The Relationship of Leptin (+19) AG, Leptin (2548) GA, and Leptin Receptor Gln223Arg Gene Polymorphisms with Obesity and Metabolic Syndrome in Obese Children and Adolescents.

PURPOSE: Obesity is defined as the abnormal or excessive accumulation of fat over acceptable limits. Leptin is a metabolic hormone present in the circulation in amounts proportional to fat mass. Leptin reduces food intake and increases energy expenditure, thus regulating body weight and homeostasis. Various polymorphisms are present in the leptin gene and its receptor. These polymorphisms may be associated with obesity. This study aimed to show the association of leptin (+19) AG, leptin (2548) GA, and Gln223Arg leptin receptor polymorphisms with obesity and metabolic syndrome in Turkish children aged 6-17 years, and to conduct further investigations regarding the genetic etiology of obesity. METHODS: A total of 174 patients diagnosed with obesity and 150 healthy children who were treated at Tokat Gaziosmanpasa Medical School Hospital between September 2014 and March 2015 were included in this study. The ages of the children were between 6 and 17 years, and anthropometric and laboratory results were recorded. Genotyping of leptin (+19) AG, leptin (2548) GA, and leptin receptor Gln223Arg polymorphisms was performed by polymerase chain reaction. RESULTS: An association between leptin receptor Gln223Arg gene polymorphism and obesity was detected. CONCLUSION: Further studies are needed to determine the role of genetic etiologies and to indicate the role of leptin signal transmission impairment in the pathogenesis of obesity. We hope that gene therapy can soon provide a solution for obesity.

Association Between Trp64arg Polymorphism of the ß3 adrenoreceptor Gene and Female Sex in Obese Turkish Children and Adolescents.

PURPOSE: The ß3-adrenergic receptor (ADRB3) is expressed in visceral adipose tissue and has been speculated to contribute to lipolysis, energy metabolism, and regulation of the metabolic rate. In this study, we aimed to investigate the association of polymorphism of the ADRB3 gene with the sex of children with obesity and related pathologies. METHODS: ADRB3 gene trp64arg genotyping was conducted in 441 children aged 6-18 years. Among these subjects, 264 were obese (103 boys; 161 girls) and 179 were of normal weight (81 boys; 98 girls). In the obese group, fasting lipids, glucose and insulin levels, and blood pressure were measured. Metabolic syndrome (MS) was defined according to the modified World Health Organization criteria adapted for children. RESULTS: The frequency of trp64arg genotype was similar in obese and normal weight children. In obese children, serum lipid, glucose, and insulin levels; homeostasis model assessment of insulin resistance (HOMA-IR) scores; and MS were not different between arg allele carriers (trp64arg) and noncarriers (trp64trp). In 264 obese children, genetic analysis results revealed that the arg allele carriers were significantly higher in girls than in boys (p=0.001). In the normal weight group, no statistically significant difference was found between genotypes of boys and girls (p=0.771). CONCLUSION: Trp64arg polymorphism of the ADRB3 gene was not associated with obesity and MS in Turkish children and adolescents. Although no relationships were observed between the genotypes and lipids, glucose/insulin levels, or HOMA-IR, the presence of trp64arg variant was frequent in obese girls, which can lead to weight gain as well as difficulty in losing weight in women.

Clinical and Demographic Evaluation According to MEFV Genes in Patients with Familial Mediterranean Fever.

The present study examined the relationship between clinical findings and mutation analyses in children with Familial Mediterranean Fever (FMF) in the inner Black Sea region of Turkey. This retrospective, cross-sectional study included patients with FMF who were evaluated between 2007 and 2015. FMF was diagnosed according to the Tel Hashomer criteria. FMF mutations were analyzed using a Real-time PCR System (Roche Diagnostics, Mannheim, Germany), and patients were classified into three groups according to allele status. The most common symptom was abdominal pain (99%, n = 197). The most frequent mutations were M694V and R202Q. Chest pain was reported more often in patients homozygous for M694V (61.4%). Although fever, abdominal pain, and arthritis were more commonly observed with the M694V mutation, chest pain was the most common symptom in R202Q carriers (n = 10, 32.3%). Proteinuria was observed in 42 (21.2%) patients, frequently accompanied by the M694V mutation (28.6%). The most common mutations in children with FMF in Turkey were M694V and R202Q. Recurrent abdominal pain and arthritis/arthralgia were commonly observed in patients with M694V and R202Q mutations. Moreover, chest pain was commonly seen with the R202Q mutation. Thus, R202Q might be a disease-causing mutation in FMF patients.

