ESPE Abstracts

Background: NKX2-2 gene mutation (reported in 3 cases worldwide) cause severe IUGR and neonatal diabetes. Beta-cells of the mice Nkx2-2 (−/−) model were recently shown to convert into cells producing the appetite-promoting peptide ghrelin. Classically, ghrelin secretion is stimulated during fast and suppressed by nutrients or glucose ingestion in all age groups. In obese children this ghrelin suppression reaches a minimum of 60% of base...

Introduction: The hypothalamic melanocortin-4 receptor (MC4R) pathway plays a vital role in energy balance. Genetic defects in the MC4R pathway may result in severe early onset obesity.Objective: The TEMPO registry (NCT03479437) aims to identify and enroll approximately 1000 participants with rare genetic forms of obesity that are potentially related to key genes, upstream or downstream, of the MC4R. In addition, the TEMPO registry will evaluate the burd...

Background: Childhood obesity is a major global and European public health problem. The need for community-targeted actions has long been recognized, however it has been prevented by the lack of monitoring and evaluation framework, and the methodological inability to objectively quantify the local community characteristics in a reasonable timeframe. Recent technological achievements in mobile and wearable electronics and Big Data infrastructures allow the engagement of Europea...

Background: The increasing incidence of obesity is a global public health challenge. Although energy imbalance is the major cause of obesity, evidence suggests that other risk factors such as exposure to endocrine-disrupting chemicals (EDCs) may contribute to the development of obesity. Early life exposure to obesogens may result in a higher risk of developing obesity. Among the chemicals suspected to have obesogenic effects, bisphenol A (BPA) and phthalates are under worldwid...

Introduction: Childhood obesity (CO) is an important risk factor for the development of many chronic metabolic diseases of the adult age, and one of the most important ones is glucose homeostasis. However, the parameters used to diagnose carbohydrate metabolism disorders in obese children are not always guiding early in detecting pathologies, and may be inadequate to predict the pathologies. For this reason new diagnostic methods are needed. For this purpose, in this ...

TN was seen in India aged 7 years by her GP, with concerns about tall stature and increase in belly fat. She had a family history of diabetes, high cholesterol and early deaths. Her mother has diabetes, a round face and prominent limb musculature with very little subcutaneous fat. TN was investigated by a paediatric endocrinologist in India. Tests showed high triglycerides and insulin levels at the upper level of normal for her age. She was put on a strict diet and exercise pr...

The homeostatic control of energy balance is tightly regulated. Appetite and energy expenditure regulation involves neurons in the hypothalamus as well as other brain regions, including the limbic system, amygdala and the brainstem. Hypothalamic obesity is a well-recognized consequence of lesions such as craniopharyngiomas and other tumors in the hypothalamic region. Less known is obesity related to tumors in other brain regions. The child presented at 14 years of age with fai...

Background and aims: The spread of obesity among children and adolescents is increasing significantly in the last decades. The World Health Organisation defined the disease as a global epidemic and the need of complex interventions worldwide is well recognised. Obesity is major risk factor for many chronic diseases, including diabetes, cardiovascular and lung diseases, orthopaedic and skin problems, and cancer. There are strong predictors that 50% of pre-pubertal and 50–7...

Background: Prader-Willi syndrome (PWS) is a complex, multisystem disorder and is the most frequent cause of syndromic obesity that arises from lack of expression of paternally inherited imprinted genes on chromosome 15q11-q13. Its major clinical features include neonatal hypotonia, short stature, developmental delay, behavioral abnormalities, hyperphagia, childhood onset obesity, hypothalamic hypogonadism, and characteristic appearance.Case history: We ...

Background: Obesity is a complex disease that have an impact of many organs and systems. Syndromic obesity, although rare separately, encompasses around 70 entities with different phenotypic expression, gene involvement and associated anomalies. There are many genes that can influence obesity, either monogenic or polygenic in basis. Children with syndromic obesity need additional testing in order to indentify a specific disorder. Metabolic set up and endocrinological disturban...

The majority of treated obese children fail the goals set in the medium-long term or do not show themselves up at the short term follow up. These results, which do not improve even with the proliferation of facilities aimed to the treatment of obesity and of its complications, pose serious questions on how to make the best use of scarce resources available by the National health system. We have visited, between 2013 and 2015, 378 seriously obese children (>2 DS from nation...

