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Virginal mammary hypertrophy (VMH), also known as juvenile mammary hypertrophy, is characterized by excessive enlargement of the breasts. Especially in adolescent patients, this condition can cause a negative body image to develop and result in significant psychological stress. Furthermore, social problems can arise from difficulties in finding appropriately-fitting attire and having trouble exercising. Although the mechanism of VMH has not been fully elucidated, several associated drugs have been identified. In this report, we present a 15-year-old female patient with Wilson disease who developed macromastia after administration of penicillamine for 8 months. Despite cessation of penicillamine for 3 months, the condition remained stable; thus, reduction mammoplasty was performed. After surgery, the patient was able to return to activities of daily living. Although rare, physicians should be aware of the fact that penicillamine can cause VHM. Therefore, patients with Wilson disease should be checked regularly for changes in breast volume in order to minimize possible complications.

Purpose Childhood obesity frequently persists into adulthood, and is associated with insulin resistance (IR) and increased long-term morbidity and mortality. We compared IR criteria concerning 'age-specific cut-off points (ACOP)' and 'fixed cut-off points (FCOP)' for the identification of IR, and we investigated their correlation with metabolic syndrome (MS). Methods The data were acquired from the 5th Korea National Health and Nutrition Examination Survey (2010–2011). Participants aged from 10 to17 years underwent fasting plasma glucose, insulin concentrations and lipid panel measurements. High fasting plasma insulin levels or increased homeostatic model assessment insulin resistance (HOMA-IR) were defined as IR. We analyzed MS and IR frequencies according to FCOP or ACOP. Results Among 719 participants, 165 (22.9%) were overweight or obese based on their body mass index. We found no prevalence of MS in underweight/normal weight participants and 12.7 % prevalence rate in overweight or obese participants. IR according to ACOP was more closely associated with MS than IR according to FCOP. No differences were found in predicting the frequency of MS using FCOP or ACOP in both fasting plasma insulin and HOMA-IR. Conclusion The frequencies of MS in participants with IR defined using ACOP and FCOP were similar. However, IR using ACOP was more closely associated with MS than IR using FCOP.

Background. Little information is available on the association between parents’ metabolic syndrome (MetS) and adolescent offspring’s obesity in Korea. The aim of our study is to determine the association between parent’s metabolic syndrome and offspring’s obesity. Methods. The study data were obtained from the Korean National Health and Nutrition Examination Survey conducted during 2009–2016. In the present study, 3140 adolescents aged 12 to 18 years, their paternal pairs (PP, fathers = 2244), and maternal pairs (MP, mothers = 3022) were analyzed. Of these 3140 adolescents, 2637 had normal weight {age- and sex-specific body mass index (BMI) under the 85th percentile}, whereas 467 were overweight (age- and sex-specific BMI over the 85th percentile). Results. Offspring’s overweight and central obesity were associated with all components of the PP’s metabolic risk factors, including central obesity ( p < 0.001 ), systolic ( p < 0.001 ) and diastolic blood pressure ( p < 0.001 ), glucose intolerance ( p < 0.001 ), and triglyceride ( p < 0.002 ) and high-density lipoprotein levels ( p = 0.049 ). In addition, offspring’s overweight and central obesity were also associated with the metabolic risk factors of MP, including central obesity ( p < 0.001 ), systolic ( p < 0.001 ) and diastolic blood pressure ( p < 0.001 ), glucose intolerance ( p < 0.001 ), and triglyceride levels ( p < 0.001 ). In multivariate logistic regression analysis, offspring’s overweight was significantly and positively associated with parental central obesity (PP, adjusted odds ratio (OR) = 1.593; 95% confidence interval (CI): 1.192–2.128; MP, adjusted OR = 2.221, 95% CI: 1.755–2.812) and parental metabolic syndrome (PP, adjusted OR = 2.032; 95% CI: 1.451–2.846; MP, adjusted OR = 2.972, 95% CI: 2.239–3.964). As the number of parental metabolic risk factors increased, offspring’s risk for overweight and central obesity increased ( p for trends

