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Objectives International guidelines recommend additional salt supplementation during infancy in classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. The influence of corticoid medication and growth has not been assessed. Aim To investigate the current use of salt supplementation, fludrocortisone (FC) and hydrocortisone (HC) dosage as well as weight, height, BMI and blood pressure (BP) in CAH children aged 0–3 years. Methods Retrospective multicentre analysis using data from the I-CAH registry. Salt-treated (ST) and non-salt-treated (NST) children were compared regarding FC and HC dosage, weight, height and BP at 0, 3, 6, 9, 12, 18, 24, 30, and 36 months. Results We analysed 2483 visits of 331 patients born after year 2000 in 13 countries (male, n = 145) with 203 ST patients (61%). NST children had significantly higher FC dosages at 1.5–4.5 months and higher HC dosages until 1.5 months of age. No differences in weight, length and BP between subgroups were observed. Children of the whole cohort showed increased BMI-SDS during the study period and about half of the reported BP readings were >P95. Conclusion In children treated with additional salt supplementation, FC and HC dosages are lower during the first months of life but without differences in weight, length and BP until 3 years of age compared to NST children. All children showed an increase in BMI-SDS and a high rate of BP readings >P95 until 3 years, indicating the start of weight gain and negative effects on blood pressure already in very early life.

Objective Growth hormone deficiency (GHD) is the most common endocrine late effect in irradiated survivors of childhood brain tumors. This study aimed to determine the prevalence of GHD in adults treated with proton or photon irradiation for a brain tumor in childhood and to detect undiagnosed GHD. Design This study is a cross-sectional study. Methods We investigated GHD in 5-year survivors from two health regions in Denmark treated for childhood brain tumors with cranial or craniospinal irradiation in the period 1997–2015. Medical charts were reviewed for endocrinological and other health data. Survivors without a growth hormone (GH) test at final height were invited to a GH stimulation test. Results Totally 41 (22 females) survivors with a median age of 21.7 years (range: 15.1–33.8 years) at follow-up and 14.8 years (range: 5.1–23.4 years) since diagnosis were included; 11 were treated with proton and 30 with photon irradiation; 18 of 21 survivors were previously found to have GHD; 16 of 20 survivors with no GH test at final height were tested, 8 (50 %) had GHD. In total, 26 of 41 patients (63%) had GHD. Insulin-like growth factor-1 (IGF-1) is associated poorly with the insulin tolerance test (ITT). Conclusion This study identified a high prevalence of undiagnosed GHD in survivors with no GH test at final height. The results stress the importance of screening for GHD at final height in survivors of childhood brain tumors with prior exposure to cranial irradiation, irrespective of radiation modality and IGF-1. Significance statement This cross-sectional study reports a prevalence of 63% of GHD in irradiated childhood brain tumor survivors. Furthermore, the study identified a considerable number of long-term survivors without a GH test at final height, of whom, 50% subsequently were shown to have undiagnosed GHD. Additionally, this study confirmed that a normal serum IGF-1 measurement cannot exclude the diagnosis of GHD in irradiated survivors. This illustrates the need for improvements in the diagnostic approach to GHD after reaching final height in childhood brain tumor survivors at risk of GHD. In summary, our study stresses the need for GHD testing in all adult survivors treated with cranial irradiation for a brain tumor in childhood irrespective of radiation modality.

