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Scandinavian Journal of Surgery : SJS :... Jun 2024
PubMed: 38907591
DOI: 10.1177/14574969241264064 -
Endocrine Connections Jun 2024It is well known that both genetic background and lifestyle influence the development of "general" obesity. However, the role of parental body mass index (BMI) on the...
OBJECTIVE
It is well known that both genetic background and lifestyle influence the development of "general" obesity. However, the role of parental body mass index (BMI) on the development of obesity in long-term survivors of childhood-onset craniopharyngioma (CP) is not well understood. This study analyzed the correlation of patients' BMI at diagnosis and last visit and parental BMI at CP diagnosis and further explored potential risk factors for obesity in CP patients.
DESIGN
Registry-based retrospective cohort study.
METHODS
291 CP patients and their parents recruited in the German KRANIOPHARYNGEOM studies were included. Correlations between patient's BMI SDS at CP diagnosis and last visit and parental BMI at CP diagnosis were analyzed. The associations between hypothalamic damage, maternal/paternal BMI and CP patients' obesity at last visit were analyzed by multivariable logistic regression.
RESULTS
At follow-up, 52% of CP patients developed obesity (BMI>3SDS). Patient's BMI SDS at last visit was moderately correlated with BMI-SDS at CP diagnosis (r=0.48, 95%-CI 0.38-0.58, p<0.001), and also with maternal BMI at diagnosis (r=0.28, 95%-CI 0.17-0.38, p<0.001) and paternal BMI at diagnosis (r=0.3, 95% CI-0.19-0.41, p<0.001). However, the contributing role of parental BMI to the pathogenesis of obesity was small compared to the impact of hypothalamic damage.
CONCLUSIONS
We conclude that besides hypothalamic damage, parental disposition for obesity is associated with the development of obesity in patients after CP. Our results indicate that also the family situation could have an influence on the development of obesity after CP and might be a therapeutic target.
PubMed: 38904467
DOI: 10.1530/EC-24-0126 -
Journal of Health, Population, and... Jun 2024Childhood obesity and hypertension are growing concerns globally, especially in developing countries. This study investigated the association between overall and central...
BACKGROUND
Childhood obesity and hypertension are growing concerns globally, especially in developing countries. This study investigated the association between overall and central obesity at baseline, and prehypertension or hypertension at follow-up among preadolescent school children in urban Karachi, Pakistan.
METHODS
This is a sub study with cohort design embedded within a feasibility trial on School Health Education Program in Pakistan (SHEPP) in preadolescents aged 6-11 years, attending two private schools conducted from 2017 to 2019. Hypertension or prehypertension at follow-up were the outcomes and obesity or central obesity at baseline were the exposure variables. Hypertension was defined as systolic blood pressure and/or diastolic blood pressure ≥ 95th percentile for age, sex, and height. Obesity was defined as body mass index for-age and sex ≥ 95th percentile, whereas central obesity was determined by waist circumference measurements ≥ 85th percentile of age, sex, and height specific cut-offs. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to identify risk factors for hypertension and prehypertension.
RESULTS
Analysis was conducted for 908 participants, evenly distributed with 454 boys and 454 girls. Hypertension was observed in 19.8% of the preadolescents, with rates of 18.5% in boys and 21.0% in girls. Prehypertension was found in 16.8% of preadolescents, with 18% among boys and 16% among girls. Additionally, 12.8% of preadolescents were classified as obese and 29.8% had central obesity. Obesity at baseline was associated with hypertension at followup (OR 8.7, 95% CI 3.5, 20.4) in the final model after adjusting for age, gender, physical activity, sedentary behavior, fruits, vegetable intake and hypertension at baseline. Central obesity at baseline also yielded high odds, with prehypertension (OR 1.9, 95% CI 1.4, 2.8) and hypertension (OR 2.7, 95% CI 1.9, 3.9) at follow up in the final model.
CONCLUSION
This study highlights a concerning prevalence of hypertension and prehypertension among preadolescent school-going children. Obesity and central obesity at baseline emerged as significant predictive factors for hypertension or prehypertension at followup within this cohort. The findings emphasize the urgency of implementing comprehensive school health education programs aimed at early detection and effective management of hypertension during childhood and adolescence in school settings.