Fetuin-A and adiponectin are inflammatory cytokines associated with obesity and insulin resistance. This study aimed to examine the fetuin-A-to-adiponectin ratio (FAR) in diabetic children and to determine the role of FAR. A total of 54 children and adolescents with diabetes mellitus (DM) and 44 controls aged 9–16 years were included in this study. Clinical characteristics, including plasma fetuin-A and adiponectin levels, were compared with respect to body mass index (BMI) and diabetes type. Of 98 children, 54.1% were obese, whereas 18.4% were obese and diabetic. FAR was higher in obese children with DM than in non-obese children and also in type 2 DM children than in type 1. FAR showed a stronger association with BMI than with fetuin-A and adiponectin individually, and its association was more prominent in diabetic children than in controls. BMI was a risk factor for increased FAR. Plasma fetuin-A was elevated in obese children, and its association with insulin resistance and β cell function seemed more prominent in diabetic children after adjustment for adiponectin. Thus, FAR could be a useful surrogate for the early detection of childhood metabolic complications in diabetic children, particularly those who are obese.

(1) Background: Bone plays an important role in the regulation of the systemic glucose and energy metabolism. Sclerostin, secreted by osteocytes, is an inhibitor of the Wnt/β–catenin bone metabolic pathway, and is involved in osteoporosis and metabolic disease. The aim of this study was to investigate the relationship between sclerostin and anthropometric and metabolic parameters in children and adolescents with obesity or who are overweight. (2) Methods: This study included 63 children and adolescents (20 obese, 11 overweight and 32 healthy control subjects). We evaluated the correlation between serum sclerostin and anthropometric parameters, metabolic parameters related to glucose (homeostasis model assessment of insulin resistance [HOMA–IR]), lipid, and bone metabolism (osteocalcin and 25-hydroxy vitamin D). (3) Results: Sclerostin and osteocalcin levels did not differ between obese and control groups. Sclerostin level was higher in boys than in girls (median 20.7 vs. 18.9 pmol/L, respectively, p = 0.04). In all subjects, sclerostin levels were negatively correlated with fasting insulin (r = −0.26, p = 0.04) and HOMA–IR (r = −0.28, p = 0.03), and positively correlated with serum concentrations of triglycerides (r = 0.29, p = 0.04), alkaline phosphatase (r = 0.41, p = 0.002), and osteocalcin (r = 0.33, p = 0.008). In obese patients, sclerostin levels were correlated negatively with fasting glucose (r = −0.49, p = 0.03) and HOMA–IR (r = −0.48, p = 0.03) and positively correlated with triglyceride levels (r = 0.53, p = 0.02). In the healthy control, sclerostin levels were correlated negatively with fasting insulin levels (r = −0.61, p &lt, 0.001) and HOMA–IR (r = −0.36, p = 0.04). After adjusting for age, sex, and height SDS, a negative correlation between sclerostin and HOMA–IR was found (r = −0.39, p = 0.003) in all of the subjects. This association was more evident in obese patients (r = −0.60, p = 0.01) than in healthy controls (r = −0.39, p = 0.047). (4) Conclusions: Among children and adolescents with obesity, serum sclerostin was negatively correlated with HOMA–IR. Further studies are needed to clarify the mechanisms involved to understand how sclerostin affects the glucose metabolism.

Background Autoimmune thyroid diseases (AITDs) are female predominant and much attention has been focused on integral membrane protein 2A (ITM2A) on the X chromosome as Grave's disease (GD) susceptible locus. Methods We genotyped ITM2A rs1751094 single nucleotide polymorphism (SNP) in 166 patients (142 females and 24 males) diagnosed with AITD (67 HD and 99 GD cases). The mean age (±SD) of GD patients at enrollment was 14.4 ± 3.5 years and HD patients was 13.8 ± 3.5 years. In GD patients, 49 patients (49/99, 49.5%) had thyroid-associated ophthalmopathy (TAO). Among the 85 GD patients, 60 patients (60/85, 70.6%) were intractable GD. The data were analyzed by sex-stratified or combined with 198 healthy Korean individuals (97 females and 101 males). Results Target SNP fits the HWE. In patients with AITD (n = 166), the genotype and allele frequencies of rs1751094 AC (OR=2.5, corrected P (Pc) = 0. 000), C (OR=2. 0, Pc = 0. 000) were higher and those of AA/A (OR=0.3, Pc = 0. 000), A (OR=0.5, Pc = 0. 000) were lower than those in controls (n = 198) (Table 3). In female AITD patients (n = 143), those of rs1751094 CC (OR=2.4, Pc = 0. 031), C (OR=1.8, Pc = 0. 003) were higher and those of rs1751094 AA (OR=0.5, Pc = 0. 027), A (OR=0.6, Pc = 0. 003) were lower than those of female controls (n = 97). In patients with GD (n = 99), rs1751094 CC/C (OR=3.5, Pc = 0. 000) and C (OR=3.4, Pc = 0. 000) were higher those in controls (n = 198). In intractable GD Patients (n = 60), rs1751094 AC (OR=2.2, Pc = 0. 026) and C (OR=2.5, Pc = 0. 000) were higher than those in controls. In GD with TAO (n=49), rs1751094 CC/C (OR=2.9, Pc = 0. 003), C (OR=3.3, Pc = 0. 000) were higher than those in controls. In patients with HT (n = 67), the genotype frequencies of rs1751094 AC (OR=3. 0, Pc = 0. 000) was higher and those of AA/A (OR=0.4, Pc = 0. 002) were lower than those in controls (n = 198). Conclusions Polymorphisms in ITM2A rs1751094 on the X chromosome might be associated with AITD in Korean children. Presentation: No date and time listed