Negative correlation among vitamin B12 levels, obesity severity and metabolic syndrome in obese children: A case control study.

OBJECTIVE: To determine the relationship among vitamin B12 status, obesity severity, and metabolic syndrome and its components in obese children.. METHODS: This case-control study was conducted at the School of Medicine, Gaziosmanpasa University, Tokat, Turkey, from January 2012 and October 2014, and comprised cases of obese and healthy children. The obese children were divided into three groups according to body mass index-standard deviation score quartiles. Group 1 included the first quartile, group 2 included the second and third quartiles, and group 3 included the fourth quartile. Patients with a body mass index of >95th percentile, according to reference curves for Turkish children and adolescents, were considered obese.Patients with a body mass index between15th and 85th percentile were considered to have normal weight. The World Health Organisation's modified metabolic syndrome criteria for children were used to diagnose metabolic syndrome.SPSS 19 was used for data analysis. RESULTS: Of the 256 participants, 153(59.8%) were obese and 103(40.2%) were healthy controls. The mean age of the obese children was 12.69±2.29 years and that of healthy controls was 13.05±2.48 years. Mean vitamin B12 levels were significantly lower among obese children than healthy volunteers (p<0.001). Age and body mass index-standard deviation score were significantly associated with vitamin B12 status (r= -0.175, p=0.030; r= -0.210, p=0.09, respectively). CONCLUSIONS: Increase in body mass index-standard deviation score was associated with a decrease in vitamin B12 levels.

Role of the Polymorphisms of Uncoupling Protein Genes in Childhood Obesity and Their Association with Obesity-Related Disturbances.

BACKGROUND: Obesity, one of the most common disorders observed in clinical practice, has been associated with energy metabolism-related protein genes such as uncoupling proteins (UCPs). Herein, we evaluated UCPs as candidate genes for obesity and its morbidities. METHODS: A total of 268 obese and 185 nonobese children and adolescents were enrolled in this study. To determine dyslipidemia, hypertension, and insulin resistance, laboratory tests were derived from fasting blood samples. UCP1-3826 A/G, UCP2 exon 8 deletion/insertion (del/ins), and UCP3-55C/T variants were also genotyped, and the relationships among the polymorphisms of these UCPs and obesity morbidities were investigated. RESULTS: The mean ages of the obese and control groups were 11.61 ± 2.83 and 10.74 ± 3.36 years, respectively. The respective genotypic frequencies of the AA, AG, and GG genotypes of UCP1 were 46.3%, 33.2%, and 20.5% in obese subjects and 46.5%, 42.2%, and 11.4% in the controls (p = 0.020). G alleles were more frequent in obese subjects with hypertriglyceridemia (42.9%; p = 0.048) than in those without, and the GG genotype presented an odds ratio for obesity of 2.02 (1.17-3.47; p = 0.010). The polymorphisms of UCP2 exon 8 del/ins and UCP3-55C/T did not influence obesity risk (p > 0.05). The I (ins) allele was associated with low HDL cholesterolemia (p = 0.023). CONCLUSION: The GG genotype of the UCP1-3826 A/G polymorphism appears to contribute to the onset of childhood obesity in Turkish children. The GG genotype of UCP1, together with the del/del genotype of the UCP2 polymorphism, may increase the risk of obesity with synergistic effects. The ins allele of the UCP2 exon 8 del/ins polymorphism may contribute to low HDL cholesterolemia.

Association between vitamin D levels and cardiovascular risk factors in obese children and adolescents.

