The association of extreme body weight with bone mineral density in Saudi children.

Objective: The objective to investigate the effect of extreme body weight; obesity and undernutrition, on bone mineral density (BMD). Methodology: This study is a descriptive cross-sectional study carried between January and June of 2019, and included 224 children and adolescents without any comorbidities or chronic disease. Important data collected included anthropometrics, past medical and surgical history, history of medication intake, level of physical activity and pubertal assessment. Data entry and analysis were conducted using Statistical Package for Social Sciences version 24. Results: Gender distribution showed 48.2% were male and 51.8% were female. The mean age was 9.98 ± 3.5 years. Mean weight was 34.89 ± 18.2 kg. Mean BMD z-score was - 1.64 ± 1.4. Weight was considered to significantly correlate with BMD stature at a P = 0.014. Subjects who were underweight showed a lower mean BMD z-score of <-2 than those who were overweight/obese (mean BMD z-score = -1.60). Conclusion: Both extremes of weight are considered a significant risk factor for the development of low BMD in children. We recommend the early recognition of weight aberrations and consequent aggressive intervention with strict lifestyle modifications to promote the development of maximum peak bone mass.

Résumé Objectif: étudier l'effet du poids corporel extrême; l'obésité et la dénutrition, sur la densité minérale osseuse. Méthodologie: Cette étude est une étude transversale descriptive réalisée entre les mois de janvier et juin 2019, et a inclus 224 enfants et adolescents sans aucune comorbidité ni maladie chronique. Les données importantes recueillies comprenaient l'anthropométrie, les antécédents médicaux et chirurgicaux, les antécédents de prise de médicaments, le niveau d'activité physique et l'évaluation pubertaire. La saisie et l'analyse des données ont été effectuées à l'aide du progiciel statistique pour les sciences sociales (SPSS) version 24. Résultats: La répartition par sexe a montré que 48,2% étaient des hommes et 51,8% étaient des femmes. L'âge moyen était de 9,98 ± 3,5 ans. Le poids moyen était de 34,89 ± 18,2 kg. Le score z moyen de DMO était de -1,64 ± 1,4. On a considéré que le poids était significativement corrélé à la stature de la DMO à une valeur p de 0,014. Les sujets présentant une insuffisance pondérale ont présenté un score z de DMO moyen inférieur à <-2 que ceux qui étaient en surpoids/obèses (score z moyen de DMO = -1,60). Conclusion: Les deux extrêmes de poids sont considérés comme un facteur de risque important pour le développement d'une faible DMO chez les enfants. Nous recommandons la détection précoce des aberrations de poids et une intervention agressive conséquente avec des modifications strictes du mode de vie afin de favoriser le développement d'une masse osseuse maximale. Mots-clés: insuffisance pondérale; en surpoids; indice de masse corporelle; densité minérale osseuse; les enfants.

The relationship between body weight and dietary habits with respect to the timing of puberty among saudi children and adolescents.

Objective: The objective is to investigate the timing of pubertal onset as determined by the development of secondary sexual characteristics in relation to body weight and dietary patterns among Saudi females. Methods: Children/adolescents visiting general and endocrinology pediatric clinics in King AbdulAziz University Hospital were invited to participate in this study. Female subjects between the ages of 5 and 20 years were included in this study, and those with syndromic disease, chronic comorbidities, endocrinopathies, organic causes of precocious puberty, positive family history of early pubertal onset, and under chronic medication were excluded from the study. Data were collected through clinical interviews with the consent of the legal guardians, and physical examinations were conducted. Results: A.total of 164 females were investigated. The mean age of thelarche, adrenarche, and menarche was 10, 11.3, and 12.2 years, respectively. We found a significant correlation between higher weight standard deviation and an earlier age of both thelarche and adrenarche. In addition, daily consumption of fast foods was significantly associated with an earlier menarchal age. Consumption of nonorganic poultry was linked to early thelarche. Conclusion: Efforts should be directed to increase public and community awareness that fast food consumption, inorganic poultry, and higher body weight are important modifiable factors that lead to an earlier onset of female puberty across different parameters: breast development, adrenarche, and menstruation.

