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Background: We aimed to investigate the short-term effects of adrenocorticotropic hormone (ACTH) treatment on the adrenal pathway and bone metabolism in patients with epileptic encephalopathy. Methods: Two groups with 16 patients and 16 controls were formed. Before the treatment, all patients and controls were tested for bone and adrenal metabolism. Twenty doses of ACTH therapy were given to the patient group over 3 months. The tests on the patient group were repeated 1 month after the end of the treatment. Results: In the patient group, serum calcium, phosphorus and parathyroid hormone levels increased significantly after treatment compared with before treatment. Comparing the bone metabolism of the patient and control groups, urinary calcium/creatinine ratio was higher before treatment; serum phosphorus level, bone-specific alkaline phosphatase level and the urinary calcium/creatinine ratio were higher after treatment in the patient group. In the evaluation of the adrenal pathway, no significant differences were found between fasting serum glucose, sodium, potassium, cortisol and ACTH levels before and after treatment and in the comparison of the patient and control groups. Conclusion: Our study investigated the short-term effect of ACTH on the adrenal pathway and bone metabolism. The results show that ACTH treatment did not have a negative effect on the adrenal pathway in the early period but, its effects on bone metabolism have not been adequately clarified.

Objectives Ectopic parathyroid hormone (PTH) secretion is rare in children with rhabdomyosarcoma, and only a few pediatric cases have been reported to date. Reports of the use of zoledronic acid (ZA) and Denosumab are limited for the treatment of hypercalcemia of malignancy (HCM) in the pediatric population. The aim of presenting this pediatric case of rhabdomyosarcoma accompanied by HCM, secondary to ectopic PTH secretion, was to highlight the benefits of ZA as a first-choice bisphosphonate in this situation with Denosumab as an alternative therapy. Case presentation The patient was diagnosed at 13 years with alveolar rhabdomyosarcoma. Multiple bone metastases first appeared at 15 years, but he remained normocalcemic until 17 years old when serum calcium was 15.1 mg/dL and PTH 249 pg/mL. While serum calcium responded well after ZA and Denosumab cycles, PTH remained elevated, reaching a peak value of 1851 pg/mL during treatment cycles. Conclusions We report a patient with rhabdomyosarcoma accompanied by HCM, secondary to ectopic PTH, in whom the HCM was successfully managed with ZA and Denosumab. We believe that ZA should be the bisphosphonate of choice in pediatric HCM with rhabdomyosarcoma, while Denosumab may be another option in ZA-refractory cases.

Background Hypogonadism is a key feature of Prader–Willi syndrome (PWS) but clear strategies for hormone replacement are lacking. Objective To evaluate the gonadal status and outcome in patients attending a Scottish PWS clinic from 1991 to 2019. Methods In 93 (35F:56M) patients, median follow-up 11.2 years, gonadal and pubertal status were assessed clinically. Pelvic ultrasound findings and basal/stimulated gonadotrophins were compared with age-matched controls. Results Females:of 22 patients aged > 11, 9 had reached B4–5, while 5 were still at B2–3, and 6 remained prepubertal. Eight patients experienced menarche aged 9.8–21.4 years, none with a normal cycle. Uterine length and ovarian volumes were normal but uterine configuration remained immature, with low follicular counts. Gonadotrophins were unremarkable, serum oestradiol 129 (70–520) pmol/L. Only 5 patients received oestrogen replacement. Males:fifty-four (96%) patients were cryptorchid (9 unilateral). Weekly hCG injections resulted in unilateral/bilateral descent in 2/1 of 25 patients. Of 37 boys aged > 11, 14 (9 with failed/untreated bilateral cryptorchidism) failed to progress beyond G1, 15 arrested at G2–3 (testes 3–10 mL), and 8 reached G4–5. Gonadotrophins were unremarkable except in boys at G2–5 in whom FSH was elevated: 12.3/27.3 vs 3.25/6.26 U/L in controls (P < 0.001). In males aged > 13, testosterone was 3.1 (0.5–8.4) nmol/L. Androgen therapy, given from 13.5 to 29.2 years, was stopped in 4/24 patients owing to behavioural problems. Conclusion Despite invariable hypogonadism, few females and only half the males with PWS in this study received hormone replacement. Double-blind placebo-controlled crossover trials of sex steroids are required to address unproven behavioural concerns.

Severe hypercalcemia associated with vitamin D intoxication or malignancy in children is a rare and life-threatening condition. There is little published experience with Zoledronic acid in the treatment of pediatric severe hypercalcemia. Here, we present two pediatric cases of severe hypercalcemia, one due to vitamin D intoxication and the second to malignancy, in which Zoledronic acid was used as the first-line bisphosphonate in the treatment. While both cases responded well to a single dose of Zoledronic acid, the second case experienced hypocalcemia requiring calcium treatment after Zoledronic acid infusion. Our report shows that Zoledronic acid may be an effective option in the treatment of severe pediatric hypercalcemia, although patients should be followed closely after infusion due to the risk of hypocalcemia. We provide additional published evidence for the effectiveness of Zoledronic acid in correcting severe pediatric hypercalcemia and hope this will encourage future studies with larger numbers of patients.