Topics: Humans; Male; Female; Child; Pakistan; Hypertension; Pediatric Obesity; Risk Factors; Urban Population; Prehypertension; Cohort Studies; Prevalence; Obesity, Abdominal; Body Mass Index; School Health Services; Schools
PubMed: 38902813
DOI: 10.1186/s41043-024-00585-5 -
Journal of Pediatric Surgery May 2024Congenital adrenal hyperplasia (CAH) is the most common cause of genital atypia in females. A dedicated multidisciplinary team (MDT) should be included for an optimal...
Genito-urinary Reconstruction in Female Children With Congenital Adrenal Hyperplasia: Favorable Surgical Outcomes can be Achieved by Contemporary Techniques and a Dedicated Multidisciplinary Management.
INTRODUCTION
Congenital adrenal hyperplasia (CAH) is the most common cause of genital atypia in females. A dedicated multidisciplinary team (MDT) should be included for an optimal management. Here, we aimed to review our surgical experience and to assess long-term urinary, gynecological and endocrine outcomes after primary genitoplasty in this specific cohort.
METHODS
Patients born with CAH and who underwent feminizing genitoplasty in our institution were retrospectively identified (2001-2021). We analyzed patients' characteristics, intraoperative details, and postoperative urinary, gynecological, and endocrine outcomes.
RESULTS
Forty patients were included and followed-up for a median (IQR) time of 7 (1-19) years. Thirty-eight (95%) had 21-hydroxylase deficiency. After multidisciplinary decision and written consent from patient and/or family, a single-stage reconstructive surgery was performed at a median age of 10 (3-165) months. Median length of hospital stay was 5 (1-7) days. Procedures were: PUM (N = 35 (87.5%)), TUM (N = 3 (7.5%)), urogenital mobilization was unnecessary in 2 (5%). Reduction clitoroplasty was done in 33 (82.5%) patients. Only 3 (7.5%) experienced significant Clavien-Dindo complications requiring additional surgery during the follow-up period. Recurrent urinary tract infections (UTI) occurred in 6 (15%), one required ureteric reimplantation for symptomatic high-grade vesicoureteric reflux. All patients over 3 years were toilet-trained without incontinence. Severe vaginal stenosis occurred in 1 (2.5%) patient. In patients who achieved puberty, 6/9 had vaginal calibration at a median age of 17.3 (16-21) years without detected stenosis. One (2.5%) had major hypertrophy of the right labia minora requiring labiaplasty. Nine (22.5%) reached puberty. Two (5%) patients developed acne/hirsutism. Short stature was noted in 11 (27.5%) and obesity in 18 (45%).
CONCLUSION
Based on our contemporary series, genitourinary reconstructive surgery for female patients born with CAH is technically feasible and safe with a low complication rate. A regular follow-up with a MDT to assess long-term complications is necessary, and it is vital to inform patients and families about the different management options with all the risks and benefits of surgery.
TYPE OF THE STUDY
original research, clinical research.
LEVEL OF EVIDENCE
Level 3 retrospective study.
PubMed: 38902168
DOI: 10.1016/j.jpedsurg.2024.05.009 -
The New Zealand Medical Journal Jun 2024We described long-term trends in obesity using preschool data from New Zealand and compared rates pre- and post-COVID by key demographic variables. (Comparative Study)
Comparative Study
AIMS
We described long-term trends in obesity using preschool data from New Zealand and compared rates pre- and post-COVID by key demographic variables.
METHODS
Growth data from the B4 School Check (B4SC) information system for the period 1 July 2012 to 30 June 2022 were used to calculate obesity rates. The date 25 March 2020 was the threshold used to compare the rates between pre- and post-COVID periods. Obesity rate ratios for these two periods were calculated for each demographic sub-group.
RESULTS
The overall obesity rate increased by 1.8% after COVID-19. Males had higher obesity rates and a greater absolute increase (2%) in the post-COVID period. The greatest absolute increase in obesity was among Pacific peoples (4.3%), followed by Māori (2.2%). Children in most deprived areas and those in the Auckland Region had greater absolute increases of 3% and 2.5% respectively, post-COVID.
CONCLUSION
The COVID-19 lockdown has had an immediate impact on obesity rates among 4-year-old children, especially for the Pacific population, those living in high deprivation areas and regions with longer periods of lockdown (Auckland). There are implications for public health policy and practice to support children in adopting a healthy lifestyle, especially during pandemics.
