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Clippings
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Meghna Chawla
Email: [email protected]
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Association between neck circumference and
non-alcoholic fatty liver disease in children and adolescents with
obesity(J Pediatr Endocrinol Metab. 2019 Dec 16)
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Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic
hepatic disorder in children. This authors studied if there was an
association between neck circumference and NAFLD, and to establish
cut-off values based on gender and pubertal staging. Mexican children
and adolescents (n=112) between the ages of 6-18 y were included
and presence of NAFLD determined by hepatic ultrasound.The neck
circumference was larger in NAFLD pediatric patients as compared to
those without NAFLD (P = 0.001). Moreover, neck circumference was
associated with NAFLD as an independent risk factor [OR (95%CI) =1.172
(1.008-1.362); P = 0.038). In male adolescents, Tanner 2-3 = 35cm
and Tanner 4-5 = 38 cm were established as risk cut-off values to
develop NAFLD.
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The effect of overweight and obesity on liver biochemical
markers in children and adolescents (J Clin Endocrinol
Metab. 2019 Dec 16)
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Age- and sex-specific percentile curves were calculated for liver
biochemical markers in two cohorts of Danish children and adolescents
(between 6-18 years of age, 1858 from a population based cohort and 2155
with overweight and obesity).Children with overweight and obesity had a
higher level of alanine aminotransferase (ALT) in all age groups.
Optimal ALT cut-points for diagnosis of hepatic steatosis (liver fat
content >5%) was 24.5 U/L for girls (sensitivity: 55.6%, specificity:
84.0%) and 34.5 U/L for boys (sensitivity: 83.7%, specificity: 68.2%).
Thus obesity is associated with liver damage, underscoring the
importance of its prevention in the pediatric age group.
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A randomized clinical trial to evaluate
sitagliptin in pediatric patients with type-2 diabetes (Pediatr
Diab.2019;20:48-56)
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A randomized, placebo-controlled, double-blind evaluation of sitagliptin
in 35 patients 10-17 years old with T2DM at seven clinical research
sites was conducted. It was found that single doses of 50, 100, and 200
mg sitagliptin inhibited 67.2%, 73.8%, and 81.2% of plasma DPP-4 (dipeptidyl-peptidase
IV) activity over 24 hours, respectively. The least squares (LS) mean
glucose concentrations two hours after an oral glucose tolerance test or
a meal tolerance test decreased in patients treated with sitagliptin
compared to placebo, while active LS mean glucagon-like peptide 1
concentrations increased significantly at all sitagliptin doses in both
tests. Adverse effects of mild intensity were reported in eight study
participants; only one had intravenous site pain of moderate intensity.
It was thus concluded that a single dose of 200mg was well tolerated in
all the study participants.
There is now a need for further phase III safety and
efficacy studies in pediatric patients with type-2 diabetes using a
single dose of 100 mg of sitagliptin.
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Autonomous early detection of eye disease in childhood
photographs (Science Advances. 2019;5: eaax6363)
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Congenital adrenal hyperplasia (CAH) patients (n = 244) from dsd-LIFE
cohort (women, 147; men, 97; salt-wasters, 148; simple virilizing, 71;
non-classical-CAH, 25) were chosen.It was found that prednisolone-only
treated patients had more detrimental effects on BMD than hydrocortisone
(P<0.05).The androstenedione/testosterone ratio at the age of 16
years had a positive correlation with lumbar spine Z score in
women (r2=0.284, P = 0.024) and trochanter Z score in men
(r2 = 0.60, P = 0.025), thus showing that higher glucocorticoid
doses have lower bone mineral density in adulthood.
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Prevalence of TG and TPO mutations in Sudanese
children with Congenital Hypothyroidism (J Clin
Endocrinol Metab. 2019 Dec 23)
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Congenital hypothyroidism (CH) is due to thyroid dyshormonogenesis in
10-15% of subjects worldwide and 60% of CH cases in the Sudan.With the
aim of investigating the molecular basis of CH, clinical evaluation,
thyroid function tests, genetic sequencing and analysis was performed on
26 Sudanese families with CH.Mutations were found in DUOX1, DUOX2,
IYD, SLC26A4, SLC26A7, SLC5A5, TG, and TPO genes, and all
occurred in domains important for protein structure and function,
predicting the CH phenotype. TG mutations were significantly
higher on average in the Sudanese compared to other populations.
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Long term methimazaole therapy in pediatric Grave’s disease
(Pediatrics. 2019;143:e20183034)
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This randomized parallel-group controlled trial was performed on 66
children with Grave’s disease in Tehran, an iodine replete area, to
evaluate if long term methimazaole therapy (>4 y) was associated with
lower relapse rate than shorter therapy, thus abating the need for
ablative therapy. Fifty six patients were randomized after daily
methimazole intake of 0.25 to 0.5 mg/kg for 18-24 mo, to discontinue the
drug or continue low dose methimazole for 96-120 mo, and reassessed
after 48 mo of stopping the drug in each group. The study reported lower
relapse rate in long term therapy group than shorter therapy group (P<0.001)
with no side effects in the former group. Methimazole treatment duration
was the only significant factor on multivariate analysis to affect the
outcome.
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