Amaç: West sendromu en sık görülen süt çocukluğu epileptik ensefalopati tablosu olup, tedavisinde sıklıkla ACTH veya oral kortikosteroidler kullanılmaktadır. West sendromu tanısı alan bir grup çocukta ACTH tedavisinin etkinliğinin ve subakut-kronik dönemde kemik metabolizması ve adrenal yolak üzerine etkilerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: West sendromuyla izlenen 35 çocuk, tanı sonrası 4-68 ay arasında değişen sürelerde çalışmaya alındı. Toplam 25 hastaya sentetik ACTH tedavisi uygulandı. ACTH tedavisi alan ve almayan gruplar nöbet kontrolü, EEG bulgularındaki düzelme ve nörolojik prognoz açısından değerlendirildi. Ayrıca ACTH tedavisi alan ve almayan gruplar, kemik metabolizması değişiklikleri ve adrenal yolak işlevleri açısından karşılaştırıldı. Bulgular: West sendromu tanısıyla izlenen 35 çocuktan 31’i semptomatik (%88,6) 4’ü kriptojenik (%11,4) gruptaydı. Semptomatik gruptakilerin üçte ikisinde etyolojide yapısal beyin anomalileri (11 olgu) ve hipoksik-iskemik ensefalopati (9 olgu) saptandı. Semptomatik gruptan 22, kriptojenik gruptan 3 olguya ACTH tedavisi uygulandı. Tedavi sonrası semptomatik grupta 15 olguda tam (%68,2), 4 olguda kısmi (%18,2) nöbet kontrolü sağlanırken, kriptojenik grupta 2 olguda tam, 1 olguda kısmi nöbet kontrolü sağlandı. Semptomatik grupta ACTH ile nöbet kontrolü ve EEG bulgularında düzelme yüksek oranda (%68,2) saptanmasına karşın, nörolojik gelişimde beklenen düzelmenin gerçekleşmediği gözlendi. ACTH uygulanan ve uygulanmayan olgularda kemik metabolizması ve adrenal yolak tetkikleri arasında anlamlı fark bulunmadı, hiçbir olguda adrenal yetersizlik saptanmadı. Sonuç: West sendromunda etiyolojiden bağımsız olarak ACTH tedavisi etkindir ancak, semptomatik grupta nöbet kontrolüne karşın nörolojik gelişimde ağır gerilik devam etmiştir. ACTH tedavisi sonrası subakut-kronik dönemde kemik metabolizması ve adrenal işlev bozukluğu açısından bir risk olmadığı ortaya konmuştur., Objective: West syndrome is the most common infantile epileptic encephalopathy, and ACTH or oral corticosteroids are frequently used in its treatment. The aim of this study was to evaluate the efficacy of ACTH therapy and its effects on bone metabolism and adrenal pathway in the subacute-chronic period in a group of children diagnosed with West syndrome. Materials and Methods: Thirty-five children followed up with West syndrome were included in the study for a period ranging from 4 to 68 months after diagnosis. A total of 25 patients were treated with synthetic ACTH. The groups that received and did not receive ACTH treatment were evaluated in terms of seizure control, improvement in EEG findings and neurological prognosis. In addition, the groups that received and did not receive ACTH therapy were compared in terms of bone metabolism changes and adrenal pathway functions. Results: Of the 35 children followed up with the diagnosis of West syndrome, 31 (88.6%) were in the symptomatic group and 4 (11.4%) were in the cryptogenic group. Structural brain anomalies (11 cases) and hypoxic-ischemic encephalopathy (9 cases) were found in the etiology in two-thirds of those in the symptomatic group. ACTH treatment was applied to 22 patients from the symptomatic group and 3 patients from the cryptogenic group. After treatment, complete seizure control was achieved in 15 cases (68.2%) and partial seizure control in 4 cases (18.2%) in the symptomatic group, while complete seizure control was achieved in 2 cases and partial seizure control in 1 case in the cryptogenic group. Although a high rate of improvement in seizure control and EEG findings with ACTH was detected in the symptomatic group (68.2%), it was observed that the expected improvement in neurological development did not occur. There was no significant difference between bone metabolism and adrenal pathway examinations in cases with and without ACTH, and adrenal insufficiency was not detected in any of the cases. Conclusion: ACTH treatment was effective for West syndrome regardless of the etiology, but severe retardation in neurological development continued despite seizure control in the symptomatic group. It was demonstrated that there is no risk in terms of bone metabolism and adrenal dysfunction in the subacute-chronic period after ACTH treatment.

Objective: Turkish Directorate of Public Health introduced the first pilot screening program for congenital adrenal hyperplasia (CAH) in four Turkish cities in 2017, and in 2018 extended the program, with a slight change in screening strategy, to fourteen cities. To evaluate the performance of the extended study and update previously reported outcomes. Methods: Retrospective, descriptive study. Neonates of >= 32 gestational weeks and >= 1500 gr birth weight from fourteen cities, born between May-December 2018, were included. Screening protocol included one sample, two-tier testing as applied in the previous pilot study. In the first step, 17 alpha-hydroxyprogesterone (17-OHP) was measured by fluoroimmunoassay in dried blood spots (DBS) obtained at 3-5 days of life. Cases with positive initial screening underwent second tier testing by steroid profiling in DBS using liquid chromatography-tandem mass spectrometry to measure 17-OHP, 21-deoxycortisol (21-S), cortisol (F), 11-deoxycortisol and androstenedione. The babies with a steroid ratio (21-S+ 17-OHP)/F of >= 0.7 (increased from >= 0.5 in the earlier pilot study) were referred to pediatric endocrinology clinics for diagnostic assessment. Results: In the evaluated period, 241,083 newborns were screened. 12,321 (5.11 %) required second-tier testing and 880 (0.36 %) were referred for clinical assessment, twenty of whom were diagnosed with CAH (10 females, 10 males). Sixteen were diagnosed as classical 21-hydroxylase deficiency (21-OHD) CAH (12 with salt-wasting and four with simple virilising CAH), and four cases were identified with 11 beta-OHD CAH. No case of salt-wasting CAH was missed by neonatal screening (sensitivity was 100 %). The incidence of classical 21-OHD and 11 beta-OHD in the screened population was 1:15,067 and 1:60,270, respectively. Conclusion: Turkish neonatal CAH screening effectively led to earlier diagnosis of 21-OHD and 11 beta-OHD, using steroid profiling as a second-tier test. This will result in improved care of these patients in the future.