Topics: Humans; New Zealand; COVID-19; Male; Child, Preschool; Female; Pediatric Obesity; SARS-CoV-2; Native Hawaiian or Other Pacific Islander; Pandemics
PubMed: 38901045
DOI: 10.26635/6965.6388 -
JMIR Research Protocols Jun 2024Chronic stress is an important risk factor in the development of obesity. While research suggests chronic stress is linked to excess weight gain in children, the... (Observational Study)
Observational Study
Testing a Biobehavioral Model of Chronic Stress and Weight Gain in Young Children (Family Stress Study): Protocol and Baseline Demographics for a Prospective Observational Study.
BACKGROUND
Chronic stress is an important risk factor in the development of obesity. While research suggests chronic stress is linked to excess weight gain in children, the biological or behavioral mechanisms are poorly understood.
OBJECTIVE
The objectives of the Family Stress Study are to examine behavioral and biological pathways through which chronic stress exposure (including stress from COVID-19) may be associated with adiposity in young children, and to determine if factors such as child sex, caregiver-child relationship quality, caregiver education, and caregiver self-regulation moderate the association between chronic stress and child adiposity.
METHODS
The Family Stress Study is a prospective cohort study of families recruited from 2 Canadian sites: the University of Guelph in Guelph, Ontario, and McMaster University in Hamilton, Ontario. Participants will be observed for 2 years and were eligible to participate if they had at least one child (aged 2-6 years) and no plans to move from the area within the next 3 years. Study questionnaires and measures were completed remotely at baseline and will be assessed using the same methods at 1- and 2-year follow-ups. At each time point, caregivers measure and report their child's height, weight, and waist circumference, collect a hair sample for cortisol analysis, and fit their child with an activity monitor to assess the child's physical activity and sleep. Caregivers also complete a web-based health and behaviors survey with questions about family demographics, family stress, their own weight-related behaviors, and their child's mental health, as well as a 1-day dietary assessment for their child.
RESULTS
Enrollment for this study was completed in December 2021. The final second-year follow-up was completed in April 2024. This study's sample includes 359 families (359 children, 359 female caregivers, and 179 male caregivers). The children's mean (SD) age is 3.9 years (1.2 years) and 51% (n=182) are female. Approximately 74% (n=263) of children and 80% (n=431) of caregivers identify as White. Approximately 34% (n=184) of caregivers have a college diploma or less and nearly 93% (n=499) are married or cohabiting with a partner. Nearly half (n=172, 47%) of the families have an annual household income ≥CAD $100,000 (an average exchange rate of 1 CAD=0.737626 USD applies). Data cleaning and analysis are ongoing as of manuscript publication.
CONCLUSIONS
Despite public health restrictions from COVID-19, the Family Stress Study was successful in recruiting and using remote data collection to successfully engage families in this study. The results from this study will help identify the direction and relative contributions of the biological and behavioral pathways linking chronic stress and adiposity. These findings will aid in the development of effective interventions designed to modify these pathways and reduce obesity risk in children.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05534711; https://clinicaltrials.gov/study/NCT05534711.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/48549.
Topics: Humans; Prospective Studies; Female; Male; Child, Preschool; Stress, Psychological; Child; Weight Gain; COVID-19; Pediatric Obesity; Ontario; Canada; Risk Factors
PubMed: 38900565
DOI: 10.2196/48549 -
Revista Espanola de Salud Publica Jun 2024Childhood flatfoot and overweight can affect children's quality of life and influence their development, increasing the risk of musculoskeletal problems in adulthood....
OBJECTIVE
Childhood flatfoot and overweight can affect children's quality of life and influence their development, increasing the risk of musculoskeletal problems in adulthood. There is evidence linking overweight to the development of childhood flatfoot. The aim of the study was to assess the relationship between the weight status of school children and their foot posture and to determine whether there are differences between both sexes.
METHODS
A cross-sectional study (2021) in a sample of schoolchildren (n=296, 153 boys and 143 girls, mean age 8.5±2.7) from Colegio San Agustín in Zaragoza was carried out. Foot posture was assessed according to the foot postural index, and weight status was obtained using the body mass index according to the criteria of the International Obesity Task Force. The correlation between weight status and foot posture was analyzed using Spearman's coefficient. The Chi-square test was used to determine the differences between the variables according to sex.
RESULTS
Weight status showed no correlation with foot posture in boys (right foot p=0.095; left foot p=0.067) and girls (right foot p=-0.04; left foot p=0.008). Boys had a higher prevalence of flat feet than girls (boys foot posture index=8; girls foot posture index=7; right foot p<0.036; left foot p<0.009). Boys had higher prevalence of overweight than girls (28.75; 18.18, p<0.027).
