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Andrews A, Maharaj A, Cottrell E, Chatterjee S, Shah P, Denvir L, Dumic K, Bossowski A, Mushtaq T, Vukovic R, Didi M, Shaw N, Metherell LA, Savage MO, Storr HL. Genetic Characterization of Short Stature Patients With Overlapping Features of Growth Hormone Insensitivity Syndromes. J Clin Endocrinol Metab 2021; 106:e4716-e4733. [PMID: 34136918 PMCID: PMC8530715 DOI: 10.1210/clinem/dgab437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Growth hormone insensitivity (GHI) in children is characterized by short stature, functional insulin-like growth factor (IGF)-I deficiency, and normal or elevated serum growth hormone (GH) concentrations. The clinical and genetic etiology of GHI is expanding. OBJECTIVE We undertook genetic characterization of short stature patients referred with suspected GHI and features which overlapped with known GH-IGF-I axis defects. METHODS Between 2008 and 2020, our center received 149 GHI referrals for genetic testing. Genetic analysis utilized a combination of candidate gene sequencing, whole exome sequencing, array comparative genomic hybridization, and a targeted whole genome short stature gene panel. RESULTS Genetic diagnoses were identified in 80/149 subjects (54%) with 45/80 (56%) having known GH-IGF-I axis defects (GHR n = 40, IGFALS n = 4, IGFIR n = 1). The remaining 35/80 (44%) had diagnoses of 3M syndrome (n = 10) (OBSL1 n = 7, CUL7 n = 2, and CCDC8 n = 1), Noonan syndrome (n = 4) (PTPN11 n = 2, SOS1 n = 1, and SOS2 n = 1), Silver-Russell syndrome (n = 2) (loss of methylation on chromosome 11p15 and uniparental disomy for chromosome 7), Class 3-5 copy number variations (n = 10), and disorders not previously associated with GHI (n = 9) (Barth syndrome, autoimmune lymphoproliferative syndrome, microcephalic osteodysplastic primordial dwarfism type II, achondroplasia, glycogen storage disease type IXb, lysinuric protein intolerance, multiminicore disease, macrocephaly, alopecia, cutis laxa, and scoliosis syndrome, and Bloom syndrome). CONCLUSION We report the wide range of diagnoses in 149 patients referred with suspected GHI, which emphasizes the need to recognize GHI as a spectrum of clinical entities in undiagnosed short stature patients. Detailed clinical and genetic assessment may identify a diagnosis and inform clinical management.
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Affiliation(s)
- Afiya Andrews
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Avinaash Maharaj
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Emily Cottrell
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sumana Chatterjee
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | | | | | - Artur Bossowski
- Department of Peadiatrics, Endocrinology and Diabetes with a Cardiology Unit, Medical University of Białystok, Poland
| | | | - Rade Vukovic
- Mother and Child Health Care Institute of Serbia, “Dr Vukan Cupic”, Belgrade, Serbia
| | | | - Nick Shaw
- Birmingham Children’s Hospital, Birmingham, UK
| | - Louise A Metherell
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Martin O Savage
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Helen L Storr
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Correspondence: Professor Helen L. Storr, Professor and Honorary Consultant in Paediatric Endocrinology, Centre for Endocrinology, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK.