BACKGROUND AND AIM: Childhood obesity is associated with an increased risk of chronic disease. We aimed to determine the association between vitamin D deficiency and cardiovascular risks in obese children. METHOD: The studied children were selected from obese children who were followed up at obesity clinic, aged 6-17 years. Basic demographic information and laboratory data were collected retrospectively from hospital records. RESULTS: A total of 310 students (178 [57.4%] girls) were evaluated for 25-hydroxyvitamin D (25[OH] D) levels in late winter/spring. The prevalence rates of vitamin D deficiency, insufficiency, and sufficiency were 62.3%, 34.5%, and 3.2%, respectively. Insulin resistance was observed in 146 (47.1%) children; the frequencies of dyslipidemia and hypertension were 31% and 19.4%, respectively. The mean atherogenic dyslipidemia ratio was higher in the deficient group (p = 0.049). Inverse correlations of 25(OH) D levels were observed with homeostasis model assessment of insulin resistance values (r = -0.146, p = 0.010). The mean values of 25(OH) D (ng/mL) were lower in girls (12.15 ± 6.60) than in boys (16.48 ± 8.69) (p < 0.05) and in children with hypertension (11.92 ± 5.48) than in those without (14.50 ± 8.24) (p < 0.05). CONCLUSIONS: Vitamin D deficiency is observed more frequently than expected in obese children and adolescents. Our findings indicate that low 25(OH) D levels are associated with insulin resistance. Vitamin D deficiency could contribute to the morbidities associated with childhood obesity, such as insulin resistance or diabetes mellitus, increased cardiovascular/cardiometabolic risks, atherogenic dyslipidemia, and hypertension.

Association between vitamin D levels and cardiovascular risk factors in obese children and adolescents / Asociación entre los niveles de vitamina D y factores de riesgo cardiovascular en niños y adolescentes obesos

Background and aim: Childhood obesity is associated with an increased risk of chronic disease. We aimed to determine the association between vitamin D deficiency and cardiovascular risks in obese children. Method: The studied children were selected from obese children who were followed up at obesity clinic, aged 6-17 years. Basic demographic information and laboratory data were collected retrospectively from hospital records. Results: A total of 310 students (178 [57.4%] girls) were evaluated for 25-hydroxyvitamin D (25[OH] D) levels in late winter/spring. The prevalence rates of vitamin D deficiency, insufficiency, and sufficiency were 62.3%, 34.5%, and 3.2%, respectively. Insulin resistance was observed in 146 (47.1%) children; the frequencies of dyslipidemia and hypertension were 31% and 19.4%, respectively. The mean atherogenic dyslipidemia ratio was higher in the defi cient group (p = 0.049). Inverse correlations of 25(OH) D levels were observed with homeostasis model assessment of insulin resistance values (r = -0.146, p = 0.010). The mean values of 25(OH) D (ng/mL) were lower in girls (12.15 ± 6.60) than in boys (16.48 ± 8.69) (p < 0.05) and in children with hypertension (11.92 ± 5.48) than in those without (14.50 ± 8.24) (p < 0.05). Conclusions: Vitamin D deficiency is observed more frequently than expected in obese children and adolescents. Our findings indicate that low 25(OH) D levels are associated with insulin resistance. Vitamin D deficiency could contribute to the morbidities associated with childhood obesity, such as insulin resistance or diabetes mellitus, increased cardiovascular/cardiometabolic risks, atherogenic dyslipidemia, and hypertension (AU)

Introducción y objetivo: la obesidad infantil se asocia a un riesgo aumentado de enfermedades crónicas. El objetivo de este estudio es determinar la relación entre la deficiencia en vitamina D y el riesgo cardiovascular en niños obesos. Método: se seleccionaron niños tratados en la clínica de obesidad, con edades entre 6 y 17 años. Los datos de laboratorio y la información demográfica básica se recogieron de forma retrospectiva a partir de las historias clínicas. Resultados: se evaluaron 310 estudiantes (178, 57,4% mujeres) midiendo los niveles de vitamina D a finales de invierno y en primavera. La prevalencia de deficiencia en vitamina D, insuficiencia y suficiencia fueron 62,3%, 34,5% y 3,2% respectivamente. Se encontró resistencia insulínica en 146 niños (47,1%); mientras que la frecuencia de dislipemia e hipertensión fue de 31% y 19,4%, respectivamente. La razón de aterogenicidad debida a dislipemia fue mayor en el grupo deficiente (p = 0,049). Se encontró una correlación inversa entre los niveles de 25-OH-D y los valores de HOMA (r = -0,146; p = 0,01). Los valores medios de vitamina D (ng/Ml) fueron inferiores en niñas (12,15 ± 6,60) que en niños (16,48 ± 8,69) (p < 0,05) y en niños con hipertensión (11,92 ± 5,48 vs. 14,50 ± 8,24 en normotensos) (p < 0,05). Conclusiones: se encontró una prevalencia de deficiencia en vitamina D en niños y adolescentes obesos superior a lo esperado. Nuestros hallazgos indican que los niveles bajos de vitamina D se asocian con resistencia insulínica. La deficiencia en vitamina D podría contribuir a las morbilidades que se asocian a la obesidad infantil, como la resistencia insulínica o la diabetes mellitus, el aumento del riesgo cardiovascular, la dislipemia y la hipertensión (AU)