Backgrounds Diabetic children especially who are obese lead to poor glycemic control thus are at higher risk for early microvascular complications. Renal tubulointerstitial markers play integral role in the evaluation of diabetic nephropathy and various biomarkers have been proposed. Yet, their role in obese pediatric population is uncertain. The aim of this study is to investigate renal injury markers in children with diabetes mellitus (DM) in relation with obesity and determine their role for early predictor of diabetic complications. Methods Fifty-three children and adolescents diagnosed with either type 1 or 2 DM and 44 controls aged 7-18 years were included. Clinical and laboratory characteristics including renal injury markers among subjects were compared with respective to body mass index (BMI), presence and type of DM. Results Urine neutrophil gelatinase associated lipocalin and kidney injury molecule-1 were lower whereas beta-2 microglobulin and n-acetylglucosamine (NAG) concentrations were higher in controls compared to diabetic children. None of renal injury markers showed significant difference between normoweight and obese children. In multiple regression analyses, urine NAG was associated with HbA1c and the presence of DM while high homeostatic model assessment of insulin resistance was identified as a risk factor of for increased urine NAG in type 2 diabetic children. Conclusion Urine NAG could be a marker associated not only with diabetic nephropathy, but also with insulin resistance regardless of BMI. Presentation: No date and time listed

In the present study, the results of brain magnetic resonance imaging (MRI) in girls with central precocious puberty (CPP) were compared those in with girls evaluated for headaches. A total of 295 girls with CPP who underwent sellar MRI were enrolled. A total of 205 age-matched girls with chronic or recurrent headaches without neurological abnormality who had brain MRI were included as controls. The positive MRI findings were categorized as incidental non-hypothalamic–pituitary (H–P), incidental H–P, or pathological. Positive MRI findings were observed in 39 girls (13.2%) with CPP, 8 (2.7%) were classified as incidental non-H–P lesions, 30 (10.2%) as incidental H–P lesions, and 1 (0.3%) as a pathological lesion (tuber cinereum hamartoma). The prevalence of positive MRI findings in girls with CPP did not differ from girls with headaches (13.2% vs. 12.2%, p = 0.74). The prevalence of incidental H–P lesions in girls with CPP &lt, 6 years of age, 6–6.9 years of age, and 7–7.9 years of age was 21.2%, 13.5%, and 9.6%, respectively (p = 0.21). Known pathological lesions were detected in only one (3.0%) girl with CPP aged &lt, 6 years and in no girls with CPP aged 6–7.9 years. Microadenomas were detected in no girls with CPP aged &lt, 6 years and in 5 (1.9%) girls with CPP aged of 6–7.9 years. Our findings call into question the routine use of brain MRI in girls with CPP, especially in girls 6 years or older. Current guidelines recommend a follow-up MRI in cases of microadenoma, but few data exist to support this recommendation for children.