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Messina V, Hirvikoski T, Karlsson L, Vissani S, Wallensteen L, Ortolano R, Balsamo A, Nordenström A, Lajic S. Good overall behavioural adjustment in children and adolescents with classic congenital adrenal hyperplasia. Endocrine 2020; 68:427-437. [PMID: 32152914 PMCID: PMC7266840 DOI: 10.1007/s12020-020-02244-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 02/24/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE Patients with classic congenital adrenal hyperplasia (CAH) are treated postnatally with life-long glucocorticoid (GC) replacement therapy. Although prolonged exposure to GCs may have a negative impact on behaviour, few studies have studied this issue. We therefore investigated behavioural outcomes in male and female children and adolescents with CAH. METHODS An observational study in which Swedish and Italian children and adolescents with CAH identified through neonatal screening for CAH (n = 57, age range 7-17 years) were compared with healthy population controls matched for age and sex (n = 72, age range 7-17 years). Thirteen (eight females) of the fifty-seven children and adolescents with CAH had been treated prenatally with dexamethasone (DEX). Standardised questionnaires for parents and self-report scales for children/adolescents were used to assess behavioural and emotional problems, social anxiety, temperament and scholastic competence. RESULTS There were no statistically significant differences between CAH patients (not prenatally treated with DEX) and controls on most of the scales measuring adaptive functioning or behavioural problems. However, children with CAH were rated by their parents to have more social problems than controls (Child Behaviour Checklist, CBCL social problems, p = 0.032). In the small group (n = 13) of prenatally DEX-treated cases parents rated their children/adolescents to have more mood problems compared with non-DEX-treated children/adolescents with CAH (CBCL-withdrawn/depressed, p = 0.019). CONCLUSION Children/adolescents with CAH showed good overall adjustment. The clinical significance of the parentally perceived increase in social problems in children/adolescents with CAH requires further investigation. The findings underline the importance of psychological support for children/adolescents with a chronic condition.
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Affiliation(s)
- Valeria Messina
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-17176, Stockholm, Sweden
| | - Tatja Hirvikoski
- Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, SE-17177, Stockholm, Sweden
- Unit for Habilitation & Health, Stockholm County Council, Stockholm, Sweden
| | - Leif Karlsson
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-17176, Stockholm, Sweden
| | - Sophia Vissani
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Pediatric Endocrinology Unit, 40138, Bologna, Italy
| | - Lena Wallensteen
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-17176, Stockholm, Sweden
| | - Rita Ortolano
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Pediatric Endocrinology Unit, 40138, Bologna, Italy
| | - Antonio Balsamo
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Pediatric Endocrinology Unit, 40138, Bologna, Italy
| | - Anna Nordenström
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-17176, Stockholm, Sweden
| | - Svetlana Lajic
- Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit (QB83), Karolinska University Hospital, SE-17176, Stockholm, Sweden.
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Balyura M, Gelfgat E, Steenblock C, Androutsellis-Theotokis A, Ruiz-Babot G, Guasti L, Werdermann M, Ludwig B, Bornstein T, Schally AV, Brennand A, Bornstein SR. Expression of progenitor markers is associated with the functionality of a bioartificial adrenal cortex. PLoS One 2018; 13:e0194643. [PMID: 29596439 PMCID: PMC5875767 DOI: 10.1371/journal.pone.0194643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/07/2018] [Indexed: 11/19/2022] Open
Abstract
Encapsulation of primary bovine adrenocortical cells in alginate is an efficacious model of a bioartificial adrenal cortex. Such a bioartificial adrenal cortex can be used for the restoration of lost adrenal function in vivo as well as for in vitro modeling of the adrenal microenvironment and for investigation of cell–cell interactions in the adrenals. The aim of this work was the optimization of a bioartificial adrenal cortex, that is the generation of a highly productive, self-regenerating, long-term functioning and immune tolerant bioartificial organ. To achieve this, it is necessary that adrenocortical stem and progenitor cells are present in the bioartificial gland, as these undifferentiated cells play important roles in the function of the mature gland. Here, we verified the presence of adrenocortical progenitors in cultures of bovine adrenocortical cells, studied the dynamics of their appearance and growth and determined the optimal time point for cell encapsulation. These procedures increased the functional life span and reduced the immunogenicity of the bioartificial adrenal cortex. This model allows the use of the luteinizing hormone-releasing hormone (LHRH) agonist triptorelin, the neuropeptide bombesin, and retinoic acid to alter cell number and the release of cortisol over long periods of time.