AYDIN, MURAT/0000-0001-7374-229X; Gurbuz, Fatih/0000-0003-2160-9838; Kara, Cengiz/0000-0002-8989-560X; GURAN, TULAY/0000-0003-2658-6866; Tezel, Basak/0000-0001-9280-6746 WOS: 000459188200003 PubMed: 30111524 Objective: Congenital adrenal hyperplasia (CAH) is the most common form of primary adrenal insufficiency in children. Neonatal screening for CAH is effective in detecting the salt-wasting (SW) form and in reducing mortality. in this study, our aim was to estimate the incidence of CAH in Turkey and to assess the characteristics and efficacy of the adopted newborn CAH screening strategy. Methods: A pilot newborn CAH screening study was carried out under the authority of the Turkish Directorate of Public Health. Newborn babies of >= 32 gestational weeks and >= 1500 gr birth weight from four cities, born between March 27-September 15, 2017 were included in the study. Screening protocol included one sample two-tier testing. In the first step, 17 alpha-hydroxyprogesterone (17-OHP) was measured by fluoroimmunoassay in dried blood spots (DBS) obtained at 3-5 days of life. The cases with positive initial screening were tested by steroid profiling in DBS using a liquid chromatography-tandem mass spectrometry method to measure 17-OHP, 21-deoxycortisol (21-S), cortisol (F), 11-deoxycortisol and androstenedione as a second-tier test. The babies with a steroid ratio (21-S + 17-OHP)/F of >= 0.5 were referred to pediatric endocrinology clinics for diagnostic assessment. Results: 38,935 infants were tested, 2265 (5.82 %) required second-tier testing and 212 (0.54 %) were referred for clinical assessment, six of whom were diagnosed with CAH (four males, two females). Four cases were identified as SW 21-hydroxylase deficiency (21-OHD) (two males, two females). One male baby had simple virilizing 21-0HD and one male baby had II-OHD CAH. The incidence of classical 21-0HD in the screened population was 1:7,787. Conclusion: The incidence of CAH due to classical 21-OHD is higher in Turkey compared to previous reports. We, therefore, suggest that CAH be added to the newborn screening panel in Turkey. The use of steroid profiling as a second-tier test was found to improve the efficacy of the screening and reduce the number of false-positives.

Purpose: We aimed to compare the body mass index and vitamin and mineral status of children with and without amblyopia. Methods: Amblyopic children aged between 5 and 18 years (n=46) and age-matched control children (n=32) were evaluated in terms of anthropometric parameters, including height, weight, body mass index and demographic features. Serum vitamin B12 and folate were measured using an Advia Centaur XP (Siemens, Ireland) biochemistry analyzer. We evaluated the inorganic mineral elements from hair samples with inductively coupled plasma-mass spectrometry using a Thermo XSeries 2 analyzer (Thermo Fisher Scientific, Bremen, Germany). Results: No significant difference was found between the two groups in terms of height, weight, and body mass index or serum B12 and folate concentrations (p>0.05). Children with severe amblyopia had lower vitamin B12 and folate and higher body mass index. The levels of phosphorus (p=0.012), selenium (p=0.002), molybdenum (p

The infrachiasmatic corridor is the most important surgical access route for craniopharyngiomas and was identified and used in clinical series. The aims of this study were to describe the characteristics that assist dissection and resection rates in endoscopic surgery of solid, cystic, and recurrent cases and their importance in the infrachiasmatic corridor in endoscopic surgery. One hundred operations on 84 patients with pathologically identified craniopharyngioma were included in the study. The MRI findings were evaluated, and the location of the lesions was classified as (1) infrasellar; (2) sellar; or (3) suprasellar. In the sagittal plane, we measured the longest diameter of cystic and solid components and the height of chiasm-sella. Images were assessed for the extent of resection and were classified as gross total resection. This was deemed as the absence of residual tumor and subtotal resection, which had residual tumor. The infrasellar location was reported in 7/84 (8.3%) patients, the sellar location in 8/84 (9.5%), and the suprasellar location in 69/84 (82.1%) patients. The narrow and high chiasm-sella were observed in 28/69 (40.5%) and 41/69 patients (59.4%), respectively. The mean distance of the chiasm-sella was 9.46± 3.76. Gross total tumor resection was achieved in 60/84 (71.4%) and subtotal tumor resection was performed in 24/84 (28.6%) patients. The results revealed that suprasellar location (OR: 0.068; p = 0.017) and recurrent cases (OR: 0.011; p

Objective Premature thelarche (PT) is defined as isolated breast development in girls before eight years of age. Gonadotropin-releasing hormone (GnRH) stimulation test is sometimes used to distinguish between PT and central precocious puberty (CPP), although the interpretation of the test at early ages is challenging. The objective of this study was to determine the follicle stimulating hormone (FSH) and luteinizing hormone (LH) responses to GnRH stimulation in girls with PT below 3 years of age. Methods A standardized GnRH stimulation test, bone age and pelvic ultrasound were evaluated and those without pubertal progression after a minimum of one-year follow up were included in the study. Results On GnRH stimulation test, the median (range) baseline LH was 0.29 (0.10-0.74) IU/L, baseline FSH was 4.96 (3.18-7.05) mIU/mL, and the peak median LH was 5.75 (3.31-8.58) IU/L with the peak mean±standard deviation FSH was 40.38±20.37 mIU/mL. Among the patients, 33.3% (n=10) had baseline LH >0.3 IU/L, 67% (n=20) had peak LH >5 IU/l and 16.6% (n=5) >10 IU/L. The mean peak LH/FSH ratio was 0.17±0.09 and was ≤0.43 in all participants. Conclusion Although consensus statements usually define baseline LH >0.3-0.5 IU/L, peak LH >5 IU/L, and LH/FSH ratios >0.66-1.0 as diagnostic cut-offs for CPP, in children below 3 years of age, the baseline and peak LH values may be similar to pubertal values, possibly due to mini-puberty. A dominant FSH response on GnRH stimulation test is more valuable than the peak LH response in the diagnosis of PT.

Background/aims: maturity onset diabetes of the young (MODY) is a rare condition often misdiagnosed as type 1 diabetes (T1D). The purposes of this study were: to identify any patients followed in a large Turkish cohort as T1D, with an atypical natural history, who may in fact have MODY, and to define the criteria which would indicate patients with likely MODY as early as possible after presentation to allow prompt genetic testing. Methods: Urinary C-peptide/creatinine ratio (UCPCR) was studied in 152 patients having a diagnosis of T1D for at least 3 years. Those with a UCPCR ≥0.2 nmol/mmol were selected for genetic analysis of the Glucokinase (GCK), Hepatocyte nuclear factor 1a (HNF1A), Hepatocyte nuclear factor 4a (HNF4A), and Hepatocyte nuclear factor 1b (HNF1B) genes. This UCPCR cut-off was used because of the reported high sensitivity and specificity. Cases were also evaluated using a MODY probability calculator. Results: twenty-three patients from 152 participants (15.1%) had a UCPCR indicating persistent insulin reserve. The mean age ± SD of the patients was 13.6 ± 3.6 years (range 8.30-21.6). Of these 23, two (8.7%) were found to have a mutation, one with HNF4A and one with HNF1B mutation. No mutations were detected in the GCK or HNF1A genes. Conclusion: in Turkish children with a diagnosis of T1D but who have persistent insulin reserve 3 years after diagnosis, up to 9% may have a genetic mutation indicating a diagnosis of MODY., NA