RésuméObjectif: Étudier le moment de l'apparition de la puberté tel que déterminé par le développement de caractères sexuels secondaires en relation avec le poids corporel et les habitudes alimentaires chez les femmes saoudiennes. Méthodes: Les enfants / adolescents visitant les cliniques pédiatriques générales et d'endocrinologie de l'hôpital universitaire King AbdulAziz ont été invités à participer à cette étude. Les sujets de sexe féminin âgés de 2 à 18 ans ont été inclus dans cette étude, et ceux atteints de maladie syndromique, de comorbidités chroniques, d'endocrinopathies, de causes organiques de puberté précoce, d'antécédents familiaux d'apparition pubertaire précoce et sous traitement chronique ont été exclus de l'étude . Les données ont été recueillies lors d'entretiens cliniques avec le consentement des tuteurs légaux et des examens physiques ont été effectués. Résultats: Un total de 163 femmes ont été étudiées. L'âge moyen de la larche, de l'adrénarche et de la ménarche était respectivement de 10, 11,3 et 12,2 ans. Nous avons trouvé une corrélation significative entre un écart-type de poids plus élevé et un âge plus précoce de la larche et de l'adrénarche. De plus, la consommation fréquente de fast-foods était significativement associée à un âge ménarché plus précoce. Une consommation plus élevée de volaille non biologique était liée à la croissance précoce. Conclusion: Des efforts devraient être déployés pour sensibiliser le public et la communauté aux habitudes alimentaires et au poids corporel en tant que facteurs modifiables importants qui favorisent l'apparition précoce de la puberté féminine, indépendamment de leurs effets les uns sur les autres.

Endocrinopathies complicating transfusion-dependent hemoglobinopathy.

OBJECTIVES: To investigate the prevalence and significance of different endocrinopathies in children and adolescents with transfusion-dependent thalassemia and sickle-cell anemia. METHODS: This is a descriptive, retrospective study between January 2010 and July 2018 in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Data was collected through reviewing electronic hospital medical records then filling out data collection sheets and was interpreted through the IBM SPSS Statistics for Windows version 20.0 (IBM Corp, Armonk, NY, USA). Results: The total sample size was 119 patients, gender equality was almost achieved with 55.5% being male and 45.5% being female. The most common endocrinopathies were identified in the following order of short stature (39.5%), diabetes mellitus (29.4%), hypogonadism (12.6%), osteopenia (12.6%), osteoporosis (9.2%), hypothyroidism (9.2%), hypocortisolism (3.4%), and hypoparathyroidism (2.5%). All of which were statistically significant in their relationship to hemoglobinopathies with the exception of osteopenia and osteoporosis. Hypogonadism and hypocortisolism were found to be statistically significant in their relationship to a positive history of splenectomy at p=0.026 and p=0.012. Short stature was found to be statistically significant in its relationship to the male gender with a p=0.001. Conclusion: Endocrinopathy is a frequent complication of hemoglobinopathies, for which the most common were found to be short stature, diabetes mellitus,  and low bone mineral density.

Determinants of bone mineral density through quantitative ultrasound screening of healthy children visiting ambulatory paediatric clinics.

OBJECTIVES: To investigate the determinants of bone mineral density through screening healthy children using a non-invasive quantitative ultrasound measurement device. METHODS: A descriptive cross-sectional study carried out at King AbdulAziz University Hospital, Jeddah, Kingdom of Saudi Arabia. between May 2018 and January 2019 through interviewing, examining, and screening healthy children visiting general paediatric. Total sample size encompassed 450 children. The inclusion criteria were healthy children between the ages of 2 and 20 years. Exclusion criteria were previous pathological fractures, chronic medical diseases, or long-term medications. Data entry and analysis was conducted using Statistical Package for Social Sciences version 24 (IBM Corp, Armonk, NY, USA). Chi-square tests were used to determine the association between categorical variables, with calculated p<0.05 considered significant. With one-way Anova testing to study the relationship between categorical variables and continuous variables. Results: A significant association with bone mineral density (BMD) was found during first 2 years with height (p=0.015), vitamin D supplementation (p=0.03), and breastfeeding (p=0.025). A directly proportional relationship with BMD was found with pubertal status, physical activity, diet, sun exposure, and calcium supplement intake. CONCLUSION: This is a novel study in the investigation of the dietary, lifestyle and demographic determinants of bone mineral density in the healthy middle-eastern child otherwise unaffected by chronic medical or metabolic disease or exposed to long term medications that could have affected bone metabolism.

Growth characteristics in children with congenital adrenal hyperplasia.

OBJECTIVES: To evaluate the growth parameters in congenital adrenal hyperplasia patients in Jeddah, Saudi Arabia.  Methods: This is a descriptive retrospective study over the period of 5 years. Data analysis was using Statistical Package for Social Science. The study included 90 participants in which 61 were girls and 29 were boys aged 0 to 18 years . They were evaluated in Pediatric Endocrinology Clinic at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, between January  2012 and January 2017. RESULTS: A total of 90 subjects, of which 67.8% were females and 32.2% were males. Subjects who were underweight  constituted 19.1% of the population, while those who were obese were estimated up to 17.6% of the population. Of the children, 25.7% were suffering from short stature and 74.3% had normal height. Approximately 11.8% of the children who suffered from short stature also suffered from hypothyroidism. Mid-parental height of those who suffered from short stature is 159.8 cm. CONCLUSION: This study showed a significant effect of congenital adrenal hyperplasia on both height, weight, and body mass index. Risk factors includes glucocorticoids dosage, compliance to treatment, and regular follow up. Personalized treatment approach should be followed with all patients diagnosed with congenital adrenal hyperplasia as well as close monitoring and targeted therapy.