Insulin Resistance and Lipid Profiles in Obese Children / 대한소아내분비학회지

PURPOSE:Obesity is associated with complications such as unfavorable lipid profiles, hyperinsulinemia, and hypertension. We investigated the degree of obesity, especially defined as BMI and the percentage of overweight for the standard weight (%Wt) on plasma lipid levels and insulin resistance in the pediatric age group. METHODS:In this cross sectional study, 64 children and adolescents were included. Anthropometric data including body weight, height, BMI, %Wt, fat percentage of body weight (Fat%), and waist to hip ratio (WHR) were collected. For metabolic data, 14 hour fasting serum glucose, insulin and lipid profiles were measured and index for insulin resistance (HOMA-IR, FGIR) were calculated. We analyzed if there exist relationship between each anthropometric data and metabolic data. Gender differences were also assessed. RESULTS:Hyperinsulinemia showed high prevalence in obese children (total=21.9%, male=22.5%, female= 20.8%). HOMA-IR correlated with BMI and %Wt (BMI:r=0.308, P<0.05; %Wt:r=0.414, P<0.05). FGIR also correlated with BMI and %Wt (BMI:r=-0.406, P<0.05; %Wt:r=-0.437, P<0.05). Fasting serum triglyceride levels showed statistically significant correlation with BMI and %Wt [Boys (BMI:r=0.334, P<0.05; %Wt: r=0.487, P<0.05), Girls (BMI:r=0.482, P<0.05; %Wt:0.406, P<0.05)]. CONCLUSION: BMI and %Wt were valuable for predicting insulin resistance and triglyceride level. Sexual dimorphism related to insulin resistance and dyslipidemia in obese children was not certain in this study.

A Case of Influenza-associated Encephalopathy

Influenza-associated encephalopathy is regarded as one of the major neurologic disease entities along with those of Reye syndrome, acute necrotizing encephalopathy, and myelitis which are known to be related to influenza virus, mostly type A. And it is being actively researched in Japan as it has caused a tremendous increase in the number of deaths from 1997 to 2002, but it has not been yet reported in the Korean pediatric medical community. It attacks those previously healthy children, who have not been vaccinated. Patients start with such symptoms as fever and common respiratory problems, but within 24 to 48 hours they suffer from seizures with acute mental deterioration, become worse, and suffer multiple organ failures including marked elevated transaminase levels as well as coagulopathy. It induces deaths in a couple of days after the symptoms appear or remains a serious neurologic sequelae. Confirmative diagnosis is used to demonstrate influenza viral infection. We report here a 37 month aged boy who was admitted to our hospital during the last influenza season under the diagnosis of influenza associated encephalopathy on the basis of serologic testing by hemagglutinin inhibition(HI). This is the first report confirmed by increased antibody titer of the influenza A virus in Korea.