Clinical history and symptoms: XX, 9.37 years, was referred to our Clinic for obesity and psycho-motor delay. Family history: Fibromyalgic mother, two maternal cousins with psycho-motor delay, paternal uncle with epilepsy and intellectual disability. Born at term from caesarean section for placental detachment after physiological pregnancy (birth weight g 1900, SGA). In the first years of life she had psychomotor retardation, episodes of affective spasms, nocturnal enuresis, a...

Objective: Determination of changes in metabolic status and vitamin D concentrations in obese children.Methods: We examined 212 children in the University Hospital (Minsk) from 2016 to 2018 years. Their anthropometric parameters (height, weight, body mass index (BMI)) were determined. Blood levels of vitamin D, insulin, uric acid were determined. All children were divided into 2 groups: group 1 children with morbid obesity – 140 patients (90 boys(B)...

Objective: The aim of this study was to detect potential gene mutation of Methylmalonic acidemia (MAA) in a Chinese patient.Methods: Patient with clinical diagnosis and parents were analyzed in this study. The analysis included medical histories, clinical analysis, and genetic tests. A NGS panel include MUT,MMAA,MMAB,MMADHC and MCEE genes was identify the pathogenic mutation responsible for the MAA and verified by Sanger.Results: A...

The deficit of lysosomal acid lipase (LAL) is an infrequent (1: 40,000–300,000 prevalence), autosomal recessive, monogenic pathology. It can aggressively (Wolman’s disease): malabsorption and severe dyslipidemia with survival less than one year of life. The cholesterol ester storage disease (CESD) presents with dyslipidemia, liver disease and early cardiovascular disease.Goals: Descriptive study of the prevalence of LAL deficiency and carriers ...

Introduction: Hepatic steatosis(HS) is a frequent finding in obese children. Insulin resistance, hypertriglyceridemia and abdominal circumference (AC) are known risk factors, similar to Metabolic Syndrome (MS), but the precise pathophysyology remains unexplained.Objectives: To analyze the prevalence of HS as identified by ultrasound as well as acanthosis Nigricans (AN) in two groups of obese patients; with or without presence of MS; by studying anthropom...

Introduction: Obesity is the direct cause of a number of immediate problems during childhood. Recently, fat mass was described as a significant negative predictor of serum iron. Hepcidin is a hormone stimulated by an increase in plasma iron levels and iron deposits in tissues, and decreases iron release from macrophages and duodenal enterocytes into the plasma. This protein prevents excessive iron absorption and iron accumulation in tissues. Ferritin is the most commonly deplo...

Introduction: The term lipodystrophy describes a rare disease subdivided into a heterogenous group of even rarer subforms. The rarity of this disease makes research in this area extremely difficult and international co-operation is mandatory to accumulate data sets of sufficient size. The European Consortium of Lipodystrophy (ECLip) consisting of an association of European experts in the field of lipodystrophy has therefore decided to set up a registry for patients with lipody...

Acnathosis nigricans (AN) is known to be common dermatologic manifestation in obese children and adolescents. The aim of this study is to examine the association of AN and insulin resistance in obese children and adolescents. One hundred seventy-nine obese subjects aged 6-17 years who participated in the intervention study, Childhood and Adolescents Obesity via Activity and Nutrition (ICAAN) study, were enrolled in 2017-2017. AN was diagnosed by physician. Anthropomet...

Objective: To study the relationship between serum uric acid (SUA) and metabolic syndrome (MS) factors in simple obesity children.Methods: Data of 70 simple obesity children (50 boys and 20 girls, ages 10.50±3.44) and 30 age- and sex-matched children (17 boys and 13 girls, ages 9.96±2.48) with normal body mass index (BMI) were studied. Anthropometrics, SUA, lipid profiles, glucose and insulin concentration were determined. The differences of pa...

Introduction: Alstrom syndrome is an autosomal recessive genetic disorder with mutation in the ALMS 2p12-13 gene and its characteristic features are: pigmented retinopathy, deafness, growth deficiency, obesity, metabolic syndrome, diabetes, thyroid dysfunction, nephropathy and cardiomyopathy.Aim of the study: Evaluation of anthropometric parameters, thyroid function, carbohydrate metabolism and lipid profile in five patients with diagnosed Alstrom syndro...

Introduction: Several studies show the negative impact of low level of studies of parents on the dietary patterns and the degree of adiposity of their children. The objective of this study is to evaluate the relationship between the level of studies and compliance with the recommendations of healthy eating pyramid.Material and method: An anthropometric study was conducted in 895 Spanish children and adolescents (53% women), between 3 and 18 years old (10...