Objective: To examine the prevalence, time trends, and risk factors of diabetic retinopathy (DR) among youth with type 1 diabetes (T1D) from 11 countries (Australia, Austria, Denmark, England, Germany, Italy, Luxemburg, Netherlands, Slovenia, United States, and Wales). Subjects and Methods: Data on individuals aged 10–21 years with T1D for >1 year during the period 2000–2020 were analyzed. We used a cross-sectional design using the most recent year of visit to investigate the time trend. For datasets with longitudinal data, we aggregated the variables per participant and observational year, using data of the most recent year to take the longest observation period into account. DR screening was performed through quality assured national screening programs. Multiple logistic regression models adjusted for the year of the eye examination, age, gender, minority status, and duration of T1D were used to evaluate clinical characteristics and the risk of DR. Results: Data from 156,090 individuals (47.1% female, median age 15.7 years, median duration of diabetes 5.2 years) were included. Overall, the unadjusted prevalence of any DR was 5.8%, varying from 0.0% (0/276) to 16.2% between countries. The probability of DR increased with longer disease duration (aORper-1-year-increase = 1.04, 95% CI: 1.03–1.04, p < 0.0001), and decreased over time (aORper-1-year-increase = 0.99, 95% CI: 0.98–1.00, p = 0.0093). Evaluating possible modifiable risk factors in the exploratory analysis, the probability of DR increased with higher HbA1c (aORper-1-mmol/mol-increase-in-HbA1c = 1.03, 95% CI: 1.03–1.03, p < 0.0001) and was higher among individuals with hypertension (aOR = 1.24, 95% CI: 1.11–1.38, p < 0.0001) and smokers (aOR = 1.30, 95% CI: 1.17–1.44, p < 0.0001). Conclusions: The prevalence of DR in this large cohort of youth with T1D varied among countries, increased with diabetes duration, decreased over time, and was associated with higher HbA1c, hypertension, and smoking.

It has long been understood that psychosocial issues are important to an understanding of diabetes among young people. The diagnosis and management of diabetes places a substantial burden on youths and their families. This burden may disrupt normal developmental processes, and can have a major impact on psychosocial adjustment and successful disease management. The multinational DAWN Study was a pioneering effort to identify psychosocial barriers to optimal health and quality of life of people with diabetes and new ways to overcome those barriers. The DAWN Study interviewed more than 5000 adults with diabetes and almost 4000 diabetes care professionals, but did not include children and young people with diabetes, their families, or their care providers because it was recognized that diabetes in young people presents different psychosocial issues and challenges than diabetes in adults, and that a separate study would be required to identify opportunities to improve outcomes among young people with diabetes and their families. This realization gave rise to theDAWNYouth WebTalk Study. The objectives of this study were to: • gain understanding of the challenges and issues facing young people with diabetes and those with responsibility for supporting them; • identify new avenues for improving the psychosocial management of diabetes among young people; • stimulate new efforts to improve care for young people with diabetes and their families. This paper presents an initial overview of the methods and findings of theDAWNYouthWebTalk Study and discusses some of the implications of those findings.

Growth monitoring is essential for the evaluation of health in children. Growth and final height have changed over time, the secular trend, and therefore updated growth curves are important. In this article the growth curves in use in Denmark are reviewed. In 2003 two different growth curves with older reference populations were used for growth evaluation after the neonatal period, and five different growth curves were in use for neonatal growth evaluation. To make growth evaluation more homogeneous we recommend one updated Scandinavian growth curve for child growth monitoring in Denmark. Udgivelsesdato: 2007-Apr-30

Udgivelsesdato: 2005-null Simkania negevensis is a recently discovered intracellular organism that has been associated with respiratory tract infections. To determine the seroprevalence of the organism in adult Danes and to study the association between the organism and persistent cough, we developed an immunofluorescence assay based on S. negevensis infected Hep2 cells for antibody determination and a real time PCR assay for direct detection of the organism. Among 100 healthy blood donors, 41 (41%) had IgG antibodies to S. negevensis (cut-off titre =1:16) and the antibody level increased with increasing age (correlation coefficient 0.124, p=0.037). 80 of 185 patients (43%) with chronic cough had IgG antibodies to S. negevensis which was no different from the 41% in the control population (Chi2=0.13, p=0.72). None of the patients or controls had any detectable IgA antibodies to S. negevensis. PCR was performed on nasopharyngeal aspirates from a subgroup of 176 patients with persistent cough and in none of these was S. negevensis DNA detected. We conclude that the seroprevalence of S. negevensis is high in Denmark and positively correlated with age. However, we were unable to show an association between S. negevensis and persistent cough.

Girls with diabetes mellitus (DM) (N = 21, age 11-17 years) completed measures of objective overeating episodes (OOE) and objective bulimic episodes (OBE) from the EDE-Q. Data regarding metabolic control (HbA1c) were obtained through a national diabetes register.41 % of the girls had one or more episodes of OOE, and 29 % had one or more episodes of OBE in the preceding month. Significant higher HbA1c were found among girls with than without episodes of OOE ( 9.1 versus 8.1, p = .033), and among girls with than without episodes of OBE ( 9.4 versus 8.1, p = .013).