Endocrinology and Metabolism

Original Articles

Hypothalamus and Pituitary Gland
Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency: Yun Jeong Lee, Yunha Choi, Han-Wook Yoo, Young Ah Lee, Choong Ho Shin, Han Saem Choi, Ho-Seong Kim, Jae Hyun Kim, Jung Eun Moon, Cheol Woo Ko, Moon Bae Ahn, Byung-Kyu Suh, Jin-Ho Choi; Endocrinol Metab. 2022;37(2):359-368. Published online April 25, 2022; DOI: https://doi.org/10.3803/EnM.2021.1384

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Background
Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period.
Methods
This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption.
Results
Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates.
Conclusion
GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.

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Ghrelin regulating liver activity and its potential effects on liver fibrosis and Echinococcosis
Jiang Zhu, Tanfang Zhou, Meng Menggen, Kalibixiati Aimulajiang, Hao Wen
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Composición de la microbiota en pacientes con déficit de hormona de crecimiento antes y después de recibir tratamiento
Patricia García Navas, María Yolanda Ruíz del Prado, Pablo Villoslada Blanco, Emma Recio Fernández, María Ruíz del Campo, Patricia Pérez Matute
Anales de Pediatría.2024;[Epub] CrossRef
Relationship between the Stimulated Peak Growth Hormone Level and Metabolic Parameters in Children with Growth Hormone Deficiency
Seong Yong Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Dyslipidaemia and growth hormone deficiency – A comprehensive review
Matthias Hepprich, Fahim Ebrahimi, Emanuel Christ
Best Practice & Research Clinical Endocrinology & Metabolism.2023; 37(6): 101821. CrossRef

Clinical Study
Cross-Sectional and Longitudinal Examination of Insulin Sensitivity and Secretion across Puberty among Non-Hispanic Black and White Children: Shannon E. Marwitz, Megan V. Gaines, Sheila M. Brady, Sarah J. Mi, Miranda M. Broadney, Susan Z. Yanovski, Van S. Hubbard, Jack A. Yanovski; Endocrinol Metab. 2020;35(4):847-857. Published online November 18, 2020; DOI: https://doi.org/10.3803/EnM.2020.771

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Background
Few studies using criterion measures of insulin sensitivity (SI) and insulin secretory capacity (ISC) have been conducted across puberty to adulthood. We examined how SI and ISC change from pre-puberty through adulthood.
Methods
Hyperglycemic clamp studies were performed in a convenience sample of non-Hispanic Black (NHB) and White children evaluated at age 6 to 12 years and at approximately 5-year intervals into adulthood (maximum age 27 years). SI and ISC (first-phase and steady-state insulin secretion) were determined cross-sectionally in 133 unique participants across puberty and in adulthood. Additionally, longitudinal changes in SI and ISC were compared at two timepoints among three groups defined by changes in pubertal development: pre-pubertal at baseline and late-pubertal at follow-up (n=27), early-pubertal at baseline and late-pubertal at follow-up (n=27), and late-pubertal at baseline and adult at follow-up (n=24).
Results
Cross-sectionally, SI was highest in pre-puberty and early puberty and lowest in mid-puberty (analysis of covariance [ANCOVA] P=0.001). Longitudinally, SI decreased from pre-puberty to late puberty (P<0.001), then increased somewhat from late puberty to adulthood. Cross-sectionally, first-phase and steady-state ISC increased during puberty and decreased in adulthood (ANCOVA P<0.02). Longitudinally, steady-state and first-phase ISC increased from pre-puberty to late puberty (P<0.007), and steady-state ISC decreased from late puberty to adulthood. The NHB group had lower SI (P=0.003) and greater first-phase and steady-state ISC (P≤0.001), independent of pubertal development.
Conclusion
This study confirms that SI decreases and ISC increases transiently during puberty and shows that these changes largely resolve in adulthood.

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Veronica Maria Tagi, Sona Samvelyan, Francesco Chiarelli
Frontiers in Endocrinology.2022;[Epub] CrossRef
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Review Article

Obesity and Metabolism
Epidemiology of Childhood Obesity in Korea: Kyoung Hwa Ha, Dae Jung Kim; Endocrinol Metab. 2016;31(4):510-518. Published online November 3, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.510

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Over the past several decades, the prevalence of obesity has increased dramatically worldwide and is increasing not only in developed countries, but also in developing countries. This increase may lead to an increase in the incidence of chronic diseases throughout the lifespan. In Korean children and adolescents, the prevalence of obesity increased from 6.8% in 1998 to 10.0% in 2013. Obesity is a state that more commonly influences children and adolescents of lower socioeconomic status (SES) than those with a higher SES. However, the prevalence of metabolic syndrome in a nationally representative sample of Korean adolescents decreased from 1998 to 2012. According to the Diabetes Fact Sheet of the Korean Diabetes Association, the prevalence of type 2 diabetes among children aged 18 years or younger was 153.5 per 100,000 in 2006 and 205.0 per 100,000 in 2013. Obesity is a complex disease influenced by many interacting factors, such as adipocytokines, lipopolysaccharide-binding protein, adenovirus 36 infection, birth weight, lifestyle, and endocrine-disrupting chemicals. Obesity in youth can adversely impact practically every organ system and lead to serious consequences, such as metabolic, gastrointestinal, pulmonary, cardiovascular, and psychosocial complications. Therefore, coordinated efforts by governments, organizations, communities, and individuals are needed to prevent and treat childhood obesity. In particular, a long-term policy to improve the social environment will also be necessary.

