Spot Urine Albumin to Creatinine Ratio and Serum Cystatin C are Effective for Detection of Diabetic Nephropathy in Childhood Diabetic Patients

Spot urinary albumin to creatinine ratio (ACR) measurement has been suggested as a surrogate to 24-hr urine collection for the assessment of microalbuminuria, and cystatin C (cysC) is known as an advantageous marker for renal function. The aim of this study was to evaluate the clinical values of spot urinary ACR and serum cysC for the assessment of diabetic nephropathy instead of 24-hr urine microalbumin in children and adolescents with diabetes. A total of 113 children and adolescents (age 12-19 yr, M:F = 47:66) with type 1 or 2 diabetes were enrolled. We evaluated the validity of spot urine ACR and serum cysC, and then compared them to 24-hr urine microalbumin and creatinine clearance. Spot urine ACR was correlated with 24-hr urine albumin excretion (R2 = 0.828, P = 0.001) and creatinine clearance (R2 = 0.249, P = 0.017). The ROC curve analysis of serum cysC demonstrated higher diagnostic accuracy than that of serum creatinine (AUC 0.732 vs 0.615). Both the measurements of spot urine ACR and serum cysC might better predict the presence of diabetic nephropathy than 24-hr urine microalbumin in childhood diabetic patients.

¿Es importante la salud oral en los niños con diabetes?: [revisión} / Is oral health in diabetic children important?: [review]

Introduction: Diabetes Mellitus (DM) affects a high proportion of the population, seen more frequently among children and adolescents. Various organs are affected, including oral tissues. Objectives: Review the relationship between DM and oral health among pediatric patients, highlighting measures that assist in prevention and early detection of these complications. Methods: A review of the literature was performed, focusing on the pediatric population. Results: Most studies agree in finding that patients with DM1 show accelerated dental exchange, gingival and periodontal disease, and abnormalities in the composition of saliva. Most studies find risk of decay, especially if there is poor metabolic control. Conclusions: Due to the increased risk, dental control should be incorporated in the multidisciplinary routine control of children with CM1. Oral health education in this risk group could decrease risk in these pathologies.

Introducción: La Diabetes Mellitus (DM) afecta a un porcentaje importante de la población y cada vez se observa con mayor frecuencia en niños y adolescentes. Diferentes órganos y tejidos se ven afectados en el paciente diabético, incluyendo complicaciones a nivel de los tejidos orales. Objetivo: Revisar la potencial relación entre DM y salud oral en pacientes pediátricos y buscar cuáles serían las medidas que ayudarían en la prevención y detección precoz de estas complicaciones. Método: Se realizó una búsqueda bibliográfica en Internet, ingresando a través del sitio del Sistema de Bibliotecas de la Pontificia Universidad Católica de Chile (SIBUC) a un metabuscador que permite acceder a revistas electrónicas, bases de datos y un catálogo en línea que contiene libros y revistas impresas. Se utilizaron los términos: Diabetes, Diabetes Mellitus, Diabetes Juvenil y Salud Oral. Se seleccionaron aquellos trabajos que estudiaron pacientes pediátricos. Resultados: La mayoría de los estudios concuerda en que los pacientes con DM-1 tienen recambio dental acelerado, más enfermedad gingival y periodontal, y alteración en la composición salival. Respecto de la relación con caries, la mayoría encuentra mayor riesgo de caries, especialmente en los con mal control metabólico. Conclusiones: Dado el mayor riesgo de enfermedades de la salud oral en niños con DM-1, debiera incorporarse el control dental al control multidisciplinario habitual en niños con DM-1. La incorporación de educación en salud oral es este grupo de riesgo permitiría disminuir estas patologías.

Epidemiología de la diabetes mellitus en la infancia y adolescencia: tipo 1, tipo 2 y ¿diabetes "doble"? / Epidemiology of diabetes mellitus in childhood and adolescence: type 1, type 2 and "double" diabetes?

Durante las últimas décadas, el aporte de la epidemiología a través de la estandarización de los métodos y las definiciones y la colaboración internacional ha permitido una mejor estimación de la incidencia y prevalencia de la diabetes mellitus (DM) en la infancia y la adolescencia, así como la detección de probables factores de riesgo para los distintos tipos de la enfermedad, lo que orientaría al desarrollo de medidas preventivas y terapéuticas y la mayor comprensión de la magnitud del problema. Se ha observado un aumento global y amplias diferencias entre distintas regiones en la incidencia de la diabetes tipo 1 (DM1), al igual que un incremento en la frecuencia de la diabetes tipo 2 (DM2) en ciertas etnias asociado a un aumento de la obesidad. Se ha descripto la existencia de la llamada DM "doble" o "híbrida", caracterizada por la asociación de un fenotipo de DM2 (obesidad, acantosis nigricans) con manifestaciones de autoinmunidad anti células beta.

During the last decades, the contribution of epidemiology through the standardization of methods and definitions and international collaboration allowed a better estimation of the incidence and prevalence of DM in children and adolescents, as well as the detection of likely risk factors for the different types of the disease, which would allow the development of preventive and therapeutic measures and a better understanding of the magnitude of the problem. A global increase and wide differences in the incidence of type 1 diabetes have been observed among regions, as well as an increase in the frequency of type 2 diabetes in some ethnic groups, associated to a growing prevalence of obesity. The existence of what has been named "double" or "hybrid" DM has also been described, characterized by a phenotype of DM2 (obesity and acantosis nigricans) associated with manifestations of autoimmunity.

Analysis of the Inquiry Types of the Pediatric Endocrinologic Diseases Counseled on the Internet / 대한소아내분비학회지

PURPOSE: On account of the civilization progress and popularization of the internet, we have researched the current public understandings of the pediatric endocrinologic diseases. METHODS: Analyzable 582 cases of 1,160 cases inquired by the online counsel board for the pediatric endocrinologic diseases from March of 2001 to January of 2004 were classified into four groups. RESULTS: There were 187 inquiries related to short stature. Most counsels were taken by their mothers. In the height distribution of them, under 3 percentile were 27 (21.4%). About precocious puberty, there were 82 for girls and 8 for boys of the total 110 inquiries. The number of children among 6-10 year old were 62. The main subject matter of inquiry accounted for the great majority as 67 cases was about breast budding. And there were 117 inquiries related to childhood diabetes. The number of children among 1-5 year old were 43 (49.4%). Lastly, there were 149 inquiries related to the thyroid diseases. The number of children under 1 year old were 55 (45.8%). CONCLUSION: Considering the most cases of the stature under 50 percentile on the current Korean growth curve begun since 1998, a present phase of quite competition of the stature was recognized. And it could be possible to say that the maternal factor for short stature seems more important than the paternal factor, because our data show that the short stature mothers of the short stature children is two folds more than the short stature fathers of them.