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Background/Aims: Length and weight of all children in Flanders are monitored every three years at school from the age of 3 years. The current criteria used for referral to specialized care are: height SDS < -2.5, height SDS between -2 and -2.5 SDS with a height SDS adjusted for parental height < -1.64, or a decrease in height SDS of more than 1 SDS in the past 3 years. The aim of this study is to investigate the sensitivity of the Flemish referral criteria to detect idiopathic/congenital growth hormone deficiency (GHD) and Turner syndrome (TS). Methods: A cross-sectional analysis of data from children with idiopathic/congenital GHD and girls with TS included in the BELGROW register – a national register of all GH treated children – from January 2018 through December 2020. Height at the start of GH treatment and 2-3 years before GH treatment and parental heights (reported or measured) were retrieved from the database. Height SDS adjusted for parental height was calculated according to Hermanussen & Cole. The referral analysis only included prepubertal children below 10 years of age. Results: In the 112 children with GHD (78 male), GH treatment was started at a median age of 8.86 years (P10, P90: 2.86, 13.11) and a median height SDS of -2.99 (-4, -1.77). In the 43 girls with Turner syndrome this was 9.63 years (5.42, 14.44) and a height SDS of -2.79 (-3.77, -1.83). In the 97 children younger than 10 years of age, a height SDS < -2.5 was reported in 56 (76 %) out of 74 children with GHD and in 14 (61 %) out of 23 girls with TS. The SDS adjusted for parental height was < -1.64 in 60 (81 %) and 18 (78 %) respectively. In children older than 3 years with data on pre-treatment height, 5 (10 %) out of 49 with GHD and 1 (6 %) out of 17 with TS had a height decrease > 1 SDS before the start of GH treatment. Conclusion: In Belgium, GH treatment is started relatively late in children with congenital/idiopathic growth hormone deficiency and Turner syndrome, despite systematic growth monitoring at school. Height SDS adjusted for parental height was the most sensitive criterium for auxological detection of growth hormone deficiency and Turner syndrome, stressing the need of collection of parental height in school health surveys

P1-473Background/ Aims: Hyperuricemia (HU) is a frequent findingin childhood obesity, ranging between 12 and 40%, and associatesto a variable extent with different components of the metabolicsyndrome (MS). In this study, the effect of gender, (a Belgiannative vs a non-Belgian native) descent and degree of general andcentral adiposity on serum uric acid (SUA) and the prevalence ofHU was investigated in a multi-ethnic population of overweight/obese children and adolescents living in/around Brussels, using anage and sex-specific SUA reference ranges.Methods: Fasting morning serum concentrations of uric acid,glucose, insulin, total cholesterol, HDL cholesterol and triglycerides were measured in 388 overweight (BMI 1.3 – 2 SDS)/obese(BMI SDS > 2) children and adolescents, entering an ambulatoryweight loss program. Routine anthropometry and blood pressuremeasurements were performed. SUA was measured by enzymaticcolorimetry. HU was defined by a SUA above the assay specific andage and gender defined reference range. MS was defined by the IDFcriteria. Insulin resistance was defined by a HOMA-IR >2.16 forprepubertal children and >3.6 for pubertal children.Results: Their median age was 10.45 years (range 6-16). Intotal, 219/388 (56.4%) were females, 67/388 (17.2%) were pubertalor postpubertal, 65/388 (16.8%) subjects had MS, while insulinresistance was present in 258/388 (66.5%) subjects. Median SUAwas 4.8 mg/dL and ranged between 0.5-9.5 mg/dL, with 80 (20.6%) children and adolescents showing an elevated SUA. Degree ofgeneral obesity (BMI Z-score) and central adiposity (waist SDS), pubertal status (prepubertal, pubertal and postpubertal), gender,descent (Belgian native and non-Belgian native origin), as well asthe presence of MS and insulin resistance were not significantlydifferent between those with and without hyperuricemia. Medianwaist-to-height ratio, serum triglycerides and insulin resistancewere significantly (respectively P=0.011, P=0.006, P=0.008) higherin Turkish children/adolescents compared to Moroccan and children of other (mainly Belgian native) descent.Conclusion: Hyperuricemia was present in one fifth of innercity living overweight/obese children, irrespective of age ethnicbackground and severity of global or central obesity. No significantassociation between HU and metabolic syndrome or its differentcomponents was found. Future studies should focus on investigating the association with diet composition, obesity duration anddegree of sedentary lifestyle and the eventual risk for cardiovascular complications.