Evaluation of executive functions in children and adolescents with familial Mediterranean fever.

The aim of the present study was to investigate neuropsychological test performance in children and adolescents with familial Mediterranean fever (FMF). A total of 88 children and adolescents aged 8 to 17 years were included, 52 with FMF and 36 healthy controls. After the participants were administered the Children Depression Inventory (CDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), they completed the battery tests of the Central Nervous System Vital Signs (CNSVS), a neurocognitive test battery, via computer. The battery calculates seven domain scores (Memory, Psychomotor Speed, Processing Speed, Reaction Time, Complex Attention, Executive Function, and Cognitive Flexibility) and a summary score (Neurocognition Index [NCI]). A statistically significant difference between the FMF and control groups was found in six out of seven domains, where the scores of the participants with FMF were found to be significantly lower than those of the control participants (p < .05). Although the mean Reaction Time score of the participants with FMF was found to be lower than that of the control participants, the finding was not statistically significant (p > .05). The mean CDI and SCARED scores of the participants with FMF were found to be significantly higher than those of the control participants (p < .05). Low scores in the Processing Speed and Psychomotor Speed domains of the CNSVS were significantly correlated with higher SCARED scores (r = -.37, p = .01). Impaired cognitive functions should be taken into consideration in children and adolescents with FMF when assessing and managing this population.

Assessment of Neurocognitive Functions in Children and Adolescents with Obesity.

Obesity is linked to adverse neurocognitive outcomes including reduced cognitive functioning. We aimed to investigate the differences in neuropsychological test performance of Turkish children and adolescents with obesity and healthy peers. Study includes 147 children and adolescents ranging in age from 8 to 16 years: 92 with obesity and 55 with healthy controls. After the participants were administered the Children's Depression Inventory (CDI) and the Screen for Child Anxiety Related Disorders (SCARED), they completed the battery tests of the Central Nervous System Vital Signs (CNSVS), a neurocognitive test battery, via computer. The battery calculates seven domain scores (Memory, Psychomotor speed, Processing speed, Reaction time, Complex attention, Executive Function, Cognitive flexibility), and a summary score (Neurocognition Index [NCI]). There was a statistically significant difference between the obesity and control groups on all cognitive domains. The mean NCI score of the obesity group was 81.3 ± 10.24 compared to 97.29 ± 4.97 for the control group. The mean NCI score in the obesity group was significantly lower than that of the control group (p < 0.001). The mean scores of other domains of obese patients were also found to be significantly lower than those of the control participants (p < 0.001). The mean SCARED scores of the participants with obesity were found to be significantly higher than those of the control participants (p < 0.05). However, no statistically significant relationship was found between the SCARED and the CNSVS scores. Cognitive dysfunction in children and adolescents with obesity should be taken into consideration when assessing and managing this population.

Hemophagocytosis in the Acute Phase of Fatal Kawasaki Disease in a 4 Month-Old Girl.

BACKGROUND: Kawasaki disease is a systemic vasculitis predominately affecting coronary arteries. Hemophagocytic lymphohistiocytosis can complicate the course of Kawasaki disease. Rare cases of secondary hemophagocytic lymphohistiocytosis occurring during the acute phase of Kawasaki disease have been reported. CASE REPORT: We report here a 4 month-old girl with diffuse coronary ectasia and secondary hemophagocytic lymphohistiocytosis occurring during the acute phase of incomplete Kawasaki disease. CONCLUSION: Due to the large overlap in clinical symptoms, the presence of atypical findings for Kawasaki disease should suggest the possible diagnosis of hemophagocytic lymphohistiocytosis in these patients.