Objective: Early diagnosis is of proven benefit in Prader-Willi syndrome (PWS). We therefore examined key perinatal features to aid early recognition. Methods: Data were collected from case records of subjects attending a multi-disciplinary clinic and from a retrospective birth questionnaire. Results: Ninety patients (54 male-36 female) were seen between 1991-2015, most with paternal deletion (n=56) or maternal isodisomy (n=26). Features included cryptorchidism in 94% males, preterm birth (26%), birthweight 28 days: 1-12 months in seven; and 3.75-10.5 years in five. Typical PWS features in these 12 infants included hypotonia (100%), feeding difficulties (75%), cryptorchidism (83% males) and reduced FM (66%). Causes other than PWS including neuromuscular disease were considered in nine patients. Conclusion: Neonatal hypotonia, reduced FM, feeding difficulties and cryptorchidism should immediately suggest PWS, yet late diagnosis continues in some cases. Awareness of the typical features of PWS in newborn units is required to allow prompt detection even in the presence of confounding factors such as prematurity.

Early diagnosis of Turner syndrome (TS) is necessary to facilitate appropriate management, including growth promotion. Not all girls with TS have overt short stature, and comparison with parental height (Ht) is needed for appropriate evaluation. We examined both the prevalence and diagnostic sensitivity of measured parental Ht in a dedicated TS clinic between 1989 and 2013. Lower end of parental target range (LTR) was calculated as mid-parental Ht (correction factor 12.5 cm minus 8.5 cm) and converted to standard deviation scores (SDS) using UK 1990 data, then compared with patient Ht SDS at first accurate measurement aged > 1 year. Information was available in 172 girls of whom 142 (82.6%) were short at first measurement. However, both parents had been measured in only 94 girls (54.6%). In 92 of these girls age at measurement was 6.93 ± 3.9 years, Ht SDS vs LTR SDS − 2.63 ± 0.94 vs − 1.77 ± 0.81 (p

ABALI, SAYGIN/0000-0001-6552-2801; Turan, Serap/0000-0002-5172-5402; Hatun, Sukru/0000-0003-1633-9570; Akgun, Abdurrahman/0000-0002-2917-2469; yesiltepe mutlu, gul/0000-0003-3919-7763; Ozgen, Ilker Tolga/0000-0001-6592-9652 WOS: 000451667000006 PubMed: 29789274 Objective: To assess the incidence of type I diabetes mellitus (T1DM) in children under 18 years of age in the northwest region of Turkey during 2013-2015. Methods: All newly diagnosed T1DM cases were recorded prospectively during 2013-2015. Total, as well as gender and age group specific (0-4, 5-9. 10-14 and 15-17 age) mean incidences per 100,000 per year were calculated. Results: There were 1,773 patients diagnosed during 2013-2015 (588 cases in 2013, 592 cases in 2014, 593 cases in 2015). Of these, 862 (48.6 %) were girls and 911 (51.4%)were boys. The mean age at diagnosis was 9.2 +/- 4.2 years and it was not significantly different between girls (9.0 +/- 4.1 years) and boys (9.4 +/- 4.4 years) (p = 0.052). The crude mean incidence was 8.99/100.000 confidence interval (CI) (95% CI: 8.58-9.42). Although mean incidence was similar between boys [8.98/100.000 (CI: 8.40 to 9.58)] and girls [9.01/100.000 (CI: 8.42 to 9.63)], there was male predominance in all groups except for 5-9 year age group. The standardized mean incidence was 9.02/100.000 according to the World Health Organization standard population. The mean incidence for the 0-4, 5-9, 10-14 and 15-17 age groups was 6.13, 11.68, 11.7 and 5.04/1 00.000 respectively. The incidence of T1DM was similar over the course of three years (p = 0.95). A significant increase in the proportion of cases diagnosed was observed in the autumn-winter seasons. Conclusion: The northwest region of Turkey experienced an intermediate incidence of T1DM over the period of the study.

PubMedID: 29353264 The aim of the study was to assess the response to growth hormone (GH) treatment in very young patients with GH deficiency (GHD) through a national, multi-center study. Possible factors affecting growth response were assessed (especially mini-puberty). Medical reports of GHD patients in whom treatment was initiated between 0 and 3 years of age were retrospectively evaluated. The cohort numbered 67. The diagnosis age was 12.4±8.6 months, peak GH stimulation test response (at diagnosis) as 1.0±1.4 ng/mL. The first and second years length gain was 15.0±4.3 and 10.4±3.4 cm. Weight gain had the largest effect on first year growth response; whereas weight gain and GH dose were both important factors affecting second year growth response. In the multiple pituitary hormone deficiency (MPHD) group (n=50), first year GH response was significantly greater than in the isolated GH deficiency (IGHD) group (n=17) (p=0.030). In addition first year growth response of infants starting GH between 0 and 12 months of age (n=24) was significantly greater than those who started treatment between 12 and 36 months of age (n=43) (p

Study Objective To investigate the characteristics of children with ovarian cysts and evaluate treatment strategies. Design Retrospective study. Setting Eight pediatric endocrinology clinics, Turkey. Participants A total of 100 children and adolescents with ovarian cysts. Interventions Patient data collected via retrospective chart review. Patients were stratified according to age into 4 groups (newborns, 1-12 months, 1-8 years, and 8-18 years). Main Outcome Measures Special emphasis was given to torsion and tumor cases, concomitant diseases, treatment modalities, and problems during follow-up. Results Most newborns and infants were asymptomatic with the cysts being discovered incidentally; in girls ages 1-8, symptoms were common, including breast budding (47.1%, 16 of 34) and vaginal bleeding (29.4%, 10 of 34). Girls older than 8 years mostly presented with abdominal pain (31.6%, 12 of 38) and menstrual irregularity (21.1%, 8 of 38). Most of our patients were diagnosed with a simple ovarian cyst, but 9 patients were found to have ovarian tumors. Ovarian torsion was detected in 7 patients; 5 with large and 2 with small cysts (

