The Auxological and Hormonal Differences in Girls with Atypical Thelarche and Central Precocious Puberty / 대한소아내분비학회지

PURPOSE:We compared anthropomorphic measures and hormone levels in girls with atypical thelarche (AT) and central precocious puberty (CPP) and tried to find out factors discriminating AT from CPP. METHODS:We analyzed clinical and laboratory data of 62 girls with precocious breast development from May 2004 to May 2008 at Kangnam St. Marys Hospital. Immunoradiometeric assay (IRMA) was used to estimate gonadotropins and growth related hormones. CPP was diagnosed if peak luteinizing hormone (LH) level was >6.9 IU/L after gonadotropin hormone releasing hormone (GnRH) stimulation test. A multiple logistic regression analysis and the area under the receiver operating characteristics curve (AUC) were used to analyse the prediction capacity of variable factors to diagnose CPP. RESULT:The basal LH levels (P=0.001), IGF-I levels (P=0.049) and the peak LH levels (P<0.001) in GnRH-stimulation test in girls with CPP were higher than those with AT. Girls with AT had a lower degree of breast maturation than girls with CPP (P=0.001). A multivariate logistic regression model including the basal LH levels and IGF-I levels revealed a strong relation of the basal LH levels to CPP [OR:2.7, 95% confidence interval (CI): 1.1-6.7, P=0.035]. The AUC for basal LH levels showed prediction capacity of basal LH levels to diagnose CPP [AUC: 0.70, 95% CI: 0.57-0.81, P=0.009]. The statistically ideal cut-off value of basal LH levels to discriminate CPP from AT was 2.66 IU/L (sensitivity 40%, specificity 98%) and the clinically meaningful cut-off value was 1.86 IU/L (sensitivity 70%, specificity 62%). CONCLUSION:These results suggest that the basal LH level using IRMA could be a useful parameter discriminating AT from CPP. Further study with larger number of subjects will be needed.

Serum leptin, adiponectin and resistin levels in obese children and their correlations with insulin resistance / 소아과

PURPOSE: The objective of this study was to compare the levels of adipocytokines in obesity group with those in control group and examine their correlation with insulin resistance. METHODS: We enrolled 36 obese children (male:female [M:F]=17:19; age, 9.3+/-1.9 yrs) with > or =95th percentile body mass indexes (BMIs) (obesity group) and 35 healthy children (M:F=16:19; age, 9.1+/-2.1 yrs) with 25th-75th percentile BMIs (control group). We measured the serum leptin, adiponectin, and resistin levels and insulin resistance in both the groups. RESULTS: The weights, heights, BMIs, fasting sugar levels, insulin levels, and homeostasis model assessment for insulin resistance (HOMA-IR) values were higher in the obesity group than in the control group. As compared to the control group, the obesity group showed significantly higher leptin levels and lower adiponectin levels; no significant difference was observed in the resistin levels. The leptin/adiponectin (L/A) ratio was higher in the obesity group than in the control group. In the obesity group, HOMA-IR showed significant positive correlations with weight, height, BMI, and leptin level. However, it was not correlated with age and adiponectin and resistin levels. In the obesity group, leptin level showed significant positive correlations with age, weight, height, and BMI, while adiponectin and resistin levels showed no such correlations with the other variables CONCLUSION: We suggest that adiponectin plays an important protective role against weight gain in obese children. Further, L/A ratio can be used as a parameter for predicting the prognosis of obese children.