CONCLUSIONS
Weight status has no effect on foot posture. The male gender could predispose to the development of flat feet and overweight in childhood.
Topics: Humans; Male; Cross-Sectional Studies; Female; Child; Flatfoot; Posture; Overweight; Body Mass Index; Prevalence; Foot; Sex Factors; Pediatric Obesity; Spain
PubMed: 38899629
DOI: No ID Found -
Ciencia & Saude Coletiva Jun 2024This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is...
This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.
Topics: Humans; Child; Male; Cross-Sectional Studies; Female; Schools; Pediatric Obesity; Exercise; Body Mass Index; Physical Education and Training; Sex Factors; Age Factors; Overweight
PubMed: 38896672
DOI: 10.1590/1413-81232024296.05162023 -
Nutricion Hospitalaria May 2024a relationship has been observed between elevated levels of liver enzymes and uric acid with the presence of metabolic syndrome (MS) in the pediatric population.
INTRODUCTION
a relationship has been observed between elevated levels of liver enzymes and uric acid with the presence of metabolic syndrome (MS) in the pediatric population.
OBJECTIVE
to compare serum liver enzyme and uric acid levels between adolescents with and without MS.
METHODS
a cross-sectional study was carried out in adolescents with obesity between 10 and 18 years old. Somatometric data, serum insulin, lipid profile, uric acid levels and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and gamma-glutamyl transferase [GGT]) were analyzed.
STATISTICAL ANALYSIS
Student's t test or the Chi-square test was used to evaluate differences between groups.
RESULTS
a total of 1095 adolescents with obesity were included (444 with MS and 651 without MS). The group with MS had a higher BMI (with MS 2.28 vs without MS 2.11 p < 0.001), with no difference in body fat (42.9 % vs 42.9 %, p = 0.978). The MS group had significantly higher levels of AST (34.4 vs. 29.5, p = 0.013), ALT (42.2 vs. 34.6, p = 0.003), and uric acid (6.17 vs. 5.74, p = 0.002). comparison to the group without MS. The proportion of ALT (40.5 % vs 29.5 %, p = 0.029) and altered uric acid (58.1 % vs. 45.6 %, p = 0.019) was higher in the MS group.
CONCLUSIONS
serum levels of ALT, AST and uric acid in adolescents with obesity and MS were higher compared to those without MS. Altered ALT was a risk factor for SM.
PubMed: 38896119
DOI: 10.20960/nh.05137 -
Dental and Medical Problems Jun 2024Dentofacial infection resulting from untreated dental caries or periodontal disease is a serious disease that can spread to deeper tissues of the face and neck.
BACKGROUND
Dentofacial infection resulting from untreated dental caries or periodontal disease is a serious disease that can spread to deeper tissues of the face and neck.
OBJECTIVES
The present study aimed to analyze the salivary cytokine profile and oxidative stress parameters as potential biomarkers of acute odontogenic infections in children.
MATERIAL AND METHODS
The prospective study group (DI) consisted of 28 children aged 3-17 years with acute dentofacial infections, and the control group (CG) comprised 52 children aged 4-17 years with uncomplicated dental caries. The cytokine profile was analyzed using the Bio-Plex Pro™ Human Cytokine 27-plex kit. In addition, oxidative stress parameters, such as catalase (CAT), glutathione reductase (GR), superoxide dismutase (SOD), manganese SOD (Mn-SOD), copper-zinc SOD (CuZn-SOD), total antioxidant capacity (TAC), total oxidant status (TOS), and malondialdehyde (MDA), in the saliva of children in both groups were compared.
RESULTS
The levels of interleukin 6 (IL-6), macrophage inflammatory protein 1 alpha (MIP-1α) and tumor necrosis factor alpha (TNF-α) were significantly increased in children with dentofacial infections as compared to CG. In contrast, the levels of other pro-inflammatory cytokines, such as IL-1β, IL-1 receptor agonist (IL-Ra), IL-8, monocyte chemoattractant protein 1 (MCP-1), and MIP-1β, did not show statistically significant differences between the 2 groups. Among the measured oxidative stress and antioxidative parameters, only CAT and GR were elevated in children with dentofacial infections as compared to controls.
CONCLUSIONS
IL-6, MIP-1α, TNF-α, CAT, and GR can serve as selective biomarkers of oral cavity inflammation in children. These biomarkers can be useful in identifying and monitoring the progress and treatment of bacterial infections resulting in dentofacial inflammation.
PubMed: 38895870
DOI: 10.17219/dmp/185733