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Affiliation(s)
- Mariya Balyura
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
- * E-mail:
| | - Evgeny Gelfgat
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Charlotte Steenblock
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
| | | | - Gerard Ruiz-Babot
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Leonardo Guasti
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Martin Werdermann
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Barbara Ludwig
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of Helmholtz Centre Munich at University Clinic Carl Gustav Carus of TU Dresden Faculty of Medicine, Dresden, Germany
- Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
| | - Tobias Bornstein
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
- Diabetes and Nutritional Sciences Division, King's College London, London, United Kingdom
| | - Andrew V. Schally
- Divisions of Endocrinology and Hematology–Oncology, Departments of Medicine and Department of Pathology, University of Miami, Miller School of Medicine, Miami, FL, United States of America
- Veterans Affairs Medical Center, Miami, FL, United States of America
| | - Ana Brennand
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
- Diabetes and Nutritional Sciences Division, King's College London, London, United Kingdom
| | - Stefan R. Bornstein
- University Hospital Carl Gustav Carus, Dept. of Medicine III, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of Helmholtz Centre Munich at University Clinic Carl Gustav Carus of TU Dresden Faculty of Medicine, Dresden, Germany
- Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
- Diabetes and Nutritional Sciences Division, King's College London, London, United Kingdom
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Kämpe AJ, Costantini A, Mäkitie RE, Jäntti N, Valta H, Mäyränpää M, Kröger H, Pekkinen M, Taylan F, Jiao H, Mäkitie O. PLS3 sequencing in childhood-onset primary osteoporosis identifies two novel disease-causing variants. Osteoporos Int 2017; 28:3023-3032. [PMID: 28748388 PMCID: PMC5624974 DOI: 10.1007/s00198-017-4150-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 07/06/2017] [Indexed: 12/12/2022]
Abstract
UNLABELLED Altogether 95 children with primary bone fragility were screened for variants in PLS3, the gene underlying X-linked osteoporosis. Two children with multiple peripheral and spinal fractures and low BMD had novel disease-causing PLS3 variants. Children with milder phenotypes had no pathogenic variants. PLS3 screening is indicated in childhood-onset primary osteoporosis. INTRODUCTION The study aimed to determine the role of pathogenic PLS3 variants in children's bone fragility and to elucidate the associated phenotypic features. METHODS Two cohorts of children with bone fragility were screened for variants in PLS3, the gene underlying X-linked osteoporosis. Cohort I comprised 31 patients with childhood-onset primary osteoporosis of unknown etiology. Cohort II comprised 64 children who had sustained multiple fractures but were otherwise healthy. Clinical and radiological data were reviewed. Peripheral blood DNA was Sanger sequenced for coding exons and flanking intronic regions of PLS3. RESULTS In two patients of cohort I, where other common genetic causes had been excluded, we identified two novel disease-causing PLS3 variants. Patient 1 was a male with bilateral femoral fractures at 10 years, low BMD (Z-score -4.1; 18 years), and multiple vertebral compression fractures. He had a novel nonsense variant in PLS3. Patient 2 was a girl with multiple long bone and vertebral fractures and low BMD (Z-score -6.6 at 6 years). She had a de novo missense variant in PLS3; whole exome sequencing and array-CGH identified no other genetic causes. Iliac crest bone biopsies confirmed low-turnover osteoporosis in both patients. In cohort II, no pathogenic PLS3 variants were identified in any of the subjects. CONCLUSIONS Two novel disease-causing variants in PLS3 were identified in a boy and a girl with multiple peripheral and spinal fractures and very low BMD while no pathogenic variants were identified in children with less severe skeletal fragility. PLS3 screening is warranted in male and female patients with childhood-onset primary osteoporosis.
