| 1. |
- West, Rachel, et al.
(author)
-
Newborn Screening TSH Values Less Than 15 mIU/L Are Not Associated With Long-term Hypothyroidism or Cognitive Impairment
- 2020
-
In: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 105:9, s. E3329-E3338
-
Journal article (peer-reviewed)abstract
- Background: It is unclear whether newborns with mild thyrotropin elevation (mTSHe) are at risk of neurocognitive impairment. We assessed whether mTSHe at birth persists during childhood and compared neurocognitive functioning to siblings.Methods: This study encompassed children born in the Auckland region (New Zealand) with a newborn screen TSH level of 8 to 14 mIU/L blood, age 6.9 to 12.6 years at assessment, and their siblings. Thyroid function tests (serum TSH and free thyroxine) and neurocognitive assessments were performed, including IQ via the Wechsler Intelligence Scale for Children, fourth edition.Results: Ninety-six mTSHe individuals were studied, including 67 children recruited with 75 sibling controls. Mean mTSHe newborn TSH level was 10.1 mIU/L blood and 2.4 mIU/L at assessment (range, 0.8-7.0 mIU/L, serum). Although higher newborn TSH levels in the mTSHe group correlated with lower full-scale IQ scores (r = 0.25; P =.040), they were not associated with the magnitude of the IQ difference within sibling pairs (P =.56). Cognitive scores were similar for mTSHe and controls (full-scale IQ 107 vs 109; P =.36), with a minor isolated difference in motor coordination scores.Conclusions: Our data do not suggest long-term negative effects of neonatal mild TSH elevation. TSH elevation below the screen threshold appears largely transient, and midchildhood neurocognitive performance of these children was similar to their siblings. We propose that associations between neonatal mild TSH elevation and IQ are due to familial confounders. We caution against the practice of reducing screening CH cutoffs to levels at which the diagnosis may not offer long- term benefit for those detected.
|
|
| 2. |
- Jin, Binghan, et al.
(author)
-
Abdominal Adiposity and Total Body Fat as Predictors of Cardiometabolic Health in Children and Adolescents With Obesity
- 2020
-
In: Frontiers in Endocrinology. - : FRONTIERS MEDIA SA. - 1664-2392. ; 11
-
Journal article (peer-reviewed)abstract
- Objective:We aimed to assess the role of adipose tissue distribution in cardiometabolic risk (in particular insulin sensitivity) in a population of children and adolescents with obesity. Methods:In this cross-sectional study, participants were 479 children and adolescents with obesity (322 boys and 157 girls) aged 3 to 18 years attending the Children's Hospital at Zhejiang University School of Medicine (Hangzhou, China). Clinical assessments included anthropometry, body composition (DXA scans), carotid artery ultrasounds, and OGTT. Insulin sensitivity was assessed using the Matsuda index. Participants were stratified into groups by sex and pubertal stage. Key predictors were DXA-derived android-to-gynoid-fat ratio (A/G) and total body fat percentage (TBF%). Results:Irrespective of sex and pubertal stage, there was a strong association between increasing A/G (i.e., greater abdominal adiposity) and lower insulin sensitivity. In multivariable models, every 0.1 increase in A/G was associated with a reduction in insulin sensitivity in prepubertal boys [-29% (95% CI -36%, -20%);p< 0.0001], pubertal boys [-13% (95% CI -21%, -6%);p= 0.001], and pubertal girls [-16% (95% CI -24%, -6%);p= 0.002]. In contrast, TBF% was not associated with insulin sensitivity when A/G was adjusted for, irrespective of pubertal stage or sex. In addition, every 0.1 increase in A/G was associated with increased likelihood of dyslipidemia in prepubertal boys [adjusted odds ratio (aOR) 1.62 (95% CI 1.05, 2.49)], impaired glucose tolerance in pubertal boys [aOR 1.64 (95% CI 1.07, 2.51)] and pubertal girls [aOR 1.81 (95% CI 1.10, 2.98)], and odds of NAFLD in both prepubertal [aOR 2.57 (95% CI 1.56, 4.21)] and pubertal [aOR 1.69 (95% CI 1.18, 2.40)] boys. In contrast, higher TBF% was only associated with higher fasting insulin and ALT in pubertal boys, being also predictive of NAFLD in this group [aOR 1.15 per percentage point (95% CI 1.06, 1.26)], but was not associated with the likelihood of other cardiometabolic outcomes assessed in any group. Conclusions:A/G is a much stronger independent predictor of cardiometabolic risk factors in children and adolescents with obesity in China, particularly glucose metabolism.
|
|
| 3. |
- Rerkasem, Kittipan, et al.
