Leptin, Neuropeptide Y and Islet Amyloid Polypeptide Levels in Obese Children / 대한소아소화기영양학회지

PURPOSE: The aim of this study was to compare serum leptin, neuropeptide Y (NPY), and islet amyloid polypeptide (amylin) levels in obese and normal weight children, and to investigate their correlations with anthropometric parameters and metabolic bio-marker levels. METHODS: Body mass index (BMI), waist and hip circumference, blood pressure (systolic/diastolic), lipid profile, fasting glucose, and serum insulin, leptin, NPY, and amylin levels were measured in 56 children (24 obese children and 32 non-obese controls). Homeostatic model assessment-insulin resistance (HOMA-IR) values were calculated and the relationships between anthropometric variables, metabolic biomarkers, and diet-regulating factors (leptin, NPY, and amylin levels) were examined. RESULTS: BMI, hip circumference, waist circumference, and systolic and diastolic pressure were significantly higher in the obese group than in the non-obese group (p<0.0001). Total cholesterol, triglyceride, low-density lipoprotein-cholesterol, glucose, and insulin levels were also significantly higher in the obese group (p<0.05). On the other hand, high-density lipoprotein-cholesterol levels were higher in the non-obese group , but this was not significant. Serum leptin, NPY, and amylin levels were significantly higher in the obese group (p<0.05). Furthermore, in the obese group, leptin levels were found to be significantly correlated with BMI (r=0.379, p=0.043), and NPY levels (r=0.377, p=0.044), and amylin levels were found to be significantly correlated with insulin levels (r=0.400, p=0.048), and HOMA-IR (r=0.459, p=0.028). CONCLUSION: Metabolic risk factor alterations are present in obese children, and these children show abnormalities in the diet regulatory system caused by leptin, NPY, and amylin resistance. Of particular note, amylin was found to be positively correlated with insulin resistance.

Relationship of Calcitonin Gene-Related Peptide and Pediatric Headache in Obesity / 대한소아신경학회지

PURPOSE: Both headache and obesity are prevalent and chronic conditions among children. A well-known pathophysiology of migraine is that calcitonin gene-related peptide (CGRP) is an important postsynaptic mediator of trigemino-vascular inflammation. Plasma CGRP levels have been shown to increase in obese individuals during the headache phase of migraines. The purpose of this study was to assess the relationship between headache and plasma CGRP levels in obese children. METHODS: We prospectively studied plasma CGRP levels in 33 patients (20 overweight and obese subjects without headache, 13 overweight and obese subjects with headache) who visited Chosun University Hospital from March 2009 to September 2009. Blood samples were collected from cubital veins and plasma levels of CGRP were measured by radioimmunoassay. RESULTS: The mean age was 12.3+/-2.3 (range 6-15 years) and mean CGRP level was 19.1+/-2.5 pg/ml in the overweight and obese with headache group and 17.4+/-5.1 pg/mL in the overweight and obese without headache group. In the group CGRP levels lower than 19 pg/mL, mean headache frequency per month, mean severity, and mean disability were 17.0+/-18.4, 4.0+/-2.8 and 2.0+/-0.0, respectively. In the group with CGRP levels of 19 or greater pg/ml, levels were 11.0+/-9.8, 5.6+/-1.0, and 23.1+/-8.2, respectively. CONCLUSION: The mean CGRP level in overweight and obese children with headache was not significantly higher than in those without headache (P =0.202). Further, there was no significant correlation between CGRP level and frequency, severity of headache, and disability due to headache (P > 0.05). Further studies are needed to access the relationship of CGRP and pediatric headache in obese subjects.

Acute Suppurative Thyroiditis Caused by Methicillin - Resistant Staphylococcus Aureus in Healthy Children / 대한소아내분비학회지

Acute suppurative thyroiditis is an uncommon condition because the thyroid gland is remarkably resistant to infection. In children, anatomic defects, such as a left piriform sinus fistula, predispose subjects to this infection. It is very important yet difficult to differentiate acute thyroiditis with thyrotoxicosis from subacute thyroiditis; and if left untreated, acute suppurative thyroiditis can lead to thyroid abscess formation. Bacterial infections with staphylococcus and streptococcus species are the most common causes of acute suppurative thyroiditis. Occasionally, the thyroid gland can be infected with fungi, parasites, or mycobacterium. An 8-year-old boy presented with acute fever and tender neck swelling. The patient was admitted to the hospital and was diagnosed with acute suppurative thyroiditis. The culture result of the drained fluid revealed methicillin-resistant staphylococcus aureus (MRSA). The patient's condition improved after the use of antibiotics and drainage. There was no evidence of fistula formation between the thyroid and the pyriform sinus on a computed tomography (CT) scan. Here we describe rapidly progressive thyroid abscesses caused by MRSA in healthy children.