Objective Partial/total urogenital sinus mobilization (UGSM) is one of the recommended techniques for treatment of female congenital adrenal hyperplasia (CAH). In this study we compared the length of common channel (CC) and type of operation performed in CAH patients. Patients and methods We retrospectively analyzed data of patients receiving surgery for female CAH. Patients were separated into three groups: group 1 had partial UGSM, group 2 had total UGSM, and group 3 had total UGSM plus the vaginal anterior wall was made from CC. Age at surgery, length of CC, surgical time, follow-up time, and complications were compared. Results There were a total of 29 patients. For groups 1, 2, and 3, the average age at surgery was 47.2 months, 14.4 months, and 21.3 months, respectively, and the average CC length was 1.25 cm, 3.1 cm, 4.3 cm, respectively. The average time of surgery was 165 min, 193.1 min, 282.5 min, respectively. The average follow-up time was 34.7 months, 36.3 months, 28.3 months, respectively. There were two complications (UGS flap necrosis and opening of sutures) in the third group. Conclusion We advise the use of partial UGSM for CC of 0.5–2 cm, total UGSM for CC of 2.5–3.5 cm, and total USM with use of CC as the anterior vaginal wall in CC ≥ 4 cm in length. Good cosmetic and functional results are obtained with this approach.

Aim To describe mood and psychosensorial symptoms of hypoglycaemia in adolescents with Type 1 diabetes mellitus in two countries with different cultures, Turkey and the USA. Methods We developed a 68-item questionnaire assessing physical, behavioural, mood and psychosensorial symptom frequency and ratings [‘good’, ‘bad’, or ‘both’ (sometimes good, sometimes bad)]. Adolescents with Type 1 diabetes were recruited from paediatric diabetes clinics at the University of North Carolina at Chapel Hill in the USA and Kocaeli University in Turkey. The percentages of participants at each clinic who endorsed individual symptoms, symptom categories and symptom ratings were calculated and compared. Results Cronbach's α values were > 0.7 for each real symptom category. No symptom items were excluded from the questionnaire analysis based on item-total correlation results which were all > 0.2. Data were collected from 132 participants (69 from University of North Carolina, 63 from Kocaeli University, 54% male). The mean (sd) age of the participants was 14.9 (1.9) years, HbA1c level was 8.7 (1.8) % and duration of Type 1 diabetes was 5.8 (3.7) years. On average, each physical symptom was experienced by 65.2% of participants, each behavioural symptom by 46.5%, each mood symptom by 42.8%, and each psychosensorial symptom by 48.9%. On average, each physical, behavioral, mood and psychosensorial symptom was rated as ‘good’ or ‘both’ by 23.0, 29.1, 36.9 and 37.2% of participants, respectively. There were no symptom differences between the groups in each country. Conclusions In addition to the classic physical symptoms experienced during hypoglycaemia, adolescents with Type 1 diabetes report psychosensorial, mood and behavioral symptoms, and some describe them as positive experiences. Symptom experiences were similar in these two countries with different cultures.

IMAGe syndrome is an exceedingly rare condition first described in 1999. Components of the syndrome are intrauterine growth retardation (IUGR), metaphyseal dysplasia, congenital adrenal hypoplasia and genital anomalies. Cases generally present with life-threatening adrenal insufficiency in the neonatal period. Herein, we describe a patient with pronounced IUGR diagnosed with severe hyperpigmentation and adrenal insufficiency in the neonatal term in order to attract the attention to this rare entity.

Objective: To investigate whether glycosylated hemoglobin (HbA1c) and 1-hour glucose level in oral glucose tolerance test (OGTT) are useful parameters for evaluation of glucose homeostasis in childhood. Methods: The medical records of 106 obese/overweight children aged from 7 to 18 years who underwent OGTT were evaluated retrospectively. The subjects were divided into 2 groups according to their one-hour glucose concentration. Group 1 consisted of subjects whose one-hour glucose level was

Objective: The study aimed to determine the level of knowledge and the sources of information about normal puberty and menstrual patterns in Turkish schoolgirls from İstanbul. Methods: The study sample was comprised of 922 randomly chosen schoolgirls. A questionnaire survey of knowledge of normal pubertal development and menstrual patterns was conducted. Results: The age of the girls ranged between 10 and 17 years and 82.3% had had menarche. The leading source of pubertal information was the mothers (84.2%). There was no statistically significant relationship between the mothers’ education level and the level of knowledge of the students about pubertal development (p>0.05). The main source for 18% of students was their teacher, but only 6% had a preference for their teacher providing education on this topic. Students who attained menarche preferred education about puberty to be given by health professionals and to both genders at the same setting (p

ABALI, SAYGIN/0000-0001-6552-2801; Gurbuz, Fatih/0000-0003-2160-9838; Hatun, Sukru/0000-0003-1633-9570; Abaci, Ayhan/0000-0002-1812-0321; Turan, Serap/0000-0002-5172-5402; Buyukinan, Muammer/0000-0002-2937-823X; yuksel, bilgin/0000-0003-4378-3255; Ozgen, Ilker Tolga/0000-0001-6592-9652; binay, cigdem/0000-0002-7749-8818; ozkan, Behzat/0000-0002-9153-8409; Demir, Korcan/0000-0002-8334-2422; Eren, Erdal/0000-0002-1684-1053 WOS: 000373099300016 PubMed: 26788866 To evaluate the anthropometric features of girls with Turner syndrome (TS) at birth and presentation and the effect of karyotype on these parameters. Data were collected from 842 patients with TS from 35 different centers, who were followed-up between 1984 and 2014 and whose diagnosis age ranged from birth to 18 years. Of the 842 patients, 122 girls who received growth hormone, estrogen or oxandrolone were excluded, and 720 girls were included in the study. In this cohort, the frequency of small for gestational age (SGA) birth was 33%. The frequency of SGA birth was 4.2% (2/48) in preterm and 36% (174/483) in term neonates (P

Objective: To investigate the frequency and effects of vitamin D deficiency in children with type 1 diabetes (T1D) in a region which is known to have a high rate of vitamin D deficiency among adolescents. Methods: In this prospective cross-sectional study, 120 children and adolescents with T1D (55 girls and 65 boys) aged 3-20 years were evaluated. Serum 25-hydroxyvitamin D [25(OH)D], parathormone (PTH), and alkaline phosphatase (ALP) levels were measured. Hemoglobin A1c levels and daily insulin requirement were also evaluated. Classification of vitamin D status was made according to the American Academy of Pediatrics (AAP)/LWEPS’s recommendations. The patients were divided into 2 groups according to their vitamin D status and also according to the season of the year in which 25(OH)D sampling was done. Results: Serum 25(OH)D levels revealed vitamin D deficiency or insufficiency in 38% of the patients. Higher PTH levels were found in the patient group whose mean 25(OH)D level was 20 ng/mL (p