Purpose: The aim of this study is to evaluate the effect of body mass index (BMI) on peak serum growth hormone (GH) level after GH stimulation test in children with short stature.Methods: Data were obtained from retrospective medical record reviews of those who visited the pediatric endocrine clinic at St. Vincent’s Hospital of Catholic University for short stature from January 2010 to June 2019. A total of 115 children (66 boys and 49 girls) whose height was less than the third percentile according to age and sex underwent GH stimulation testing.Results: Of the 115 subjects, 47 were diagnosed with GH deficiency (GHD) and 68 were diagnosed with idiopathic short stature (ISS). In patients with GHD, weight standard deviation score (SDS) (P

Background: Neonatal diabetes mellitus (NDM) occurs within the first 6 months of life. Advances in molecular genetics have identified various causatives genes. Mutations in EIF2AK3 causes Wolcott-Rallison syndrome characterized by NDM, multiple epiphyseal dysphasia and growth retardation. PTF1A is associated with the development of pancreas and cerebellum. Both EIF2AK3 and PTF1A mutations are causative genes for permanent NDM with spontaneous and autosomal recessive inheritance. We report a neonate with transient NDM with both EIF2AK3 and PTF1A variants confirmed by Sanger sequencing where each parent found to be a heterozygous carrier of each mutation. Case presentation: A two-day old boy was transferred from a local hospital due to hyperglycemia (blood glucose of 385 mg/dL) and glycosuria. Serum c-peptide (0.06 ng/mL) and insulin (0.64 μU/mL) were low. The patient did not present sings of ketoacidosis and was screened negative for pancreatic autoantibodies. The patient did not have any family history of diabetes. Molecular genetic analysis was performed and continuous infusion of intravenous insulin with pre-prandial bolus was started. Oral sulfonylurea therapy was attempted to prevent adverse neurocognitive outcome however, it showed no response and unable to stabilize blood glucose level. Targeted panel sequencing identified two different novel variants: a heterozygous missense mutation (c.3272G>T) in exon 17 of EIF2AK3 gene and heterozygous missense mutation (c.53C > T) in exon 1 of PTF1A gene; both of which have not been previously reported and were no likely pathogenic variants. The patient’s father confirmed to be heterozygous carriers of the EIF2AK3 mutation while mother being heterozygous carriers of the PTF1A mutation. Blood glucose level gradually began to stabilize with insulin therapy, and upon discharge the patient switched to continuous subcutaneous insulin infusion (pump) with continuous glucose monitoring. Conclusions: NDM caused by in combination of EIF2AK3 and PTF1A gene mutation is a rare condition and could resemble the disease progress of transient form of NDM. Although hyperglycemia might not be an issue of lifelong period, early genetic screening and prompt insulin initiation with consistent glucose monitoring are able to prevent further diabetic complications. In addition, the result of genetic testing in our patient raises the possibility of NDM as polygenic form of diabetes.

Purpose: To investigate the overall prevalence of vertebral fractures (VF) following childhood acute lymphoblastic leukemia (ALL) treatment and examine the association of VF with growth trajectory and insulin-like growth factors. Methods: Children (n=172; 59.3 % male) diagnosed with ALL at age between 2 and 18 years were assessed for VF by screening the lateral thoracolumbar spine radiographs (Genant’s semi-quantitative method) when treatment was completed (baseline). Anthropometric measurements between pre- to post-treatment period were obtained and the association of VF with insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) were examined. Results: Thirty-five children (20.3 %) had vertebral fractures at baseline. Among children with vertebral fractures, 97.1 % had either mild or moderate deformity, and the 5th lumbar vertebrae was the most frequently injured site (20.0 %). Median lumbar spine bone mineral density Z-score was -1.0 (IQR of -1.6 and -0.8) in children with VF. Baseline Z-scores for height and weight were lower in children with VF than without VF (-0.5±1.3 and 0.0±0.9, P=0.01; -0.2±1.6 and 0.3±1.1, P=0.04, respectively). Height Z-score in children with VF had greater height decline than without VF (0.5±0.6 and 0.2±0.8; P=0.02). Children with VF had lower IGF-1 and IGFBP-3 Z-score than without VF at baseline (-1.2±1.0 and 0.0±0.8, P

