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Serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein-3 (IGFBP-3) levels in healthy children reflect endogenous growth hormone (GH) levels, and their daily variations are very low. This study investigated the relationship between growth response and serum IGF-1 and IGFBP-3 levels before and on the first year of treatment in children with GH deficiency (GHD) started on GH therapy. The records of 44 patients diagnosed with GHD, under follow-up at the Adıyaman Education and Research Hospital Pediatric Endocrinology Clinic, and receiving GH therapy for at least one year were examined retrospectively. Patients’ ages, pubertal development stages, peak GH-responses to GH stimulation tests and height standard deviation scores (SDS) measured before and at the first year of treatment, and IGF-1 and IGFBP-3 levels were recorded. Girls represented 27 (61.4%) of the cases in the study and boys 17 (3.6%), with ages ranging between 0.5 and 16.6 years (mean=11.5±3.3). Partial GHD was present in 33 patients (75%) and complete GHD in 11 (25%). Basal height SDS, IGF-1 and IGFBP-3 values were compared with those after one year of treatment. Patients with basal IGF-1 levels < -2 SDS exhibited significantly higher growth responses (p < .05). All three parameters’ mean values were significantly higher after one year compared to baseline. Δ IGF-1 and Δ IGFBP-3 values investigated in the fırst year of treatment together with basal IGF-1 levels can be a useful diagnostic tool in showing growth response in children with GHD started on GH therapy.

Purpose: The aim of this study was to investigate tear function-associated clinical findings and conjunctival histopathological changes in children with vitamin D (Vit-D) deficiency. Methods: This study used a prospective case-control design. Group 1 (n=38) comprised pediatric patients with Vit-D deficiency, and group 2 (n=45) was the control group. Tear break-up times (TBUTs), Schirmer-1 test measurements, ocular surface disease index (OSDI) scores, and conjunctival impression cytology (CIC) results of the groups were compared. Results: The participant demographic characteristics, including the mean age and the male-to-female ratio, were similar (P>0.05). The median TBUT and Schirmer-1 test measurement were 10 s (5-15) and 12 mm (6-19) in group 1 and 11 s (6-16) and 15 mm (8-21) in group 2 (P=0.004 and P=0.013, respectively). The median OSDI scores were 16 (10-20) in group 1 and 17 (10-21) in group 2 (P=0.092). According to the CIC, 25 samples in group 1 and 40 samples in group 2 were categorized as grade 0, 11 samples in group 1 and 5 samples in group 2 were categorized as grade 1, and 2 samples in group 1 and no sample in group 2 were categorized as grade 2 (P=0.027). Conclusion: Significant conjunctival histopathological changes occur in children with Vit-D deficiency, and these changes have effects on some tear function-associated clinical findings including the Schirmer-1 test and TBUT measurements.

Aim: The study aims 1) to determine the clinical status of obese children at the admittance to the pediatric endocrinology referral center 2) to investigate the efficiency and compliance of the low-carb diet in a pediatric population with or without exercise, metformin Material and Methods: All subjects with the complaint of obesity and BMI percentile >95 were recruited from January 2012-August 2014. We evaluated basal retrospectively, recommended low carbohydrate family-wide eating practice and exercise to all, and metformin to selected cases, and recorded Self-reported adherence at first, third, sixth, and twelfth months. Results: Thirty-six subjects used metformin with a higher ratio of weight loss (90.0%, p=0.010) without a difference in the number of lost kilograms. In 160 cases without metformin; diet only, exercise only, and both diet and exercise groups lost weight significantly according to neither diet nor exercise group (OR:12.08, 95% CI 3.93-41.66, p CI 1.18-7.84, p=0.022 and OR:32.80, 95% CI 7.14-150.77, p and only diet (88.9%, p=0,023) were even more efficient than exercise alone (65.5%). In the twelfth month, 13.8% were on follow-up. Conclusion: Obesity gives rise to metabolic complications in the very early stages. A low carbohydrate diet proved to be acceptable and useful. Long-term consistency remains a challenge.

