Hormonal, sonographic, and body composition changes in Egyptian adolescent girls with hyperandrgenie manifestation

This study was conducted to assess the prevalence of hyperandrogenic disorders especially polycystic ovary syndrome [PCOS] in a random sample of adolescent girls in our locality, as well as to identify the clinical; hormonal, ultrasonic, and body composition characteristics associated with such disorders. Two hundred school girls [15-18 years old] were selected by multi-stage random sampling from different secondary schools, and screened for hyperandrogenic disorders by a validated questionnaire. Thorough history taking, physical and gynecologic examination, complete hormonal, pelvi-abdominal pulse inversion harmonic imaging [PlHl], and body composition assessment by bioelectrical impedance [BIA] were done for students presenting with menstrual dysfunction and/or clinical hyperandrogenism and 8 controls from the 4th to the 7th day of the menstrual cycle. Twenty-five out of the 200 students were thoroughly evaluated. Eighteen adolescents of the examined students [72%] were finally diagnosed as PCOS, 5 [20%] as idiopathic hyperandrogenism and 2 [8%] s non-classic congenital adrenal hyperplasia [CAH]. Despite normal weight percentiles and body mass index [BMI] for age and sex in 83.3% and 88.9% of students with PCOS respectively, fat mass, trunk fat percentage, trunk fat mass, and trunk free fat were significantly higher in PCOS patients compared to controls. PCOS was the most common hyperandrogenic disorder in this study. Combined menstrual dysfunction and clinical hyperandrogenism had adequate sensitivity and high specificity in the prediction of PCOS. PIHI is an adequately sensitive preferential diagnostic tool of PCOS in virgin adolescents who may have central adiposity. Body composition assessment by BIA in PCOS is valuable in detecting central adiposity which could be correlated to parameters of insulin resistance

Lipid metabolism and atherogenic index in turners syndrome

Turner's syndrome is the most common sex chromosome abnormality in females. Women with Turner's syndrome have short stature, hypergcnadotrophic hypogonadism and have an increased incidence of coronary heart disease. So, the aim of this work is to study growth parameters, serum FSH, LH, serum lipids and atherogenic index in girls with Turner's syndrome and highlight the correlation between different studied parameters. This work comprise 14 patients with Turner's syndrome [mean age +/- SD 11.93 +/- 3.79 years] and 14 healthy age matched Egyptian females as a control group. Thorough anthropometric measurements were done for patients and control and are expressed as standard deviation score utilizing Egyptian growth table for height and international tables for ideal weight for height. Morning blood sample after overnight fast was used for estimation of serum FSH and LH, serum lipids and atherogenic index. significant decrease in height with significant increase in weight% to ideal weight for height in Turner patients compared to controls with significant higher mean serum FSH, LH, cholesterol, LDL, TG and atherogenic index. Correlation studies showed that height SD score had significant negative correlation with weight% to ideal weight for height, serum LH, FSH and lipid profile. Meanwhile measures of weight% to ideal weight for height showed positive correlation with serum FSH, lipogram with no significant correlation with HDL and atherogenic index. Turner's syndrome is associated with hyperlipidemia and significant increased atherogenic index which explain the liability for coronary heart disease. The degree of lipid disorder is negatively correlated and height SD score

Oxidative stress and antioxidant vitamins in obese children

Oxidant-antioxidant status was investigated in a group of obese children in comparison with healthy subjects by determination of malondialdehyde [MDA], tocopherol, and ascorbic acid. Thirty five obese children [25 male and 10 female] mean age [9 +/- 4.4year] with BMI > 2SD of the mean for age and sex [BMI = 31.5 +/- 6.6]. A group of 30 healthy, age and sex matched children were used as a control group. Blood samples were collected from every subject and control after an overnight fast of which 2ml blood collected on heparin for plasma ascorbic acid [vitamin C] and 4ml blood collected into plain tube for serum tocopherol and malondialdehyde [MDA]. MDA was significantly higher in obese children compared to control [P=0.0001]. This was associated with significantly lower plasma vitamin E and vitamin C in obese children compared to control [P= 0.0001]. BMI was positively correlated with age and MDA and showed negative correlation with vitamin E and C. Severely obese children present a highly altered oxidant antioxidant status, which is alarming for the increased risk of complication so early intervention has been recommended by giving antioxidant, diet-control and exercise