Purpose To analyze the effects of clinical and laboratory factors, including insulinlike growth factor (IGF) levels, on the height velocity of normal prepubertal children. Methods Ninety-five healthy prepubertal children (33 boys, 62 girls) were enrolled. The mean chronological age was 6.3±1.4 years, with a height standard deviation score (SDS) of -0.88±0.70. IGF-1, IGF binding protein-3 (IGFBP-3), SDS for anthropometric measurements, and changes in SDS for anthropometric measurements were analyzed for 1 year, and their associations with 1-year height velocity were investigated. Results The group of children with a 1-year height velocity of ≥6 cm were chronologically younger than the group with a 1-year height velocity of l6 cm (5.9±1.3 years vs. 6.7±1.3 years, P=0.004), with a lesser increase of SDS for body mass index (BMI) over 1 year (-0.18±0.68 vs. 0.13±0.53, P=0.014). There were no differences between the 2 groups in IGF-1 SDS and IGFBP-3 SDS. Multiple linear regression showed that baseline chronological age (r=0.243, P=0.026) and height SDS (r=0.236, P=0.030) were positively associated with IGF-1 SDS. Binomial logistic regression showed that an older chronologic age at referral (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.47-0.99) and an increase of BMI SDS over 1 year (OR, 0.41; 95% CI, 0.18-0.89) were associated with a decreased growth possibility of an above-average height velocity (≥6 cm/yr). Conclusion Height velocity of normal prepubertal children is affected by an increase of BMI SDS and chronological age. Prepubertal IGF-1 SDS reflects height SDS at the time of measurement but is not associated with subsequent height velocity.

Background Given that YKL-40 is a known marker of inflammation, we sought to determine its association with urinary tract infection (UTI) in febrile children. Methods In total, 44 children aged 0 to 24 months with febrile UTI and 35 age- and sex-matched controls with fever from other causes were enrolled in the study. ELISA was performed to determine the level of YKL-40 in urine collected from each child. Results The ratio of urinary YKL-40 to creatinine (Cr) was higher in the children with a UTI than in the controls (P

Objectives The acute diarrhea is a common complaint among immunocompromised hosts, and may cause life threatening event. The infectious etiologies vary depending on virus, bacteria, and parasites. The most common etiology of acute gastroenteritis is known as enteric virus in Korea. But there are few studies about the infectious etiology of acute gastroenteritis in immunocompromised hosts. The aim of this study was to investigate the infectious etiologies of acute diarrhea in immunocompromised hosts. Methods Seventy three patients were enrolled prospectively in a university hospital from January 2013 to July 2014. Immunocompromised hosts included above 65-year-old people, patients with chronic diseases, solid organ or stem cell transplants, solid organ malignancies, hematologic malignancies, immunosuppressive or steroid taking patients. The clinical data were collected and stool samples collected during diarrhea were undergone laboratory analysis for enteric viruses and bacterial enteropathogens including Salmonella spp., Shigella spp., and Clostridium difficile. Results Fifty five patients were analyzed as follows : above 65 year-old people were 36 cases (66%), previous antibiotic usage was 22 cases (41.5%). 44 cases (81.1%) were admitted to general ward whereas 9 cases to ICU (17%). 41 cases (73.6%) were treated with antibiotics. Positive C. difficile toxin assays were 6 cases (11.9%). Other infectious etiologies were not found. Conclusions C. difficile infection was more common infectious etiology while enteric viruses and other bacteria are not associated with acute diarrhea among immunocompromised hosts in this study. So C. difficile infection must be considered preferentially in immunocompromised hosts with acute diarrhea.

Growth hormone (GH) is an essential element for normal growth. However, reports of normal growth without GH have been made in patients who have undergone brain surgery for craniopharyngioma. Normal growth without GH can be explained by hyperinsulinemia, hyperprolactinemia, elevated leptin levels, and GH variants; however, its exact mechanism has not been elucidated yet. We diagnosed a female patient aged 13 with combined pituitary hormone deficiency (CPHD) caused by pituitary stalk interruption syndrome (PSIS). The patient has experienced recurrent hypoglycemic seizures since birth, but reached the height of 160 cm at the age of 13, showing normal growth. She grew another 8 cm for 3 years after the diagnosis, and she reached her final adult height of 168 cm which was greater than the midparental height, at the age of 16. The patient's blood GH and insulin-like growth factor-I levels were consistently subnormal, although her insulin levels were normal. Her physical examination conducted at the age of 15 showed truncal obesity, dyslipidemia, and osteoporosis, which are metabolic features of GH deficiency (GHD). Herein, we report a case in which a PSIS-induced CPHD patient attained her final height above mid parental height despite a severe GHD.