[Hypovitaminosis D in Children with Hashimoto’s Thyroiditis]. / Hipovitaminosis D en niños con tiroiditis de Hashimoto.

BACKGROUND: Vitamin D deficiency or insufficiency may play a role in the pathogenesis of certain autoimmune diseases. AIM: To measure vitamin D levels in children with Hashimoto’s thyroiditis (HT) (either with subclinical or marked hypothyroidism) and in healthy controls. MATERIAL AND METHODS: We included 68 children with HT aged 12 ± 4 years (39 females) from a pediatric outpatient clinic and 68 healthy children aged 10 ± 4 years (37 females). Calcium metabolism parameters, thyroid function tests and anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) and 25 hydroxy vitamin D (25OHD) levels were measured. RESULTS: Patients were older than controls but well matched by gender distribution. Mean 25OHD levels were significantly lower in HT patients than controls (16.8 ± 9.3 and 24.1 ± 9.4 ng/mL respectively, P < 0.01). Frequency of vitamin D deficiency was 76 and 35% in HT patients and controls, respectively (P < 0.001). CONCLUSIONS: Vitamin D deficiency is more common in children with HT than healthy controls.

Is the IL-6 -174G/C Gene Polymorphism Related to the Disease Severity Score in Turkish Children with Familial Mediterranean Fever?

Familial Mediterranean fever (FMF) is an autosomal recessively inherited disease characterized by recurrent self-limited attacks of fever accompanied by aseptic inflammation of serosal spaces, joints and skin, peritonitis, pleuritis, and arthritis. Clinical features differ according to genetics variants. The aim of this study was to identify relationship between IL-6 -174G/C gene polymorphisms and clinical features, disease severity score (DSS) and proteinuria in children diagnosed with FMF. In this study, 99 children who were followed-up in Gaziosmanpasa University Medical Faculty Department of Pediatrics and diagnosed with Familial Mediterranean fever according to Tel-Hashomer criteria were included. One hundred and fifty seven children who admitted to the hospital with any complain and found healthy included in control group. Genotyping was done for polymorphism in a promoter region of IL-6 gene (G/C at -174). The IL-6 -174G/C gene polymorphism and the clinical features of FMF, proteinuria, the DSS, and the healthy control group were investigated. Data for the clinical features were obtained retrospectively from the electronic records of patients. All of the genotyping of blood samples were done in Medical Genetic laboratory of Gaziosmanpasa University School of Medicine. The results revealed that the distribution of the genotypes and allele frequencies of the IL-6 -174G/C polymorphism were not significantly different between the FMF patients and the healthy controls. The IL-6 -174G/C polymorphisms did not affect proteinuria, the DSS, and the clinical features of FMF patients.

Retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in children with obesity.

AIM: To evaluate retinal nerve fiber layer (RNFL) thickness analysis of peripapillary optic nerve head (PONH) and macula as well as ganglion cell-inner plexiform layer (GCIPL) thickness in obese children. METHODS: Eighty-five children with obesity and 30 controls were included in the study. The thicknesses of the PONH and macula of each subject's right eye were measured by high-resolution spectral-domain optic coherence tomography (OCT). RESULTS: The RNFL thicknesses of central macular and PONH were similar between the groups (all P>0.05). The GCIPL thickness was also similar between the groups. However, the RNFL thickness of temporal outer macula were 261.7±13.7 and 268.9±14.3 µm for the obesity and the control group, respectively (P=0.034). CONCLUSION: Obesity may cause a reduction in temporal outer macular RNFL thickness.

