Steady-state population pharmacokinetics of a noncommercial immediate-release metformin (hydrochloride) drug product were characterized in 28 severely obese children with insulin resistance. The concentration-time profiles with double peaks were well described by a 1-compartment model with 2 absorption sites. Mean population apparent clearance (CL/F) was 68.1 L/h, and mean apparent volume of distribution (V/F) was 28.8 L. Body weight was a covariate of CL/F and V/F. Estimated glomerular filtration rate was a significant covariate of CL/F (P < .001). SLC22A1 genotype did not significantly affect metformin pharmacokinetics. The response to 6 months of metformin treatment (HbA , homeostasis model assessment for insulin resistance, fasting insulin, and glucose changes) did not differ between SLC22A1 wild-type subjects and carriers of presumably low-activity SLC22A1 alleles. However, SLC22A1 variant carriers had smaller reductions in percentage of total trunk fat after metformin therapy, although the percentage reduction in trunk fat was small. The median % change in trunk fat was -2.20% (-9.00% to 0.900%) and -1.20% (-2.40% to 7.30%) for the SLC22A1 wild-type subjects and variant carriers, respectively. Future study is needed to evaluate the effects of SLC22A1 polymorphisms on metformin-mediated weight reduction in obese children.
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http://dx.doi.org/10.1002/jcph.796 | DOI Listing |
Sci Rep
December 2024
Affiliated Hospital of Jiangnan University, Wuxi, 214000, Jiangsu, China.
Vitamin D is crucial for maintaining bone health and development, and bone mineral accumulation during childhood and adolescence affects long-term bone health. Vitamin D deficiency has been widely recognized as one of the main causes of osteoporosis and fractures, especially during the growth and development stage of children. Recent studies have shown that vitamin D deficiency may affect the deviation of bone development in children by mediating lipid metabolism disorders, but its specific mechanism of action has not been fully elucidated.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Statistical Science, Duke University, Durham, 27708-0251, USA.
The article is motivated by an application to the EarlyBird cohort study aiming to explore how anthropometrics and clinical and metabolic processes are associated with obesity and glucose control during childhood. There is interest in inferring the relationship between dynamically changing and high-dimensional metabolites and a longitudinal response. Important aspects of the analysis include the selection of the important set of metabolites and the accommodation of missing data in both response and covariate values.
View Article and Find Full Text PDFSurg Obes Relat Dis
December 2024
Department of Surgery, Rush University Medical Center, Chicago, Illinois. Electronic address:
Background: Metabolic bariatric surgery is the most effective therapy for severe obesity, which affects the health of millions, most of whom are women of child-bearing age. Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most common bariatric procedures and are associated with durable weight loss and comorbidity resolution. Although obstetric outcomes broadly improve, the safety profile comparing the impact of RYGB and SG on obstetric outcomes is underexplored.
View Article and Find Full Text PDFJ Rural Health
January 2025
Avera Research Institute, Avera McKennan Hospital, Sioux Falls, South Dakota, USA.
Purpose: The Environmental influences on Child Health Outcomes (ECHO) Cohort has enrolled over 60,000 children to examine how early environmental factors (broadly defined) are associated with key child health outcomes. The ECHO Cohort may be well-positioned to contribute to our understanding of rural environments and contexts, which has implications for rural health disparities research. The present study examined the outcome of child obesity to not only illustrate the suitability of ECHO Cohort data for these purposes but also determine how various definitions of rural and urban populations impact the presentation of findings and their interpretation.
View Article and Find Full Text PDFJ Pediatr Urol
December 2024
Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. Electronic address:
Background: The prevalence of pediatric urolithiasis has increased rapidly, leading to more emergency department (ED) visits across the United States.
Objective: The purpose of this study was to determine emergency care practices for children and adolescents with urinary stones and characteristics associated with management.
Methods: We performed a cross-sectional study of the 2021 Nationwide Emergency Department Sample to identify pediatric patients (≤21 years) presenting to an ED in the United States with a primary diagnosis of urinary stone disease.
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