Evidence of an influence of a polymorphism near the INSIG2 on weight loss during a lifestyle intervention in obese children and adolescents.

Objective: Homozygotes for the C-allele of the single nucleotide polymorphism (SNP) rs7566605, located approximately 10 kb upstream of insulin-induced gene 2 (INSIG2), showed a slightly increased risk of becoming obese. The aim of this study was to analyze whether children homozygous for the C-allele lose less weight in an intervention than children with the GG- or GC-genotype.

Research Design And Methods: We genotyped rs7566605 in 293 obese children (mean age 10.

Adipocyte fatty acid-binding protein in obese children before and after weight loss.

Adipocyte fatty acid-binding protein (A-FABP) has been reported to be increased in obese adults and to be related to metabolic syndrome. Because studies concerning A-FABP in weight loss are limited and studies in obese children are missing, we analyzed A-FABP in obese children before and after weight loss. Fasting serum A-FABP, leptin, insulin, glucose, triglycerides, low-and high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and tumor necrosis factor alpha concentrations as markers of the metabolic syndrome, and weight status (body mass index and percentage body fat based on skinfold measurements) were determined in 30 obese children (median age, 11.

Obestatin and ghrelin levels in obese children and adolescents before and after reduction of overweight.

Objectives: Obestatin and ghrelin, which are derived from the same gene, are observed to have opposite effects on weight status. The aims of this study were to compare obestatin concentrations in obese and normal-weight children and to analyse the effect of weight loss on obestatin and ghrelin levels.

Methods: We examined anthropometrical markers and fasting serum obestatin, ghrelin, leptin, glucose and insulin concentrations in 44 obese children (mean age 11.

Growth around puberty as predictor of adult obesity.

Objectives: To contribute to the early risk identification of adult obesity, the anthropometric development in the first 23 years of life as a potential predictor for adult obesity was assessed. To identify the period (7-11 years, 11-16 years and 16-23 years) and type of anthropometric measure difference (weight, height and body mass index (BMI) gains) accounting for the best prediction of obesity at 33 years.

Subjects/methods: A total of 4952 members of the 1958 British birth cohort with full information on anthropometric measures.

Amylin and its relation to insulin and lipids in obese children before and after weight loss.

Objective: There are limited data concerning the relationships between amylin, weight status, lipids, insulin, and insulin resistance in obese humans. Therefore, the aim was to study these relationships in cross-sectional and longitudinal analyses.

Research Methods And Procedures: Fasting amylin, insulin, glucose, triglycerides, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, and percentage body fat based on skinfold measurements were determined in 37 obese children (median age, 11.

Vitamin D status and parathyroid hormone in obese children before and after weight loss.

Objective: The roles of vitamin D and parathyroid hormone (PTH) are discussed controversially in obesity, and studies of these hormones in obese children are limited. Therefore, we studied the relationships between PTH, 1,25-dihydroxy-vitamin D (1,25-OH Vit D), 25-hydroxy-vitamin D (25-OH Vit D), weight status, and insulin sensitivity before and after weight loss in obese children.

Methods: Fasting serum PTH, 1,25-OH Vit D, 25-OH Vit D, inorganic phosphate, calcium, alkaline phosphatase (AP), insulin, glucose, and weight status (SDS-BMI and percentage body fat) were determined in 133 obese children (median age 12.

Definable somatic disorders in overweight children and adolescents.

Objective: To analyze the frequencies and clinical presentation of definable somatic disorders in children who are overweight.

Study Design: We assessed prospectively 1405 children aged 4 to 16 years who were overweight and came to our specialized clinic for endocrinology and obesity with a standardized diagnostic procedure. In a subgroup of 223 children, we sought mutations in the melanocortin-4-receptor gene (MC4R).

Reduced sympathetic metabolites in urine of obese patients with craniopharyngioma.

Severe obesity is a major problem in patients suffering from craniopharyngioma (CP), a benign tumor located in pituitary and hypothalamic regions. In this study, the hypothesis that hypothalamic damage leads to a reduction in overall sympathetic tone was tested. Catecholamines, as well as their metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA), markers of catecholamine turnover, were measured in morning voided urine of 109 patients participating in a German pediatric CP study, and their physical activity was analyzed using a questionnaire.

Four-year follow-up of children and adolescents participating in an obesity intervention program.

Background: Since obesity affects children's health and social integration, treatment concepts with long-term efficiency are necessary.