Background: The aim of this study was to determine the nutritional status of students in Kocaeli, Turkey. Methods: This cross-sectional study was carried out among the students of secondary schools in Kocaeli. Of the students, 2491 subjects were selected using multi-stage stratified sampling. Results: Of the students, 51.1% were male and 48.9% were female. Mean age was 14.35 1 1.87 (range 10.1-19.8) in overall subjects, 14.38 1 1.87 in boys and 14.31 1 1.85 in girls. The prevalence of obesity and of overweight was estimated as 7.3% and 11.8%, respectively. Also, 3.1% of the subjects were underweight and 2.9% were thin. The rate of obesity was 1.5 times higher in girls and that of overweight was 1.2 times higher in girls. Similarly, students aged 15 years old and younger were 1.2 times more obese and 1.7 times more overweight than older students. Students living in urban areas had a higher prevalence of obesity and of overweight. Conclusion: Nutritional problems in students should be dealt with by some regulations in schools; for example, providing healthy food in schools or food aid, particularly in poor regions.

Objective: To investigate prevalence, persistence and clinical correlates of increased microalbumin excretion in random urine samples collected in a paediatric diabetes clinic. Method: Random urine samples were collected annually in patients >10 years attending the diabetes clinic in the Royal Hospital for Sick Children, Edinburgh. Albumin excretion is expressed as albumin:creatinine ratio (ACR) and classified as normal (10mg/mmol), or macroalbuminuria (>47 mg/mmol in females, >35 mg/mmol in males). We analyzed retrospectively results on 421 urine samples collected from 217 patients (109 males), of a median age of 12.3 years (94% 10−16 years) over 3 years. For each sample, the corresponding mean HbA1c over the previous year was calculated. Results: Prevalence of micro− and macro−albuminuria in individual samples was 1% and 0.5% respectively. ACR was equivocal in 10.1% and 4.7% in samples from females and males respectively (p=0.03). HbA1c showed borderline significant differences across ACR groups (p=0.06). Equivocal ACR excretion was associated with slightly higher mean HbA1c (9.5±1.3%) compared to normal albuminuria (9.0±1.1%, p3.5 mg/mmol. The 14−16 years age group patients were most likely to have ACR >3.5 mg/mmol (p=0.05). Conclusions: Female sex and increasing age, but not HbA1c, were independently associated with increased ACR. A robust mechanism for collection of repeat early morning urine samples from patients with increased ACR in random urine samples, and follow−up of those patients who have persistently high microalbumin excretion are important. It is also important to confirm the usefulness of ACR measurements in random urine samples as a marker of incipent nephropathy. Conflict of interest:None declared.

WOS: 000360842500004, PubMed: 26831551, Objective: Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS. Methods: Cross-sectional height and weight data of 842 patients with TS, younger than 18 years of age and before starting any therapy, were evaluated. Results: The data were processed to calculate the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for defined ages and to construct growth curves for height-for-age, weight-for-age and BMI-for-age of girls with TS. The growth pattern of TS girls in this series resembled the growth pattern of TS girls in other reports, but there were differences in height between our series and the others. Conclusion: This study provides disease-specific growth charts for Turkish girls with TS. These disease-specific national growth charts will serve to improve the evaluation of growth and its management with growth-promoting therapeutic agents in TS patients., Turkish Pediatric Endocrinology and Diabetes Society [012013], This work was supported by the Turkish Pediatric Endocrinology and Diabetes Society (Grand number: 012013).

McCune-Albright Syndrome is a rare syndrome characterized with excessive function of peripheral endocrine organs and activating mutations of the stimulatory G protein alpha subunit are involved in the pathogenesis. The three main findings of the disease include hyperpigmented cafe au lait spots, fibrous dysplasia and increased endocrine functions and excessive secretion of growth hormone is observed in 21% of the patients. Clinical signs may be missed in these patients because of precocious puberty and craniofacial fibrous dysplasia. Since radiotherapy causes to sarcomatous changes and transsphenoidal surgery may cause to severe thickening in the cranial bones, they are not appropriate treatment options and medical treatment is recommended. Bromocriptine, cabergoline and octreotide or different combinations of these drugs are used in treatment and pegvisomant has also been used in recent years. Here, we present a male patient aged 12 years and 7 months to show gigantism as a rare clinical reflection of McCune-Albright Syndrome with an excessive height (197 cm), cafe au lait spots, growht hormone levels which could not be supressed with oral glucose tolerance test and increased prolactin levels.

WOS: 000351307200005, PubMed ID: 25800473, Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population. Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014. Results: The most common karyotype was 45, X (50.7%), followed by 45, X/46, XX (10.8%), 46, X, i(Xq) (10.1%) and 45, X/46, X, i(Xq) (9.5%). Mean age at diagnosis was 10.2 +/- 4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45, X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%. Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespan.

Vitamin D deficiency continues to be a worldwide problem especially in developing countries. The aim of this study was to investigate potential risk factors for vitamin D deficiency. Girls (n = 89) aged 13 to 17 y were enrolled in the study. Study subjects were stratified into 3 groups: Group I included girls living in a suburban area; Group II girls lived in an urban area and Group III girls lived in an urban area and wore concealing clothes for religious reasons. At the end of winter (in April) serum 25-hydroxyvitamin D [25(OH)D] levels were measured and dietary data were collected using questionnaires. Vitamin D deficiency was defined as a serum 25(OH)D concentration < 25 nmol/L and insufficiency as a 25(OH)D concentration between 25 and 50 nmol/L. The lumbar and femur neck bone mineral densities (BMD) were measured using dual X-ray absorptiometry (DEXA). Overall 39 girls (43.8%) had vitamin D insufficiency and 19 (21.3%) had vitamin D deficiency. In group III (wearing covered dress) the serum 25(OH)D concentrations (28.13 ± 12.53 nmol/L) were significantly lower than in the other 2 groups and within this group 50% of girls were vitamin D deficient. The lumbar and femur neck BMD of girls with lower 25(OH)D levels did not differ from those with adequate vitamin D levels. We conclude that vitamin D deficiency is an important problem in Turkish adolescent girls especially in those who follow a religious dress code; therefore vitamin D supplementation appears to be necessary for adolescent girls. (authors)