Bone mineral density and insulin resistance in patients with turner's syndrome

The aim of this work was to study bone mineral density [BMD], gonadotropins and insulin resistance in girls with Turner's syndrome and its correlation with some growth parameters. This work comprise 14 patients with Tumers syndrome [mean age +/- SD: 11.93 +/- 3.79years] and 14 healthy age matched Egyptian females as a control group. Thorough anthropometric measurements were done for patients and controls and are expressed as standard deviation score utilizing Egyptian growth table for height and international tables for ideal weight for height. Lumber2-lumber4 [L2. L4], BMD was done using dual energy X-ray absorptiometery [DEXA] [using lunar DPXIQ, USA], in Patients and controls and compared to 352 healthy age and sex matched Egyptian controls. Morning blood sample after over night fast was used for estimation of FSH, LH, insulin [Elisa] and blood glucose. Insulin resistance index [IRl] and relative insulin resistance [RIR] were calculated from fasting blood glucose and fasting insulin. The results shows: significant decrease in height with significant increase in weight%to ideal weight for height in turner patients compared to controls with significant higher FSH, LH and increased lRl, RIR while BMD of L2-L4 showed significant osteopenia. Correlation studies shows significant positive correlation between height SD score and L2-L4 BMD and significant negative correlation between it and wt%to ideal weight for height and measures of insulin resistance, FSH awl LH demonstrated negative correlation with L2-L4 BMD and height SD score. Insulin resistance indices demonstrated a positive correlation with wt%to ideal weight for height and negative correlation with BMD. Turner's syndrome is associated with significant short stature, and overweight with significant osteopenia and insulin resistance. Height SD score is positively correlated with BMD and negatively correlated with wt% to ideal wt for height, FSH, LH, IRl and RIR. FSH and LH showed significant negative correlation with BMD

Serum leptin, insulin resistance and soft tissue composition by dual energy X-ray absorptiometry in obese children

This work aimed to study serum leptin and insulin resistance in obese children and their relation to body composition by DEXA and various measurements of obesity. Thirty-three obese subjects body mass index [BMI] > 95th centile, were enrolled in this study [12 males and 21 females]. Their age ranged from 4 years to 15 years [mean 9.4 +/- 2.93]. Sixteen healthy age- and sex- matched Egyptian children were taken as controls. Obese children and the control group were subjected to thorough anthropometric measurements, estimation of BMI and weight% to ideal weight for height, DEXA study for body composition, serum Ieptin by ELISA and serum insulin [ELISA], blood glucose fasting and postprandial to assess insulin resistance. Insulin resistance index. IRP=Fasting Glucose x Fasting Insulin / 22.5. The study showed that obese children had significantly higher BMI and weight% to ideal weight for height compared to controls. Percent total body fat by DEXA was significantly higher in obese children compared to the controls [49.47 +/- 6.12 vs 19.85 +/- 5.06] [P< 0.0001] and arm fat percent in obese children was 52.92 +/- 8.46 vs. 16.84 +/- 4.6 in controls [P< 0.0001]. Also significantly higher trunk fat/lower limb fat by DE][A was detected [1.21 +/- 0.2 vs 0.81 +/- 0.07, P<0.0001]. IRI in obese children was 68.5 +/- 26.8 vs 19.74 +/- 4.8 in controls [P<0.0001] and serum leptin was higher in obese compared to nonobese children [40.71 +/- 22.73 vs. 10.38 +/- 16.08, P<0.001]. Serum leptin and IRI showed a significant correlation with BMI, weight% to ideal weight for height,% total body fat by DEXA and% arm fat. Moreover, a significant correlation was obtained between IRI and serum leptin [P<0.001]. Obesity is associated with insulin resistance and high serum leptin level, which denote serum leptin resistance. Both are correlated with BMI, weight% to ideal weight for height,% total body fat by DEXA and% arm fat by DEXA