Methods: We analyzed changes of standard deviation score of body mass index (SDS-BMI) quarterly in the first year and once a year during the next 3 years in all obese children participating in the 1-year outpatient intervention program 'Obeldicks', which was based on physical exercise, nutrition education and behavior therapy. All analyses were performed on the intention-to-treat approach.

Fasting glucagon-like peptide-1 and its relation to insulin in obese children before and after weight loss.

Objective: To study the relationships between glucagon-like peptide-1 (GLP-1), weight status, insulin, and insulin resistance in the fasting state.

Patients And Methods: Fasting GLP-1, glucose and insulin concentrations, insulin resistance index as homeostasis model assessment (HOMA), body mass index (BMI), and percentage body fat based on skinfold thickness measurements were determined in 42 obese (median age 11 years) and in 16 lean children of the same age. The HOMA model was used to calculate degree of insulin resistance.

Comparison of metabolic syndrome prevalence using eight different definitions: a critical approach.

Objective: Multiple definitions of the metabolic syndrome (MS) have been proposed for children, adolescents and adults. The aim of this study was to analyse the variations in the MS prevalence using different definitions and to examine which factors influence the frequency of the MS in childhood and adolescence.

Methods And Design: The prevalence of the MS according to eight proposed definitions was studied in 1205 Caucasian overweight children and adolescents aged 4-16 years (mean body mass index (BMI) 27.

[Prospective comparison of different ultrasound modalities to measure thicknesses less than 1 mm].

Purpose: New ultrasound techniques with improved visualization and better transducers constantly expand the methods of measurement. In the border area in the case of thickness measurements of less than 1 millimeter, e. g.

Intima-media thickness in obese children before and after weight loss.

Objective: Obesity in childhood is related to increased intima-media thickness, a noninvasive marker for early atherosclerotic changes. The objective of this study was to analyze the changes of intima-media thickness in obese children with weight loss.

Methods: We analyzed the changes of intima-media thickness and, as markers of cardiovascular risk factor profile, systolic and diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, glucose, insulin, and insulin resistance index (homeostasis model analysis) in 56 prepubertal obese children (median: 9 years old) before and after a 1-year outpatient intervention program.

Relationships of IGF-I and andrrogens to skeletal maturation in obese children and adolescents.

Unlabelled: IGF-I and androgens are postulated to accelerate skeletal maturation in obese children.

Methods: We studied weight status (BMI-SDS), height-SDS, IGF-I, cortisol, DHEA-S, and testosterone in 356 obese children (aged 4-15 years; 54% females) and correlated them to differences between bone age and chronological age (deltaBA-CA). Direct multivariate linear regression analyses were conducted for the dependent variable deltaBA-CA, including BMI, age, gender, pubertal stage, IGF-I-SDS, cortisol, DHEA-S, and testosterone as independent variables separately in prepubertal and pubertal girls, and prepubertal and pubertal boys.

Changes of cardiovascular risk factors in obese children effects of inpatient and outpatient interventions.

Objective: The aim of the study was to compare the benefits of 2 different therapeutic approaches on cardiovascular risk factors (CVRF) in obese children and adolescents.

Methods: We analyzed the changes of weight status (as standard deviation score-body mass index [SDS-BMI]), blood pressure, lipids, and insulin levels in obese children (age range, 10-14 years) during a 1-year outpatient intervention based on lifestyle changes (group A, n = 124) and during a 6-week inpatient intervention program with dietary restriction and exercise therapy (group B, n = 119). In addition, we studied these parameters in 65 obese children without intervention for 1 year (control group).

ENPP1 variants and haplotypes predispose to early onset obesity and impaired glucose and insulin metabolism in German obese children.

Context: ENPP1 (nucleotide pyrophosphatase/phosphodiesterase-1) encodes a membrane-bound glycoprotein that inhibits the insulin-receptor tyrosine kinase activity, resulting in reduced insulin sensitivity. Hence, variants in this gene may be related to obesity and insulin resistance.

Objective: Therefore, in this study, we aimed to explore the role of ENPP1 genetic variants in obesity and related traits in a representative population of Caucasian children and in cohorts of obese children with detailed metabolic characteristics including oral glucose tolerance test.

Long-term follow-up of cardiovascular disease risk factors in children after an obesity intervention.

Background: Data concerning the long-term improvement of cardiovascular disease (CVD) risk factors after an obesity intervention in children are limited.

