michou M, Polychronaki N, Letsou K, Pervanidou P, Kanaka-Gantenbein C. Differences in segmental hair cortisol concentration analysis among children and adolescents with overweight and obesity, their parents, and normal weight peers. Hormones (Athens) 2023; 22:623-632. [PMID: 37688736 DOI: 10.1007/s42000-023-00482-2] [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: 04/04/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE Dysregulation of the stress system via incidental long exposure to glucocorticoids (GCs) can lead to weight gain. In addition, family and maternal stress can also have an impact on children's weight. Hair is used in several studies to evaluate cortisol (GC) levels in children and adolescents with excess weight as a retrospective stress biomarker, depending on the hair length the cortisol measurement depicting different time periods. We aimed to investigate whether there is a difference among segmental hair cortisol concentration (HCC) analysis between children and adolescents with overweight and obesity, their mothers, and normal weight peers. METHODS This study recruited 25 children aged 6-14 years with a body mass index (BMI) ≥ 85th centile and their mothers, as well as 20 children of the same age with a BMI < 85th centile. Hair cortisol concentration was measured using electrochemiluminescence immunoassay. RESULTS Segmental HCC analysis exhibited gradually decreasing values in all participants as segments of hair were more distantly located from the scalp. A positive correlation was found between BMI z-score and HCC of the first segment of hair in children and adolescents with elevated BMI (b = 1.84, p = 0.033), as well as with maternal HCC / of an only child (b = 15.77, p = 0.01). There were no associations between mother-child dyads and children and adolescents of different BMI groups, even though minors with excess weight exhibited higher HCC levels in all segments of hair in comparison to their normal weight counterparts. CONCLUSIONS Hair cortisol of all participants exhibited a gradually declining concentration. More studies with larger samples and more sensitive methods of analysis are warranted in order to draw firmer conclusions.
Collapse
Affiliation(s)
- Rosa-Anna Kitani
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece.
| | - Nicolas C Nicolaides
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Aimilia Mantzou
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Evi Chatzidaki
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Maria Michou
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, 17671, Athens, Greece
| | - Nektaria Polychronaki
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Konstantina Letsou
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
| | - Panagiota Pervanidou
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Christina Kanaka-Gantenbein
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| |
Collapse
|
50
|
Pomahacova R, Paterova P, Nykodymova E, Polak P, Sladkova E, Skalicka E, Sykora J. Overweight and obesity in children and adolescents with endocrine disorders. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:328-334. [PMID: 37712247 DOI: 10.5507/bp.2023.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/28/2023] [Indexed: 09/16/2023] Open
Abstract
Obesity has become a serious medical condition where many factors can contribute to excess weight gain. The most common type of childhood obesity is simple obesity, which is due to gene-obesogenic environment interaction. Only a minority are due to pathological causes. Secondary causes of obesity, while less common, include these: genetic syndromes, drug-related obesity, as well as endocrine disorders (hypothyroidism, Cushing's syndrome, growth hormone deficiency, hypogonadism, pseudohypoparathyroidism type Ia, insulinoma, hypothalamic obesity and polycystic ovary syndrome). Given that some conditions may be treatable, physicians must be aware of obesity due to endocrinopathies and distinguish them from simple obesity, and treat them properly. Although rare among children, early detection of the endocrine cause of obesity leads to reduced morbidity and, in some cases, reduced mortality in these individuals. The aim of this review is to summarize the current findings on obesity-related endocrinopathies in children (illustrated by clinical examples), highlighting aspects of pathogenetic mechanisms, genetics, the clinical diagnosis, growth, body mass index and possible therapeutic approaches. Early detection and correction of endocrine obesity is of paramount importance for obese children who could benefit from timely diagnosis and an improved management of obesity as many disturbances related to obesity can be reversed at the early stage, if weight loss is achieved.
Collapse
Affiliation(s)
- Renata Pomahacova
- Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Petra Paterova
- Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Eva Nykodymova
- Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Petr Polak
- Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Eva Sladkova
- Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Eva Skalicka
- Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Josef Sykora
- Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| |
Collapse
|