Purpose: The purpose of our study was to evaluate the thyroid function tests of children and adolescents with obesity and obesityrelated hepatic steatosis.Materials and Methods: Data for 163 patients aged between 7 and 18 years under follow-up with diagnoses of obesity at the pediatric endocrinology clinic between October 2016 and March 2020, and of 47 healthy cases were examined retrospectively. Cases were divided into obese patients with hepatic steatosis (Group 1), obese patients without hepatic steatosis (Group 2), and a healthy controlgroup (Group 3). Fasting blood sugars, alanine aminotransferase (ALT), aspartate aminotransferase (AST), free thyroxine (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone, insulin, and blood lipid values of the cases in the patient and control groups were examined. The fT3/fT4 ratio was regarded as an indirect marker of deiodinase activity. Results: Body mass index-standard deviation score values, systolic blood pressure, fasting blood sugars, insulin and lipid levels, HOMA-IR (Homeostatic Model Assessment of Insulin Resistance), AST, ALT and fT3 values were significantly higher in the patient groups (with and without hepatic steatosis) than in the healthy control group (p, Amaç: Çalışmamızda obezitesi ve obeziteye bağlı karaciğer yağlanması olan çocuk ve ergenlerin tiroid fonksiyon testlerinin değerlendirilmesi amaçlandı.Araçlar ve Yöntem: Ekim 2016 ile Mart 2020 tarihleri arasında çocuk endokrin polikliniğinde obezite tanısı ile takip edilen, yaşları 7 ile 18 arasında değişen toplam 163 hasta ile 47 sağlıklı olgunun verileri geriye dönük incelendi. Olgular karaciğerde yağlanması olan obez hastalar (Grup 1), karaciğerde yağlanması olmayan obez hastalar (Grup 2) ve sağlıklı kontrol grubu (Grup 3) olarak gruplara ayrıldı. Hasta ve kontrol grubundaki olguların açlık kan şekerleri, ALT (alanin aminotransferaz), AST (aspartat aminotransferaz), sT4 (serbest tiroksin), sT3 (serbest triiyodotironin), tiroid uyarıcı hormon (TSH), insülin ve kan lipit değerleri incelendi. İnsülin direnci, homeostaz model değerlendirmesi-insülin direnci (HOMA-IR) ile değerlendirildi. Serbest T3/T4 oranı, deiyodinaz aktivitesinin dolaylı göstergesi olarak kabul edildi.Bulgular: Sağlıklı kontrol grubuna göre obez hasta gruplarının (karaciğer yağlanması olan ve olmayan) vücut kitle indeksi-standart sapma skoru (VKİ-SDS) değerleri, sistolik kan basınçları (SKB), açlık kan şekerleri, plazma lipid düzeyleri, açlık insülin, HOMA-IR, AST, ALT ve sT3 değerleri anlamlı olarak daha yüksek saptandı (p

Objective: The purpose of this study was to evaluate the clinical and laboratory findings of 73 children and adolescents followed-up with a diagnosis of Hashimoto’s thyroiditis.Methods: Seventy-three patients aged between 4 and 18 years followed-up with a diagnosis of Hashimoto’s thyroiditis at the pediatric endocrinology clinic between 2016 and 2019 were included in the study. All patients’ thyroid function tests, thyroid antibodies, physical examination findings and thyroid ultrasonography results at diagnosis and follow-up were evaluated.Results: Fifty-seven (78.1%) patients were girls and 12 (21.9%) were boys, with a female/male ratio of 3.5/1. Goiter was detected at time of diagnosis in 25 cases (34.2%), but not in 48 (65/8%). At time of diagnosis, hyperthyroidism was present in 13 cases (17.8%), hypothyroidism in 16 (22%), subclinical hypothyroidism in 9 (12.3%), euthyroidism in 33 (45.2%), and subclinical hyperthyroidism in 2 (2.7%). The most common symptoms at time of presentation were swelling in the neck, sweating, fatigue, and lack of appetite. Heterogeneity and a hypoechoic appearance were observed in 77% of cases and nodules in 11% at thyroid ultrasonographic examination, while no pathology was determined in 12%.Conclusions: Children and adolescents with Hashimoto’s thyroiditis may exhibit different and clinical findings. Thyroid ultrasonography occupies an important place in the diagnosis and follow-up of the disease.Key words: Hashimoto’s thyroiditis, child, adolescent