Diabetic nephropathy (DN) is a serious microvascular complication in childhood diabetes and microalbuminuria has been a solid indicator in the assessment of DN. Nevertheless, renal injury may still occur in the presence of normoalbuminuria (NA) and various tubular injury biomarkers have been proposed to assess such damage. This case-controlled study aimed to evaluate plasma and urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 (KIM-1) levels in diabetic children particularly in those with normo- and high-NA stages and determine their role in predicting DN. Fifty-four children/adolescents with type 1 and 2 diabetes and forty-four controls aged 7–18 years were included. The baseline clinical and laboratory characteristics including plasma and urinary biomarkers were compared. The plasma KIM-1 levels were significantly higher in diabetic children than in the controls and in high-NA children than normo-NA children. Glycosylated hemoglobin (HbA1c) was identified as a significant risk factor for increased plasma KIM-1. The optimal cutoff for HbA1c when the plasma KIM-1 was &gt, 23.10 pg/mL was 6.75% with an area under the curve of 0.77. For diabetic children with mildly increased albuminuria, the plasma KIM-1 complementary to MA may help increase the yield of detecting DN. Our findings also suggested an HbA1c cutoff of 6.75% correlated with increased plasma KIM-1.

Background: The purpose of the current study is to investigate bone mineral deficit of children in survivors of childhood acute leukemia and examine the association of insulin-like growth factor-1 (IGF-1) with bone mineral density (BMD) status and the presence of osteoporosis. Methods: In a cross-sectional study of children diagnosed with different types of acute leukemia at age between 6 months and 18 years, serum IGF-1 and IGFBP-3, were assessed in relation to lumbar spine BMD (LSBMD) by using dual-energy x-ray absorptiometry and non-traumatic vertebral fracture by lateral thoracolumbar spine radiographs. Standard deviation scores (SDS) were calculated based on the age- and gender-adjusted population mean. Results: Among 189 children after completion of acute leukemia treatment, 22 (11.6%) children had LSBMD SDS less than -2.0 while 80 (42.3 %) children were diagnosed with osteoporosis. Mean areal BMD and LSBMD SDS of the subjects were 0.862±0.197 g/cm2 and -0.6±1.6, respectively. IGF-1 and IGFBP-3 were lower in children with LSBMD lower than -2.0 (P

Introduction: The clinical course of Graves’ disease (GD) treated with anti-thyroid drug (ATD) treatment were reviewed with the aim of establishing criteria able to predict intractable GD. Methods: The clinical course of 116 patients with GD who agreed to participate in this study between March 2009 and August 2019 in the pediatric endocrine clinic at Seoul St. Mary’s and St. Vincent’s Hospitals were reviewed. We defined an intractable as hyperthyroidism persistent over 2 years of ATD or relapsed after ATD withdrawal or had been treated ATD for at least 5 years [1-3]. Result: Of 116 patients diagnosed with GD, 37 patients (31.8%) had remission and 79 (68.2%) had intractable GD. Between intractable and remission GD group, there were no significant difference of female percentage, age at diagnosis, thyroid associated ophthalmopathy, serum levels of triiodothyronine (T3), free tetraiodothyronine (T4), Thyroid stimulating hormone (TSH) and positive rate of thyroid autoantibody (Thyroid peroxidase (TPO), Thyroglobulin (Tg), Thyroid stimulating hormone receptor (TSHR)). In intractable GD patients, the frequency of goiter at diagnosis is higher than remission group (89.9% [71/79] and 70.3% [26/37], P-value = 0.014). In correlation analysis, intractable GD showed positive correlation with goiter (R=0.247, P-value = 0.008). In multivariate logistic analyses, goiter is showed strong relationship with intractable GD (odds ratio, 3.793; 95% confidence interval, 1.367-10.524) after adjusting age and sex. Conclusion: Our study supported that goiter at initial presentation might be predicting factor for early onset intractable GD.