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Affiliation(s)
- A J Kämpe
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - A Costantini
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - R E Mäkitie
- Folkhälsan Institute of Genetics and University of Helsinki, Helsinki, Finland
| | - N Jäntti
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - H Valta
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M Mäyränpää
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - H Kröger
- Department of Orthopaedics and Traumatology, Bone and Cartilage Research Unit, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - M Pekkinen
- Folkhälsan Institute of Genetics and University of Helsinki, Helsinki, Finland
| | - F Taylan
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - H Jiao
- Department of Biosciences and Nutrition and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden
| | - O Mäkitie
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Folkhälsan Institute of Genetics and University of Helsinki, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Stanikova D, Buzga M, Krumpolec P, Skopkova M, Surova M, Ukropcova B, Ticha L, Petrasova M, Gabcova D, Huckova M, Piskorova L, Bozensky J, Mokan M, Ukropec J, Zavacka I, Klimes I, Stanik J, Gasperikova D. Genetic analysis of single-minded 1 gene in early-onset severely obese children and adolescents. PLoS One 2017; 12:e0177222. [PMID: 28472148 PMCID: PMC5417716 DOI: 10.1371/journal.pone.0177222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 04/24/2017] [Indexed: 11/23/2022] Open
Abstract
Background Inactivating mutations of the hypothalamic transcription factor singleminded1 (SIM1) have been shown as a cause of early-onset severe obesity. However, to date, the contribution of SIM1 mutations to the obesity phenotype has only been studied in a few populations. In this study, we screened the functional regions of SIM1 in severely obese children of Slovak and Moravian descent to determine if genetic variants within SIM1 may influence the development of obesity in these populations. Methods The SIM1 promoter region, exons and exon-intron boundaries were sequenced in 126 unrelated obese children and adolescents (2–18 years of age) and 41 adult lean controls of Slovak and Moravian origin. Inclusion criteria for the children and adolescents were a body mass index standard deviation score higher than 2 SD for an appropriate age and sex, and obesity onset at less than 5 years of age. The clinical phenotypes of the SIM1 variant carriers were compared with clinical phenotypes of 4 MC4R variant carriers and with 27 unrelated SIM1 and MC4R mutation negative obese controls that were matched for age and gender. Results Seven previously described SIM1 variants and one novel heterozygous variant p.D134N were identified. The novel variant was predicted to be pathogenic by 7 in silico software analyses and is located at a highly conserved position of the SIM1 protein. The p.D134N variant was found in an 18 year old female proband (BMI 44.2kg/m2; +7.5 SD), and in 3 obese family members. Regardless of early onset severe obesity, the proband and her brother (age 16 years) did not fulfill the criteria of metabolic syndrome. Moreover, the variant carriers had significantly lower preferences for high sugar (p = 0.02) and low fat, low carbohydrate, high protein (p = 0.02) foods compared to the obese controls. Conclusions We have identified a novel SIM1 variant, p.D134N, in 4 obese individuals from a single pedigree which is also associated with lower preference for certain foods.
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Affiliation(s)
- Daniela Stanikova
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
- Department of Pediatrics, Medical Faculty of Comenius University, Bratislava, Slovakia
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Marek Buzga
- Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Patrik Krumpolec
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Martina Skopkova
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Martina Surova
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Barbara Ukropcova
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
- Institute of Pathophysiolgy, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Lubica Ticha
- Department of Pediatrics, Medical Faculty of Comenius University, Bratislava, Slovakia
| | - Miroslava Petrasova
- Department of Pediatrics, Medical Faculty of Safarik University, Kosice, Slovakia
| | - Dominika Gabcova
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Miroslava Huckova
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Lucie Piskorova
- Department of Pediatrics, Vitkovice Hospital, Ostrava, Czech Republic
| | - Jan Bozensky
- Department of Pediatrics, Vitkovice Hospital, Ostrava, Czech Republic
| | - Marian Mokan
- Department of Internal Medicine, Jessenius Medical Faculty of Comenius University, Martin, Slovakia
| | - Jozef Ukropec
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Ivona Zavacka
- Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Iwar Klimes
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Juraj Stanik
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
- Department of Pediatrics, Medical Faculty of Comenius University, Bratislava, Slovakia
- Center for Pediatric Research Leipzig, University Hospital for Children & Adolescents, University of Leipzig, Leipzig, Germany
| | - Daniela Gasperikova
- Laboratory of Diabetes and Metabolic Disorders, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
- * E-mail:
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