OBJECTIVE To evaluate whether indexes of glycemic variability may overcome residual β-cell secretion estimates in the longitudinal evaluation of partial remission in a cohort of pediatric patients with new-onset type 1 diabetes. RESEARCH DESIGN AND METHODS Values of residual β-cell secretion estimates, clinical parameters (e.g., HbA1c or insulin daily dose), and continuous glucose monitoring (CGM) from 78 pediatric patients with new-onset type 1 diabetes were longitudinally collected during 1 year and cross-sectionally compared. Circadian patterns of CGM metrics were characterized and correlated to remission status using an adjusted mixed-effects model. Patients were clustered based on 46 CGM metrics and clinical parameters and compared using nonparametric ANOVA. RESULTS Study participants had a mean (± SD) age of 10.4 (± 3.6) years at diabetes onset, and 65% underwent partial remission at 3 months. β-Cell residual secretion estimates demonstrated weak-to-moderate correlations with clinical parameters and CGM metrics (r2 = 0.05–0.25; P < 0.05). However, CGM metrics strongly correlated with clinical parameters (r2 >0.52; P < 0.05) and were sufficient to distinguish remitters from nonremitters. Also, CGM metrics from remitters displayed specific early morning circadian patterns characterized by increased glycemic stability across days (within 63–140 mg/dL range) and decreased rate of grade II hypoglycemia (P < 0.0001) compared with nonremitters. Thorough CGM analysis allowed the identification of four novel glucotypes (P < 0.001) that segregate patients into subgroups and mirror the evolution of remission after diabetes onset. CONCLUSIONS In our pediatric cohort, combination of CGM metrics and clinical parameters unraveled key clinical milestones of glucose homeostasis and remission status during the first year of type 1 diabetes.

ACHTERGROND Veranderde cytokineconcentraties bij personen met een bipolaire stoornis ten opzichte van controlepersonen suggereren een rol van het immuunsysteem in de pathofysiologie van bipolaire stoornis. Farmacotherapie is een belangrijke verstorende factor in klinisch onderzoek naar cytokineconcentraties. DOEL Evalueren van cytokineconcentraties bij medicatievrije patiënten met een bipolaire stoornis en van het effect van stemmingsstabiliserende geneesmiddelen op deze concentraties. METHODE We doorzochten systematisch PubMed en Embase naar klinische studies die cytokineconcentraties bij medicatievrije patiënten met een bipolaire stoornis beschrijven of het effect van een individueel stemmingsstabiliserend geneesmiddel op deze concentraties evalueren. RESULTATEN Van de 564 gescreende artikelen werden er 17 geïncludeerd. Resultaten bij medicatievrije patiënten toonden stemmingsgerelateerde cytokineveranderingen. Hoewel geen data over de kortetermijneffecten van lithium beschikbaar waren, was lithiumgebruik langer dan 2 maanden geassocieerd met normale cytokineconcentraties. Twee studies rapporteerden geen effect van valproïnezuur. We vonden geen studies over carbamazepine, lamotrigine of antipsychotica. CONCLUSIE Dit systematisch literatuuroverzicht toont stemmingsgerelateerde cytokineveranderingen bij medicatievrije patiënten met een bipolaire stoornis met de meeste evidentie voor een proinflammatoire immuunrespons tijdens manie. Euthymie en langdurig lithiumgebruik zijn geassocieerd met normale cytokineconcentraties. Er is een belangrijke methodologische heterogeniteit en onvoldoende replicatie tussen studies. Longitudinale studies met medicatievrije beginmetingen, gerandomiseerde monotherapeutische behandelprotocollen en nauwkeurige monitoring van stemming zijn noodzakelijk.