Introduction: Patients with childhood hemato-oncologic diseases have many medical problems, not only due to disease itself, but also adverse effects of specific treatment that patients had. Osteoporosis, one of the most common side effects of the treatment, decreases quality of life when the disease progresses. Our study investigated the impact of male hypogonadism on secondary osteoporosis in childhood hemato-oncologic patients, using association between male sex hormone and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA). Methods: This study collected BMD score (T-score) of 52 male subjects who were diagnosed with hemato-oncologic diseases in the past (average age of 22.3 years at DXA examination). All subjects measured serum testosterone and we divided them into two subgroups according to gonadal status. The first group, called hypogondal group, was a group of subjects with serum testosterone level less than 3.5 ng/ml. The other group was classified into eugonadal group, with serum testosterone level equal or more than 3.5 ng/ml. Mean BMD score of spine and hip were presented and compared between the two groups. Furthermore, relativity with other risk factors for osteoporosis was calculated using multiple regression analysis. Results: Overall, spine BMD in the hypogondal group did not significantly differ from the eugonadal group. However, hip BMD was significantly lower in the hypogonadal group (mean difference; 0.8, p = 0.023). Furthermore, testosterone level itself showed linear correlation with BMD score in hip (p = 0.013). When other risk factors for osteoporosis were taken into account, hemato-oncologic patients treated with total body irradiation also had significantly lower hip BMD (p = 0.007) compared with non-irradiation group. Hypogonadism still remained a significant factor for decreased bone mineral density in hip (p = 0.022). Conclusions: Hemato-oncologic patients with hypogonadism or previously treated with total body irradiation are at increased risk of decreased bone mineral density in both hips. Hypogonadism alone remains independent risk factor for osteoporosis in hip. Attention of these male patient should be paid to prevent the incidence of secondary osteoporosis.

Objective: The interpretation of thyroid function test results in preterm infants is affected by various conditions. Neither a definite thyrotropin cut-off nor intercurrent conditions have been clearly determined for premature neonates. This study aimed to determine the specific considerations required in the interpretation of capillary blood thyrotropin concentration by comparing it to serum thyrotropin when screening for congenital hypothyroidism in preterm neonates. Methods: A retrospective review was performed on 57 premature newborns who were screened for thyroid function test. The comparison of thyrotropin measured by two different methods, dried capillary blood-spotted filter paper using an immunofluorometric assay and serum radioimmunoassay, was performed. Clinical and biochemical factors affecting the difference between the two methods were investigated. Results: Filter paper thyrotropin concentration showed a positive correlation with the serum thyrotropin concentration. In total, 50.9% of premature neonates had a difference in the concentration ≥3.0 mIU/L between the methods. In these subjects, the serum thyrotropin concentration was higher, whereas other factors, such as maternal factors, neonatal anthropometric parameters, Apgar score, and corrected age, were not different when compared to that in subjects with a difference of

The aim of this study was to evaluate the association of a urinary tubular marker, liver-type fatty acid binding protein (L-FABP) and an inflammatory marker, serum/urinary YKL-40, with albuminuria in patients with childhood-onset type 1 diabetes (T1D). Twenty-nine patients with childhood-onset T1D and 32 controls were enrolled. Serum and urinary concentrations of YKL-40 and urinary concentrations of L-FABP were measured. The serum levels of YKL-40 were not significantly different between the control group and the patient groups. However, the levels of urinary YKL-40/creatinine (Cr) were higher in the patients, even those with normoalbuminuria than in the controls (p

Purpose We aimed to investigate serum lipid profiles and glycemic control in adolescents and young adults with type 1diabetes mellitus (T1DM). Methods This cross-sectional study included 29 Korean young adults and adolescents with T1DM. The median age was 17 years (range, 10-25 years) and 18 (62.1%) were female. We compared the lipid profiles of patients with dyslipidemia and those without dyslipidemia. Correlations between glycosylated hemoglobin (HbA1c) and lipid profiles (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglyceride [TG]) were determined by linear regression analysis. Results Of the 29 patients with T1DM, 11 (37.9%) were classified as having dyslipidemia due to the following lipid abnormality: TC≥200 mg/dL in 8 patients, LDL-C≥130 mg/dL in 4 patients, TG≥150 mg/dL in 2 patients, and HDL-C≤35 mg/dL in 2 patients. Compared to patients without dyslipidemia, patients with dyslipidemia were more likely to have higher values of HbA1c (median, 10.6%; range, 7.5%-12.3% vs. median, 8.0%; range, 6.6%-10.0%; P=0.002) and a higher body mass index z score (median, 0.7; range, -0.57 to 2.6 vs. median, -0.4; range, -2.5 to 2.2; P=0.02). HbA1c levels were positively correlated with TC (P=0.03, R (2)=0.156) and TG (P=0.005, R (2)=0.261). Conclusion A substantial proportion of adolescents and young adults with T1DM had dyslipidemia. We found a correlation between poor glycemic control and poor lipid profiles in those patients.