Subclinical hyperthyroidism is defined as low or undetectable concentration of serum thyrotrophin (TSH) with normal free triiodothyronine (FT3) and free thyroxine (FT4) levels. 1). Familial subclinical hyperthyroidism is a rare entity. Activating mutations of the TSH receptor (TSH-R) gene cause genetic hyperthyroidism. Here we present a family with more than one affected individual. All family members were investigated for TSH-R mutation. No mutation was detected, while a A459 polymorphism was found in one of the cases and three other siblings. Despite the clinical and biochemical findings suggesting a TSH-R mutation, a reasonable cause could not be detected. Epigenetic and environmental modifiers, including iodine intake, should be considered in families with mutation negative, familial non auto-immune hyperthyroidism (FNAH). [Med-Science 2017; 6(1.000): 154-6]

Amaç: fiiflmanl›¤›n çocuklarda tiroid hormonlar› üzerine etkilerinin araflt›r›lmas›. Gereç ve Yöntem: Çocuk endokrinoloji ve diyabet poliklini¤inde Mart 2006- May›s 2009 tarihleri aras›nda fliflmanl›k tan›s› ile izlenen 132 olgunun dosyalar› geriye dönük olarak incelendi. Antropometrik ölçümleri, kan lipit düzeyleri, tiroid hormon düzeyleri, açl›k kan flekeri ve insulin düzeyleri de¤erlendirildi. HOMA-IR (homeostasis model assessment of insulin resistance) 3,16 olan olgular›n TSH (tiroid uyar›c› hormon) düzeyleri karfl›laflt›r›ld›. Tiroid uyar›c› düzeyi ile beden kitle indeksi (BK‹) ve HOMA-IR düzeyleri aras›ndaki iliflki incelendi. Veriler SPSS 13.0 istatistik program› ile analiz edildi. Ba¤›ms›z gruplar aras›ndaki karfl›laflt›rmalar ki-kare testi ile, korelasyon analizi ‘Pearson yöntemi’ ile yap›ld›. Anlaml›l›k s›n›r› p97,5 persantil olan hiçbir olgunun serbest/total T4 düzeyi normalin alt›nda de¤ildi. HOMA-IR3,16 olan olgular TSH düzeyleri aç›s›ndan karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› fark bulunmad›. TSH ile BK‹ ve HOMA-IR de¤eri aras›nda pozitif yönde, zay›f derecede, istatistiksel olarak anlaml› olmayan bir iliflki saptand›. Çıkarımlar: fiiflman çocuklarda TSH düzeyi, tiroid ifllevleri etkilenmeksizin yükselmifl olabilir, bu durum hipotiroidi lehine de¤erlendirilmemeli ve ilk de¤erlendirmede L-tiroksin tedavisi bafllanmamal›d›r., @font face { font family: Times ; }p MsoNormal li MsoNormal div MsoNormal { margin: 0cm 0cm 0 0001pt; font size: 12pt; font family: Times New Roman ; }div Section1 { page: Section1; }

Aim/Background: Vitamin D supplementation during pregnancy is a well-accepted recommendation worldwide; however, the debate about the correct dose is ongoing. We aimed to compare daily doses of 600, 1,200, and 2,000 IU in this randomized, controlled study. Methods: The study group consisted of 91 pregnant women aged 16-42 years admitted to Kocaeli Maternity and Children Hospital between April 2011 and April 2012. The participants were randomly divided into 3 groups. 600, 1,200, and 2,000 IU/day of vitamin D was supplemented to group 1 (control group, n = 31), group 2 (n = 31), and group 3 (n = 32), respectively. Serum calcium, 25-hydroxyvitamin D (25OHD), and the calcium/creatinine ratio in spot urine samples were measured in the follow-up period. The serum calcium and 25OHD levels of the mothers' infants were measured as well. Results: The frequency of vitamin D sufficiency after supplementation was 80% in group 3 and it was significantly higher than in groups 1 (42%) and 2 (39%) (p = 0.03). The frequency of vitamin D sufficiency in the infants of the participants was 91% in group 3 and it was significantly higher than in groups 1 (36%) and 2 (52%) (p = 0.006). Conclusions: At least 2,000 IU/day of vitamin D is needed to ensure adequate vitamin D status in pregnancy and early infancy.

It was aimed to evaluate the national congenital hypothyroidism program in terms of thyroid-stimulating hormone (TSH) cut-off level, frequency of cases that required treatment and the stages before treatment in the Kocaeli district area. This research was performed with the contribution of Kocaeli University Medical Faculty, Pediatric Endocrinology Department, and the Kocaeli Local Health District. 25,188 babies born in 2009 were evaluated. The previous laboratory data including heel prick samples and venous thyroid function tests (TSH, free/total T4 levels) of babies requiring investigation were evaluated retrospectively. 49,785 heel prick blood samples were collected from 25,188 babies born in our region. TSH levels of 3,355 babies in the first sampling were greater than the cut-off level (15 mIU/L) (recall rate was 13.3%). Venous sampling was required for 107 babies, and 39 of them needed to be treated (treatment rate was 1/645). Eleven of the babies who were treated were diagnosed with thyroid dysgenesis. Families of the babies who needed further venous sampling were given final results in an average of 28.5 days after the first heel sampling. We concluded that the recall rate is high, but raising the cut-off level for TSH may lead to overlooking the diagnosis of thyroid dysgenesis. The duration for providing final results to the families is quite long. It is necessary to take venous blood samples in the pediatric endocrinology units to reduce this duration.

Ovotesticular disorder of sexual development (DSD) is characterized by the presence of both ovarian and testicular tissues in the same individual. The most common karyotype is 46,XX. Here, we report the case of a boy with a 46,XX/47,XXY karyotype diagnosed as ovotesticular DSD by gonadal biopsy. A 5-month-old boy presented with hypospadias, unilateral cryptorchidism, and a micropenis. Pelvic magnetic resonance imaging revealed a suspicious gonad tissue that is solid in structure in the right scrotum and a suspicious gonad that is cystic in structure in the left inguinal canal. He underwent a diagnostic laparoscopy. Cytogenetic analysis of peripheral blood revealed a 46,XX/47,XXY karyotype. Histopathologic examination of the left gonad showed ovarian tissue containing primordial follicles with ipsilateral undifferentiated tuba uterina. The right gonad showed immature testis tissue. He underwent left gonadectomy and hypospadias repair, and was raised as a male. Through this rare case, we highlight the importance of histological and cytogenetic investigation in DSD.