Hypovitaminosis D in Children with Hashimoto’s Thyroiditis / Hipovitaminosis D en niños con tiroiditis de Hashimoto

Background: Vitamin D deficiency or insufficiency may play a role in the pathogenesis of certain autoimmune diseases. Aim: To measure vitamin D levels in children with Hashimoto’s thyroiditis (HT) (either with subclinical or marked hypothyroidism) and in healthy controls. Material and Methods: We included 68 children with HT aged 12 ± 4 years (39 females) from a pediatric outpatient clinic and 68 healthy children aged 10 ± 4 years (37 females). Calcium metabolism parameters, thyroid function tests and anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) and 25 hydroxy vitamin D (25OHD) levels were measured. Results: Patients were older than controls but well matched by gender distribution. Mean 25OHD levels were significantly lower in HT patients than controls (16.8 ± 9.3 and 24.1 ± 9.4 ng/mL respectively, P < 0.01). Frequency of vitamin D deficiency was 76 and 35% in HT patients and controls, respectively (P < 0.001). Conclusions: Vitamin D deficiency is more common in children with HT than healthy controls.

Antecedentes: La deficiencia o insuficiencia de vitamina D puede tener un rol en la patogenia de enfermedades autoinmunes. Objetivo: Medir niveles de vitamina D en niños con tiroiditis de Hashimoto (TH) (con hipotiroidismo subclínico o marcado) y en controles sanos. Material y Métodos: Estudiamos 68 niños con TH, de 12 ± 4 años (39 mujeres) y 68 controles sanos de 10 ± 4 años (37 mujeres). Se les midió parámetros de metabolismo de calcio, pruebas de función tiroidea, anticuerpos anti peroxidasa y anti tiroglobulina y 25 hidroxi vitamina D (25 OH vit D). Resultados: Los pacientes eran mayores que los controles pero la distribución por género era homogénea en ambos grupos. Los niveles de 25 OH vit D en pacientes y controles fueron 16,8 ± 9,3 y 24,1 ± 9,4 ng/mL respectivamente, p < 0,01. La frecuencia de deficiencia de vitamina D fue de 76 y 35% en pacientes y controles, respectivamente. Conclusiones: La deficiencia de vitamina D es más común en niños con TH.

Hereditary angioedema type 2 presented as an orbital complication of acute rhinosinusitis.

Hereditary angioedema is an autosomal dominant and life-threatening disorder characterized by recurrent episodes of non-pitting edema affecting the skin, respiratory system and digestive tracts and caused by a congenital deficiency or function defect of the C1 esterase inhibitor. Preseptal cellulitis is defined as an infection of the tissues of the anterior orbital septum. It is generally caused by complications from an upper respiratory tract infection, dacryocystitis, dermal infection, and, rarely, sinusitis. The disease presents with orbital pain, edema on the eyelids, erythema, and fever. In this case, a child with hereditary angioedema type 2 who presented as mimicking a complication of acute sinusitis is discussed.

Peripapillary Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Thickness in Children with Familial Mediterranean Fever.

PURPOSE: To evaluate the thickness of the peripapillary retinal nerve fiber layer (RNFL) and retinal ganglion cell-inner plexiform layer (GCIPL) in children with familial Mediterranean fever (FMF). METHODS: The study included 39 FMF patients and 36 healthy controls. After detailed ocular examination, the thickness of the peripapillary RNFL and GCIPL were measured by spectral domain optic coherence tomography (SD-OCT). All measurements were taken from the right eye of the patients and controls. According to their disease severity score (DSS), the patients were divided into two groups: patients with DSS ≤5 and those with DSS >5. RESULTS: There were no statistically significant differences in peripapillary RNFL and retinal GCIPL thickness between patients with FMF and controls. CONCLUSION: It appears that FMF does not affect the RNFL and GCIPL thickness.

Prevalence of hypercalciuria and urinary calcium excretion in school-aged children in the province of Tokat.