Introduction: Primary Pseudotumor cerebri (PPTC), also known as idiopathic intracranial hypertension, is clinically characterized by increased intracranial pressure in an alert and oriented patient, with no evidence of deformity or obstruction of the ventricular system on neuroimaging. Cerebrospinal fluid analysis is normal except for increased intracranial pressure at lumbar puncture, greater than the 90th percentile (28 cm of H2O) in the pediatric population. Papilledema may...

Context: Thyroid growth and insulin like growth factor-1 (IGF-1) change depending on pubertal status and body mass index (BMI). The previous studies have reported some inconsistent results on association between thyroid volume (TV) and IGF-1 in terms of puberty and obesity.Objective: The aim of present study is to investigate pubertal effect of on TV and IGF-1 in morbid obese children.Design: The study population consisted of 250 c...

Background: Accumulating evidence suggests that decreased 25-hydroxyvitamin [25(OH)D] concentrations are associated with components of the metabolic syndrome.Objective: The aim of our study was to investigate the effect of vitamin D supplementation on metabolic syndrome parameters in obese children and adolescents.Patients and methods: Two hundred thirty two (n=232) obese children and adolescents aged [mean ±S....

Background: This study aims to describe the predictive factors of severe obesity in children followed in French Guiana.Methods: In this observational study, the patients from the French Guianese Childhood Obesity Group database were prospectively included, after giving a statement of patient’s non opposition.Results: Our group classifications revealed that 36 of 150 (24%) participants were classified as being ...

Introduction: Obesity leads to the development of hypertension, cardiovascular diseases, disorders of carbohydrate metabolism, which are components of the metabolic syndrome. The nature of the changes of lipid homeostasis, leptin and adiponectin levels in relation to the severity of metabolic syndrome are not well understood.Materials and methods: 48 people with the metabolic syndrome (24, 16–18 years old and 24 young adults (19–22 years)) are ...

Background: Obesity is associated with metabolic abnormalities, which result in progression to insulin resistance and the metabolic syndrome. The underlying stimulus for these metabolic abnormalities in obesity is not clear, however, recent evidence suggests that systemic, low-level elevations of gut-derived endotoxin (lipopolysaccharide) may play a role in obesity-related metabolic abnormalities.Objective: To study the metabolic endotoxemia in obese chi...

Decreased resting metabolic rate (RMR) is a risk factor for the development and progression of obesity. Childhood obesity is accompanied by the development of metabolic disorders, which often persist in adults. The relationship between the rate of basal metabolism and development of childhood obesity complications is not well understood.Objective and hypotheses: Measure resting metabolic rate in obese children and assess the pronouncement of metabolic di...

Objective: Sedentary lifestyle obviously increases the risk of obesity. Reduced physical activity and increased screen-time seem to act as major determinants of the rapid increase of childhood obesity. Prevention of obesity is easier and more practical in comparison with treatment of obesity and its complications. Treatment of childhood obesity not only carries positive biopsychosocial consequences for the child but also serves as an important public health issue by preventing...

The prevalence of metabolic syndrome (MetS) in young population continues to rise. Obesity is a chronic inflammatory disorder in which leptin, adiponectin and C reactive protein (CRP) play an important role. This study aimed to determine whether these adipokines are significant markers in defining MetS in pediatric population and to assess the effect of hypocaloric diet and physical activity on serum concentrations of adiponectine, leptin, and high sensitivity CRP (hs-CRP).</p...

Introduction: Neck Circumference (NC) has been pointed out as an important indicator in the evaluation of overweight and may be useful to determine the level of obesity and metabolic alterations.Objective: To verify the relationship between the NC and the lipid profile in adolescents with overweight or obesity.Methods: A cross-sectional study with adolescents between 10 and 19 years old, of both sexes attended at the Endocrinology ...

Childhood obesity is the consequence of a complex interaction among several factors: environment, genetics, endocrine disorders, medications and other conditions. Genetic factors are described to be causal factors in up to 30–50% of overweight conditions. Although polygenetic obesity is by far the most commonly observed, several obesity related syndromes associated with single gene defects have been identified.Case presentation: A three year old gir...

Background: Obesity is one of the most common nutritional problems in developed countries. The prevalence of obesity is rapidly progressing in children. It is associated with serious health hazards in adolescence and especially in adulthood, like hypertension, coronary artery disease, diabetes mellitus, etc.Methods: A study was conducted including the pediatric patients presented to Indraprastha Apollo hospital with signs of insulin resistance. All patie...