(author)
-
Lower insulin sensitivity in young adults born preterm in Thailand
- 2020
-
In: Pediatric Diabetes. - : WILEY. - 1399-543X .- 1399-5448. ; 21:2, s. 210-214
-
Journal article (peer-reviewed)abstract
- Background: Previous studies reported impaired glucose homeostasis among preterm survivors, but consisted almost exclusively of Caucasians. It is unknown whether Asians born preterm display similar impairments.Aim: To assess glucose homeostasis and other cardiometabolic outcomes among young adults born preterm in Thailand.Methods: Participants were 575 young adult offspring of mothers from the Chiang Mai Low Birth Weight Study, born in 1989 to 1990 and followed up in 2010: 54.1% females, median age 20.6 years, including 33 individuals (5.7%) born preterm. After an overnight fast, participants underwent clinical assessments, including blood sampling (glucose, insulin, and lipid profile). Insulin sensitivity was assessed using HOMA-IR and insulin secretion estimated using HOMA-beta.Results: In unadjusted analyses, young Thai adults born preterm were 3.2 cm shorter (P = .037), 6 kg lighter (P = .016), and had HOMA-beta 34% higher (P = .026) than those born at term. Adjusted analyses accounting for important confounders showed marked impairments in glucose homeostasis among preterm survivors: fasting insulin levels were 32% greater (P = .011), with HOMA-IR and HOMA-beta that were 31% (P = .020) and 43% higher (P = .005), respectively, compared to peers born at term. There were no other contrasting observations between groups, with anthropometric differences disappearing after adjustment for confounders.Discussion: Young adults in Thailand born preterm were more insulin resistant than peers born at term. The observed impairments in glucose metabolism among young Thai adults born preterm corroborate findings reported mostly on Caucasians. The challenge for general practitioners and public health professionals is to encourage those born preterm to make healthier lifestyle choices early on.
|
|
| 4. |
- Vesey, Renuka M., et al.
(author)
-
Safety, feasibility and efficacy of side-alternating vibration therapy on bone and muscle health in children and adolescents with musculoskeletal disorders : A pilot trial
- 2020
-
In: Journal of Paediatrics and Child Health. - : WILEY. - 1034-4810 .- 1440-1754. ; 56:8, s. 1257-1262
-
Journal article (peer-reviewed)abstract
- Aims A pilot study was performed to establish the safety, feasibility and efficacy of vibration therapy (VT) on bone and muscle health in children and adolescents with a range of musculoskeletal disorders. Methods Seventeen participants (15.7 years +/- 2.9 years), with conditions that impacted on their musculoskeletal health, completed 20 weeks of side-alternating VT for 9 min/session, 4 times/week at 20 Hz. Data were collected at baseline and after 20 weeks of intervention. Assessments included whole-body dual-energyX-ray absorptiometry, muscle function (force plate) and 6-min walk test. Results Compliance with the prescribed VT training protocol was relatively high overall at 78% and there were no adverse events reported. After 20 weeks intervention, functional assessments showed time taken to perform the chair test was reduced by 15% (P = 0.018), leg balance improved with standard ellipse area decreasing by 88% (P = 0.006) and distance walked in the 6-min walk test improved by 9% (P = 0.002). Participants displayed increased total body mass (1.94 kg; P = 0.018) with increased lean mass (1.20 kg; P = 0.019) but not fat mass (P = 0.19). There was no change in total body bone mineral density (P = 0.44) or bone mineral content (P = 0.07). Conclusions Twenty weeks of side-alternating VT was a feasible protocol that was associated with improvements in physical function and no detrimental effects on lean mass, bone mass or density in children and adolescents with musculoskeletal disorders.
|
|