AIM: Hypercalciuria is an important cause of urinary tract symptoms, and also frequently results in urolithiasis. Urinary calcium excretion varies for geographic areas. We aimed to assess percentiles of urinary calcium excretion and prevalence of hypercalciuria for school-aged children in Tokat (city located in inner northern region of Turkey). MATERIAL AND METHODS: One thousand three hundred seventy-five children aged 6 to 18 years were enrolled in the study. Urine samples were obtained randomly. The children's variables as sex, age, length, and weight were recorded. Urinary calcium and creatinine determined from the urine samples and urinary calcium/creatinine ratios (mg/mg) were calculated. Percentiles of urinary calcium/creatinine ratios were also assessed for each age of the children. RESULTS: Six hundred eighty-three of the 1 375 children were girls and 692 were boys. The mean age of the children was 11.68±3.43 years. Some 23.9% of the children were living in rural regions and 76.1% were were living in urban regions. The mean urinary calcium/creatinine ratio was 0.080±0.24 and the 95th percentile value of the urinary calcium/creatinine ratio was 0.278. The hypercalciuria prevalence for school-aged children was 4.7% when the urinary calcium/creatinine ratio value for hypercalciuria was accepted as ≥0.21. The prevalence of hypercalciuria in rural and urban regions was 7.60% and 3.82%, respectively (p<0.05). Hypercalciuria was present in 7 of 141 patients who were obese (4.96%) and 58 of 1 234 patients who were not obese (4.70%) (p>0.05). CONCLUSION: The prevalence of hypercalciuria and urinary calcium excretion vary for different geographic areas, not only for countries. The percentiles of urinary calcium excretion should be assesed for every geographic region and the prevalance of hypercalciuria should be determined with these values. There is controversy as to whether obesity is a risk factor for hypercalciuria.

Relationships among thyroid hormones and obesity severity, metabolic syndrome and its components in Turkish children with obesity / Las relaciones entre las hormonas tiroideas y la severidad de la obesidad, el síndrome metabólico y sus componentes en niños turcos con obesidad

Background: we investigated the relationships between thyroid function and obesity severity, metabolic syndrome (MS) and MS components in 260 obese children and adolescents 10–17 years of age. Objectives: we aimed to determine the association of thyroid functions with obesity severity and the components of metabolic syndrome (MS) in pediatric obese patients. Methods: only obese children and adolescents were included, and divided the obese children into three groups according to body mass index (BMI)-SDS quartiles. The first quartile was group 1, the second and third quartiles were group 2, and the fourth quartile was group 3. Group 3 indicated severe obesity. The modified WHO criteria adapted for children were used to diagnose MS. We assessed anthropometric data and serum biochemical parameters, including the lipid profile and fasting glucose (FG), insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels. Blood pressure (BP) was measured with a standard digital sphygmomanometer. The homeostasis model assessment of insulin resistance was calculated to determine insulin resistance (IR). Results: TSH level was significantly higher in obese children with MS than that in the others (p = 0.045). Mean TSH level was not different among the BMI-SDS groups (p = 0.590). TSH levels and the fT3/fT4 ratio were not different in children with dyslipidemia, IR or hypertension (p = 0.515, 0.805, 0.973, 0.750, 0.515, and 0.805, respectively). Discussion: obesity severity does not affect TSH level or the fT3/fT4 ratio in obese children and adolescents. IR is in close relationship with TSH level. Elevated TSH level is a risk factor for MS (AU)

Antecedentes: hemos investigado las relaciones entre la función tiroidea y la severidad de la obesidad, el síndrome metabólico (MS) y los componentes del MS en 260 niños y adolescentes obesos de entre 10 y 17 años de edad. Objetivos: pretendemos determinar la asociación de las funciones tiroideas con la severidad de la obesidad y los componentes del síndrome metabólico (MS) en pacientes pediátricos obesos. Métodos: solo se incluyeron niños y adolescentes obesos, y se dividió a los niños obesos en tres grupos según los cuartiles de índice de masa corporal (BM). El primer cuartil fue el grupo 1, el segundo y tercer cuartil fueron el grupo 2, y el cuarto cuartil fue el grupo 3. El grupo 3 indicó obesidad severa. Los criterios WHO modificados adaptados para los niños se utilizaron para diagnosticar MS. Evaluamos los datos antropométricos y los parámetros del suero bioquímico, incluyendo el perfil lípido y los niveles de glucosa en ayunas (FG), insulina, hormona estimulante del tiroides (TSH), tiroxina libre (fT4) y triyodotironina libre (fT3). Se midió la presión sanguínea (BP) con un esfigmomanómetro digital estándar. La evaluación del modelo de homeostasis de la resistencia de la insulina se calculó para determinar la resistencia a la insulina (IR). Resultados: el nivel de TSH fue significativamente mayor en niños obesos con MS que en los demás (p = 0,045). El nivel medio de TSH no fue diferente entre los grupos BMI (p = 0,590). Los niveles de TSH y la proporción fT3/ fT4 no fueron diferentes en niños con dislipidemia, IR o hipertensión (p = 0,515; 0,805; 0,973; 0,750; 0,515 y 0,805, respectivamente). Discusión: la severidad de la obesidad no afecta al nivel de TSH ni a la proporción fT3/fT4 en niños y adolescentes obesos. La IR está en relación directa con el nivel de TSH. El nivel elevado de TSH es un factor de riesgo para el MS (AU)