Introduction: Childhood obesity constitutes one of the most serious public health concerns currently since its prevalence is increased rapidly worldwide and triggers raised morbidity and mortality in childhood and adulthood.Objective and hypotheses: The present study is a prospective cohort survey which aim is to find risk factors of children and their parents’ denial to compliant to the directions of a pediatric endocrinology medical office.<p ...

Introduction: The epidemic of childhood obesity has emerged as one of the most serious public health issues since this disease leads to multiple disorders in many systems of the human body and decreases the quality of life and the life expectancy. Plenty of studies have searched for risk factors which cause pediatric obesity and precocious markers of comorbidities which follow obesity.Objective and hypotheses: This study is a cross-sectional and retrospe...

Background: Translational research has provided evidence of autonomic nervous system (ANS) interactions with cytokines and gut hormones. In the gastrointestinal track, the crosstalk of the stimulated vagus nerve with immune cells enhances the cholinergic tone. In obesity, on the other hand, hyperinsulinemia and hyperleptinemia induce ANS activation.Aim: To synthesize literature results exploring links among the autonomic nervous system, gut hormones, imm...

Introduction: In the resource constrained setting of a general endocrine clinic, a brief counseling session was offered to all overweight children.Material: In the period 1996 – 2017, 2364 patients with obesity between the ages 5 and 18 years were seen. All gave consent for their data to be analysed. Patients with syndromic obesity or with a secondary cause for obesity were excluded.Methods: The caregiver, usually a parent was...

Background: Obesity is one of the most frequent chronic diseases in the world, however the true prevalence of obesity in the RF remains at the moment insufficiently studied.Aims: To study the age features of the prevalence obesity in boys in the Udmurt Republic - the region in European part of the Russian Federation with the children population of 335 000.Methods: 4795 boys aged 1–17 years were surveyed, among them 2368 (49.4%...

Introduction: About 20 thousands of new cases of obesity (Ob) are first registered in children and adolescents in Ukraine annually (morbidity 2.72/1000, prevalence 13.50/1000 of the corresponding population on 01.01.2016). Adolescent Ob shows catastrophic rise (prevalence 8.9/1000 in 2001 vs 28.3/1000 in 2015). Completely unclear the role of Ghr in the etiopathogenesis of obesity in adolescents.Methodology: A total of 39 obese children with HD (14 boys, ...

Background and Objective: Overweight/obese children may have unrecognized deficiency of several essential micronutrients owing to their faulty dietary habits. These may impair their physical and mental development. Deficiency of specific minerals and vitamins that co-factors in metabolic and signalling pathways, such as choline, zinc, magnesium, vitamins D and B12 may also predispose to insulin resistance, fatty liver and metabolic syndrome. This study was undertaken to assess...

Introduction: Obesity is one of common complications in achondroplasia (ACH) and hypochondroplasia (HCH). Obesity can be a risk factor for excessive load on joints or lower spines in aged, worsen sleep apnea and develop a metabolic syndrome. Thus, it is critical to maintain their proper weight from early childhood. ACH specific growth charts and BMI has been used to evaluate their overweight and obesity. Due to disproportional short stature, the assessment by BMI could lead an...

Introduction: Children with positive familiar history (FH) of cardiovascular disease (CVD), consist a subpopulation in higher risk for early life cardiovascular events. Obesity represents a major risk factor for coronary heart disease and premature death. Recently published studies integrate high levels of lipoprotein (a) (Lp(a)) into the group of cardiovascular risk factors. According to the Bogalusa study, increased levels of Lp(a) (>30 mg/dl) are associated with cardiov...

Introduction: Obesity in children and adolescents is a growing global health problem. Obese children and adolescents provide the pediatric healthcare professionals management challenge. Obesity with insulin resistance, dyslipidemia and elevated blood pressure constitute the metabolic syndrome and each of these is an independent risk factor for cardiovascular disease, diabetes mellitus, non-alcoholic fatty liver disease. Lifestyle modification is a primary and main milestone in...

Objective: Dental plaque removal is an important factor in preventing periodontal diseases and caries. Tooth brushing remains the most reliable method of controlling dental plaque. The purpose of this study was to compare the effectiveness of plaque control performed with a battery powered and manual toothbrushes in over-weight adolescents.Materials and methods: The twenty two adolesents with over-weight were attended in this study. These patients were d...