ABSTRACT
Type 2 diabetes mellitus (DM) is being diagnosed more frequently in children and adolescents. Thailand has a low incidence of childhood DM. This study reviewed patients with DM in the Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital compared to our previous study. The results demonstrate that type 2 DM in Thai children and adolescents has increased from 5% during 1986-1995 to 17.9% during 1996-1999. Mean age was 11.6 years. Mean BMI was 27.8 kg/m2. Fifty-six percent were diagnosed on routine examination. The period of increase in type 2 DM is associated with an increase of obesity prevalence from 5.8% in 1990 to 13.3% in 1996. This result emphasizes the importance of encouraging daily physical activity and healthy diet in our populations and also alerts our pediatricians and endocrinologists to the possibilities of type 2 DM in these age groups.
Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Obesity/epidemiology , Adolescent , Child , Child, Preschool , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/physiopathology , Drug Therapy, Combination , Female , Humans , Hypoglycemic Agents/therapeutic use , Infant , Infant, Newborn , Insulin/therapeutic use , Male , Metformin/therapeutic use , Prevalence , Sulfonylurea Compounds/therapeutic use , Thailand/epidemiologyABSTRACT
Serum IGF-I and IGFBP-3 levels are growth hormone (GH) dependent and reflect the endogenous GH secretion. Two hundred and forty-four healthy children were evaluated for serum IGF-I and IGFBP-3 levels and then the age-defined normal values for Thai children were constructed. The results showed that the serum IGF-I and IGFBP-3 levels were age dependent, gradually increased from birth and reached the peak values around the age of 14-16 years. In addition, we studied the IGF-I and IGFBP-3 values in 28 GH deficient children and 26 normal variant short stature (NVSS) by using our normal constructed values as the reference. To minimize the influence of age, both IGF-I and IGFBP-3 values were transformed to standard deviation score (SDS). In clinical practice, we recommend using the IGF-I SDS and IGFBP-3 SDS of -1 and -1.3 respectively as a cut-off point to discriminate between GH deficiency and NVSS to avoid risky GH provocative tests and unnecessary GH replacement with the sensitivity of 71 per cent and the specificity of 92 per cent.
Subject(s)
Human Growth Hormone/physiology , Insulin-Like Growth Factor Binding Protein 3/blood , Insulin-Like Growth Factor I/analysis , Adolescent , Biomarkers/blood , Body Height , Child , Child, Preschool , Human Growth Hormone/deficiency , Humans , Infant , Infant, Newborn , Reference Values , Sensitivity and Specificity , ThailandABSTRACT
Ten Turner syndrome girls whose mean age was 10.9 +/- 2.7 years were treated with recombinant human growth hormone (rhGH), dose 0.6 U/kg/week. Five of them had classical 45, XO karyotype. The mean height velocity increased from 2.8 +/- 1.3 cm/year before treatment to 6.1 +/- 2.06 cm/year after treatment for a period of 1.4 years. The response of treatment correlated well with pretreatment height velocity (<3 cm/year) but not with karyotype. However, the response has been decreasing and an increased dose after the first year of treatment is recommended.
Subject(s)
Growth Hormone/therapeutic use , Growth , Turner Syndrome/drug therapy , Turner Syndrome/physiopathology , Adolescent , Body Height/drug effects , Bone Development , Child , Clonidine/therapeutic use , Estradiol/blood , Female , Follicle Stimulating Hormone/blood , Follow-Up Studies , Glycated Hemoglobin/analysis , Gonadotropin-Releasing Hormone , Growth Hormone/blood , Humans , Karyotyping , Luteinizing Hormone/blood , Recombinant Proteins/therapeutic use , Thyroid Function Tests , Time Factors , Turner Syndrome/geneticsABSTRACT
Generalized lipodystrophy is a rare condition which can be divided into congenital and acquired types, based on the age at presentation and pattern of inheritance. The congenital type of generalized lipodystrophy or Lawrence-Seip syndrome presents in first two years of life and is inherited in an autosomal recessive pattern. The diagnosis is made on the basis of loss of body fat, muscular hypertrophy, acanthosis nigricans, hirsutism, hepatomegaly with fatty liver, hyperlipidemia and hyperglycemia with insulin resistance. A 2 1/2-year-old Thai girl with the clinical features of Lawrence-Seip syndrome is reported. Abnormal platelet function was detected in this girl.