RELATIONSHIPS AMONG THYROID HORMONES AND OBESITY SEVERITY, METABOLIC SYNDROME AND ITS COMPONENTS IN TURKISH CHILDREN WITH OBESITY.

BACKGROUND: we investigated the relationships between thyroid function and obesity severity, metabolic syndrome (MS) and MS components in 260 obese children and adolescents 10-17 years of age. OBJECTIVES: we aimed to determine the association of thyroid functions with obesity severity and the components of metabolic syndrome (MS) in pediatric obese patients. METHODS: only obese children and adolescents were included, and divided the obese children into three groups according to body mass index (BMI)-SDS quartiles. The first quartile was group 1, the second and third quartiles were group 2, and the fourth quartile was group 3. Group 3 indicated severe obesity. The modified WHO criteria adapted for children were used to diagnose MS. We assessed anthropometric data and serum biochemical parameters, including the lipid profile and fasting glucose (FG), insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels. Blood pressure (BP) was measured with a standard digital sphygmomanometer. The homeostasis model assessment of insulin resistance was calculated to determine insulin resistance (IR). RESULTS: TSH level was significantly higher in obese children with MS than that in the others (p = 0.045). Mean TSH level was not different among the BMI-SDS groups (p = 0.590). TSH levels and the fT3/fT4 ratio were not different in children with dyslipidemia, IR or hypertension (p = 0.515, 0.805, 0.973, 0.750, 0.515, and 0.805, respectively). DISCUSSION: obesity severity does not affect TSH level or the fT3/fT4 ratio in obese children and adolescents. IR is in close relationship with TSH level. Elevated TSH level is a risk factor for MS.

Antecedentes: hemos investigado las relaciones entre la función tiroidea y la severidad de la obesidad, el síndrome metabólico (MS) y los componentes del MS en 260 niños y adolescentes obesos de entre 10 y 17 años de edad. Objetivos: pretendemos determinar la asociación de las funciones tiroideas con la severidad de la obesidad y los componentes del síndrome metabólico (MS) en pacientes pediátricos obesos. Métodos: solo se incluyeron niños y adolescentes obesos, y se dividió a los niños obesos en tres grupos según los cuartiles de índice de masa corporal (BM). El primer cuartil fue el grupo 1, el segundo y tercer cuartil fueron el grupo 2, y el cuarto cuartil fue el grupo 3. El grupo 3 indicó obesidad severa. Los criterios WHO modificados adaptados para los niños se utilizaron para diagnosticar MS. Evaluamos los datos antropométricos y los parámetros del suero bioquímico, incluyendo el perfil lípido y los niveles de glucosa en ayunas (FG), insulina, hormona estimulante del tiroides (TSH), tiroxina libre (fT4) y triyodotironina libre (fT3). Se midió la presión sanguínea (BP) con un esfigmomanómetro digital estándar. La evaluación del modelo de homeostasis de la resistencia de la insulina se calculó para determinar la resistencia a la insulina (IR). Resultados: el nivel de TSH fue significativamente mayor en niños obesos con MS que en los demás (p = 0,045). El nivel medio de TSH no fue diferente entre los grupos BMI (p = 0,590). Los niveles de TSH y la proporción fT3/ fT4 no fueron diferentes en niños con dislipidemia, IR o hipertensión (p = 0,515; 0,805; 0,973; 0,750; 0,515 y 0,805, respectivamente). Discusión: la severidad de la obesidad no afecta al nivel de TSH ni a la proporción fT3/fT4 en niños y adolescentes obesos. La IR está en relación directa con el nivel de TSH. El nivel elevado de TSH es un factor de riesgo para el MS.