Objective: We studied changes in weight status and CVD risk factors in children in an intervention program and evaluated whether these changes were sustained 1 y after the end of the intervention.

Design: We analyzed changes in the SD score (SDS) of body mass index [BMI; in kg/m2 (SDS-BMI)], blood pressure (BP), lipids, and homeostasis model assessment index of insulin resistance (HOMA-IR) over the course of 2 y in 240 obese (BMI > 97th percentile) children aged 6-14 y (x age: 10.

Pancreatic polypeptide in obese children before and after weight loss.

Objective: Little is known concerning pancreatic polypeptide (PP) in weight loss and in childhood obesity.

Methods: Fasting PP, leptin and insulin concentrations were determined in 38 obese children and compared with 35 lean children of the same age, gender and pubertal stage. Furthermore, changes of PP concentrations over a 1-year period were analyzed in the obese children participating in a weight loss intervention program.

Hyperthyrotropinemia in obese children is reversible after weight loss and is not related to lipids.

Context: There is some controversy whether T(4) treatment is indicated in obese humans with hyperthyrotropinemia.

Objective: The objective of this study was to examine whether hyperthyrotropinemia is a cause or a consequence of obesity.

Design: The study was designed as a cross-sectional comparison between obese and lean children and includes a 1-yr follow-up study.

Beta-cell autoantibodies in children with type 2 diabetes mellitus: subgroup or misclassification?

Background: In adults, a fraction of diabetic individuals with beta-cell autoantibodies has initially non-insulin requiring diabetes clinically appearing as type 2 diabetes mellitus (T2DM), named latent autoimmune diabetes in adulthood (LADA). The occurrence of beta-cell autoantibodies in European children and adolescents with T2DM has not been reported so far.

Methods: The frequency of beta-cell autoantibodies (anti-GAD, anti-IA-2, and anti-ICA) was determined in 7050 diabetic children and adolescents.

Clinical presentation of type 2 diabetes mellitus in children and adolescents.

Objective: Recent reports indicate an increasing prevalence of type 2 diabetes mellitus (TD2M) in children and adolescents around the world in all ethnicities, possibly due to increasing prevalence of obesity. Therefore, it is essential that clinicians are aware of the clinical features of T2DM in these age groups.

Methods: All published cases of T2DM in children and adolescents were evaluated and the different clinical presentations of T2DM in minorities and Caucasian described.

Intima media thickness in childhood obesity: relations to inflammatory marker, glucose metabolism, and blood pressure.

Obesity in childhood is discussed to be associated with hypertension, dyslipidemia, impaired glucose metabolism, and chronic inflammation. It has not yet been studied in obese children which of these cardiovascular risk factors are related to intima media thickness (IMT), a noninvasive marker for early atherosclerotic changes. We collected the clinical data (age, sex, pubertal stage, percentage of body fat, SD score of body mass index [SDS-BMI]) and measured systolic blood pressure [SBP] and diastolic blood pressure [DBP], triglycerides [TGs], high- and low-density lipoprotein cholesterol, glucose, insulin, and high-sensitivity C-reactive protein [hsCRP]) in 96 obese children (median age, 11 years).

Longitudinal analyses among overweight, insulin resistance, and cardiovascular risk factors in children.

Objective: It has been questioned whether insulin resistance or obesity is the central abnormality contributing to the cardiovascular risk factors dyslipidemia and hypertension in obesity.

Research Methods And Procedures: We studied weight status [SD score (SDS)-BMI], lipids (triglycerides, low-density lipoprotein- and high-density lipoprotein-cholesterol), blood pressure, and insulin resistance index [as homeostasis model assessment (HOMA) model] over a 1-year period in 229 obese white children (median age 12 years).

Results: Any degree of decrease in HOMA was associated with significant decreases in triglycerides (p < 0.

The 'accelerator hypothesis': relationship between weight, height, body mass index and age at diagnosis in a large cohort of 9,248 German and Austrian children with type 1 diabetes mellitus.

Aims/hypothesis: The aim of this study was to investigate whether either increased weight or BMI are associated with the earlier manifestation of type 1 diabetes mellitus in children.

Methods: We evaluated anthropometric measurements in a large cohort of 9,248 patients of European extraction who were diagnosed in the years 1990-2003 in 116 pediatric clinics throughout Germany and Austria.

Results: Patients were divided into four groups according to age (0-4.