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Original Articles

Relationship between Childhood and Adolescent Obesity and Remnant Lipoprotein.: Yong Jun Choi, Young Eun Jo, Yun Kyung Kim, Sang Mi Ahn, Seung Hee Baik, Sun Hye Jung, Hae Jin Kim, Yoon Sok Chung, Kwan Woo Lee, Dae Jung Kim; J Korean Endocr Soc. 2006;21(4):311-318. Published online August 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.4.311

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Abstract PDF

BACKGROUND
Remnant lipoproteins are the lipolytic degradation product of the triglyceride-rich lipoproteins produced by the liver (very-low-density lipoprotein cholesterol) and intestine (chylomicrons). Recent studies have demonstrated a correlation between remnant lipoproteins and cardiovascular risk. Our study assessed the relationship between obesity and remnant lipoproteins and evaluated the factors related to remnant lipoprotein in children and adolescents. METHODS: Body mass index (BMI), waist circumference, systolic and diastolic blood pressures, body fat mass, total abdominal fat, visceral and subcutaneous fat areas, total cholesterol, triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and remnant lipoprotein cholesterol (RLP-C) were measured in 135 children and adolescents (67 boys and 68 girls). Plasma RLP fractions were isolated using an immunoaffinity gel containing specific anti-apoB-100 and anti-apoA-I antibodies. The subjects were divided into three groups: the low (< 50 percentile), mid (50~84 percentile), and high (> or = 85 percentile) BMI groups. RESULTS: RLP-C was significantly correlated with age, sex, BMI, waist circumference, systolic and diastolic blood pressures, visceral and subcutaneous fat areas, visceral fat area to subcutaneous fat area ratio (VSR), total cholesterol, TG, HDL-C, apoB, and HOMA-IR. From a multivariate regression analysis, TG (beta = 0.928, P < 0.001) was found to be independently correlated with RLP-C. After excluding TG as an independent variable, a multivariate regression analysis revealed that the HOMA-IR (beta=0.231, P=0.007) and systolic blood pressure (beta=0.169, P=0.046) were independently associated with RLP-C. CONCLUSION: RLP-C was significantly higher in obese children and adolescents. TG, systolic blood pressure, and insulin resistance were related to remnant lipoproteins.

Citations

Citations to this article as recorded by

Epidemiology of Childhood Obesity in Korea
Kyoung Hwa Ha, Dae Jung Kim
Endocrinology and Metabolism.2016; 31(4): 510. CrossRef

The Association between the Depression and the Perception of Obesity by Adolescent Girls.: Moo Jung Park, Eun Ah Lee, Sang Ho Lee, Jong In Kim, So Yeon Ryu, Ki Soon Kim; J Korean Endocr Soc. 1997;12(2):295-307. Published online January 1, 2001

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Abstract PDF: BACKGROUND
This study was performed to find the association between the depression and perception of obesity by adolescent girls in Jung Eup City, Chollapukdo. The data were collected by questionnaire from July to October, 1996. RESULTS: 1. While the obesity rate of the girls by BMI criteria was 6.0%, 41.1% of girls perceived that they were obese. 2. Forty-eight percent of respondents tried weight control already, and as the method of weight control 33.3% tried exercise, 27.2% reduced food, 23.6% avoided snack before going to bed. 3. while 39.3% among those whose BMI was lower than 20 and 54.2% among those with BMI 20-24 tried weight control, only 5.1% among those who perceived their bodies as slim tried weight control. 4. By the analysis of self-rating depression scale (SDS) only 14.8% was normal without depression and the rest showed high SDS scale; 36.9% as mild, 38.5% as moderate, and 9.7% as severe state of depression. 5. While no statistically significant difference of SDS scores by the size of BMI was shown, significant different of SDS scores was shown among groups with different perception of their obesity and practice of weight control. 6. As a result of stepwise multiple regression analysis, dieting, perceived body image, and body mass index were significantly associated with depression of the adolescent girls. CONCLUSION: Adolescent girls who perceived themselves overweight regardless of actual weight were more likely to diet than other girls. And these characteristics had an influence on the depression of the adolescents. It is suggested that appropriate education should be required to prevent thoughtless weight control of the adolescents and to maintain mental health of the adolescents.

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