Objective: To investigate the effects of vitamin D deficiency on both insulin resistance and risk of metabolic syndrome in children. Methods: The study group consisted of 301 children and adolescents with a mean age of 14.2±1.8 years. Serum 25-hydroxyvitamin D [25(OH)D] levels and insulin resistance indices were evaluated. According to serum 25(OH)D levels, the subjects were classified in 3 groups. Those with levels ≤10 ng/mL were labeled as the vitamin D deficient group (group A), those with levels of 10-20 ng/mL as the vitamin D insufficient group (group B) and those with ≥20 ng/mL as having normal vitamin D levels (group C). Metabolic syndrome was defined according to the International Diabetes Federation consensus. The participants with and without metabolic syndrome were compared in terms of 25(OH)D levels. Results: Mean 25(OH)D level of the total group was 18.2±9.3 (2.8-72.0) ng/mL. Distribution of individuals according to their vitamin D levels showed that 11.6% were in group A, 53.5% in group B, and 34.9% in group C. The proportions of boys and girls in these categories were 22.9% and 77.1% in group A, 36.6% and 63.4% in group B, 54.3% and 45.7% in group C, respectively. There were no significant differences in 25(OH)D levels in the individuals with and without impaired fasting glucose or impaired glucose tolerance. No relationship was observed between insulin resistance/sensitivity indices and vitamin D status (p>0.05). Metabolic syndrome was diagnosed in 12.3% (n=37) of the children. There was also no difference in mean 25(OH)D levels between individuals who had and those who did not have the metabolic syndrome. Conclusion: In our study, no correlations were found between insulin measurements during oral glucose tolerance test and vitamin D deficiency. Nonetheless, more extended studies including vitamin D supplementation and evaluating insulin sensitivity via clamp technique are needed to further elucidate this relationship. Conflict of interest:None declared.

Summary Aim-objective Vitamin D deficiency and rickets in developing countries continues to be a major health problem. Additionally, the increase of cases of rickets in children of some ethnic groups in the United States and European countries has provided this issue to be updated. Obviously, powerful strategies are necessary to prevent vitamin D deficiency nation-wide. In 2005, a nationwide prevention program for vitamin D deficiency was initiated, recommending 400 IU vitamin D per a day. This study was designed to evaluate the efficacy of the prevention program. Methods Eighty-five infants who were recalled as part of the national screening program for congenital hypothyroidism between February 2010 and August 2010 at Kocaeli University Children's Hospital were evaluated in terms of their vitamin D status as well. All babies had been provided with free vitamin D (Cholecalciferol) solution and recommended to receive 400 IU (3 drops) daily. Information regarding the age at start of supplementation, the dosage and compliance were obtained from the mothers with face-to-face interview. Serum 25-hydroxy vitamin D (25-OH-D), alkaline phosphatase (AP), parathormone (PTH) levels were measured. Results The mean age at which Vitamin D3 supplementation began was 16.5 ± 20.7 (3-120) days. Ninety percent of cases (n:76) were receiving 3 drops (400 IU) vitamin D3 per day as recommended; 70% of cases (n:59) were given vitamin D3 regularly, the remainder had imperfect compliance. Among those children who are older than 12 months, only 20% continued vitamin D supplementation. No subject had clinical signs of rickets. The mean 25-OH-D level was 42,5 ± 25,8 (median: 38.3) ng/ml. Ten subjects (12%) had their serum 25-OH-D levels lower than 20 ng/ml (6 between 15-20 ng/ml, 3 between 5-15 ng/ml and only one < 5 ng/ml). Conclusions 400 U/day vitamin D seems adequate to prevent vitamin D deficiency. However, we believe that the program for preventing vitamin D deficiency in Turkey, needs to be reinforced to start immediately after birth, and to continue beyond 1 year of age at 400U regular daily dosage.

Early markers are required in pathophysiological process of obesity, MS and type 2 diabetes. We aimed to clarify the usefulness of serum adipokines (adiponectin, AD and resistin) and inflammatory markers to identify obese and overweight children with MS. Three hundred and seven of 2 491 subjects aged 11-19 with BMI> or =85 centile selected with a multistage, stratified sampling were included. Their height, weight and waist circumference were measured, all subjects underwent physical examination and standard OGTT. AD, resistin and hs-CRP were measured from baseline blood sample. The mean age of subjects was 14.2+/-1.8, 57.7% was girl (n=177) and 42.3% (n=130) boy. Of the 307 subjects 40 (13%) were classified as having MS. Serum AD levels were significantly lower in boys (p=0.02), and decreased while BMI increased, but this trend was not significant (p>0.05). Although median resistin values were higher in obese than others (20, 18.5, 17 ng/ml, respectively) it was not significant (p>0.05). In obese subjects, hs-CRP levels were significantly high (0.21 mg/L) (p=0.000). All three markers in obese and overweight children with and without MS were not significant (p>0.05). Girls with MS had lower adiponectin levels than those without MS. Waist circumference had the highest sensitivity and specificity for predicting MS in ROC analysis. The area under the curve (AUC) was 0.831 for WC standard error (SE) 0.033; 95% CI 0.767-0.896; p

Background: Parental height data are essential in the assessment of linear growth in children. A number of studies have documented inaccuracy in self-reported adult height. Aims: To determine whether there is a tendency for men to overestimate and women to underestimate their height. Methods: Heights of parents of children attending outpatient clinics were measured (MHt) and compared with reported heights (RHt). Results: Two hundred parents (100 males; 100 females), mean (range) age 37.8 (20.8–69.3) years, were measured. Males overestimated height, with mean (SD) RHt–MHt 1.09 (1.96) cm, while females reported height relatively accurately, with RHt–MHt −0.09 (2.37) cm. Conclusions: The hypothesis that males overestimate height is confirmed. While the hypothesis that women underestimate is not supported, we recommend accurate measurement of both parents, given the considerable degree of individual variation in RHt−MHt for both sexes.