Pediatric Endocrinology, Diabetes and Metabolism最新文献

{"title":"The epidemic of childhood obesity and the COVID-19 pandemic: metabolic characteristics and effects of therapy.","authors":"Kalina Fabin-Czepiel, Agnieszka Zachorzuk, Karolina Pieczyńska-Chapuła, Aleksandra Pyziak-Skupień, Paweł Matusik, Przemysława Jarosz-Chobot, Grażyna Deja","doi":"10.5114/pedm.2026.161141","DOIUrl":"10.5114/pedm.2026.161141","url":null,"abstract":"<p><strong>Introduction: </strong>The&nbsp;aim of the study was to analyse whether children whose obesity occurred during the pandemic differed metabolically from children who were obese earlier and to assess the effect of one-year treatment following the end of pandemic restrictions.</p><p><strong>Material and methods: </strong>A prospective study of 55 children aged 10-18 years who were referred to the outpatient's clinic during the pandemic due to obesity was conducted. The following clinical data were analysed: time of obesity onset, body mass index (BMI) z-score, body mass composition, blood pressure, abdominal ultrasound, biochemical parameters of lipid and carbohydrate metabolism, aminotransferases and fetuin-A concentration. Participants received recommendations to improve their diet and increase physical activity (PA). After 3, 6 and 12 months, we assessed: BMI z-score, compliance with recommendations, and biochemical parameters.</p><p><strong>Results: </strong>No significant differences between pandemic obesity and non-pandemic obesity were observed at the beginning and after one year. Children who followed the dietary recommendations had a significantly lower BMI z-score after 3 months (median 2.08 vs. 1.89, p = 0.044). Children who reported increased PA (47.3%) also showed lower BMI z-scores after 6 (median 2.12 vs. 1.86, p = 0.53) and 12 months (median 2.12 vs. 1.78, p = 0.008). The beneficial effect of PA was demonstrated in lower levels of fetuin-A in children with increased PA after 6 months (median 480 vs. 395 mg/ml, p = 0.07).</p><p><strong>Conclusions: </strong>The \"obesity pandemic\" does not appear to be metabolically distinct from obesity that developed earlier and lasted longer. An increase in PA and compliance with dietary recommendations remain important elements of therapy, particularly in the context of metabolic complications. Fetuin-A may serve as a potential parameter for assessing compliance with PA recommendations and the rate of obesity progression.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 2","pages":"77-85"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of early menarche on adolescent health: a single-centre retrospective study.","authors":"Semra Bahar Akin, Ilker Tolga Özgen, Yaşar Cesur","doi":"10.5114/pedm.2026.163170","DOIUrl":"10.5114/pedm.2026.163170","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past century, the onset of puberty and age at menarche in girls has progressively occurred earlier. This study investigates the effects of early menarche on final height, psychological health, and gynaecological outcomes in adolescent girls.</p><p><strong>Material and methods: </strong>This retrospective study included 58 female patients who were diagnosed with early menarche at ages 9.5 to 10.75 years. Target height (TH) was calculated based on medical records from their initial clinic visit. Data on final adult height (FAH), TH, weight, menstrual patterns, dysmenorrhoea, abnormal bleeding, the time taken for menstrual regularisation, diagnosis of polycystic ovary syndrome (PCOS), and any psychiatric or psychological disorders requiring medication were collected via questionnaire. FAH was compared to TH.</p><p><strong>Results: </strong>The average TH of the patients was 159.27 ±4.52 cm, and FAH was 157.71 ±5.19 cm (p = 0.029). The TH standard deviation score (SDS) was 0.64 ±0.76, and the FAH SDS was 0.81 ±0.91 (p = 0.160). It was noted that 6 out of the 11 patients who experienced a reduction of more than -1 SDS in their height compared to the TH also had a chronic illness (especially asthma). Half of the girls reported experiencing dysmenorrhoea, and around 15% were diagnosed with PCOS. Psychological problems were found in 22.4% of the patients (n = 13), and 15.5% of the patients (n = 9) were receiving treatment for mental health conditions.</p><p><strong>Conclusions: </strong>Early menarche was associated with a higher prevalence of PCOS and psychiatric/psychological disorders, with a more pronounced adverse impact on final height among those with chronic illnesses.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"181-186"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucopolysaccharidosis type IIIC diagnosed at the age of 12 years: Why was the disease diagnosed so late?","authors":"Patryk Lipiński, Rafał Płoski, Agnieszka Ługowska","doi":"10.5114/pedm.2026.163913","DOIUrl":"10.5114/pedm.2026.163913","url":null,"abstract":"<p><p>Mucopolysaccharidoses (MPS) are a group of inherited metabolic diseases associated with impaired lysosomal degradation of glycosaminoglycans. The aim of this manuscript is to report a case of a patient with mucopolysaccharidosis type IIIC (MPS IIIC) diagnosed at 12 years of age - to raise awareness among pediatricians, pediatric neurologists, and endocrinologists about the possible misdiagnosis. The patient was initially diagnosed with autism spectrum disorder and hyperactivity with normal motor development. During follow-up, psychomotor regression with moderate intellectual disability was observed. The patient was referred for further metabolic work-up only after the results of molecular analysis suggesting MPS IIIC. The final diagnosis was established based on clinical, biochemical, and molecular analyses.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"234-236"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidative stress and insulin resistance in Libyan Down syndrome individuals: assessment and association compared to a healthy comparison group.","authors":"Amani Mohamed Tayeh, Osama Hussien El-Deeb, Mohamed Hamza Ahmeida","doi":"10.5114/pedm.2026.161190","DOIUrl":"10.5114/pedm.2026.161190","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with Down syndrome (DS) are at increased risk of metabolic disturbances, including oxidative stress (OS) and insulin resistance (IR). The relationship between OS and IR in this population remains unclear.</p><p><strong>Aim of the study: </strong>To assess OS and IR in Libyan individuals with DS and examine the influence of adiposity and age.</p><p><strong>Material and methods: </strong>Fifty individuals with DS (aged 5-25 years) and 58 age-, sex-, and body mass index-matched individuals (comparison group, CG) were included. Anthropometric measurements, fasting glucose, insulin, malondialdehyde (MDA), and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were assessed. Associations between MDA, HOMA-IR, and body composition were evaluated.</p><p><strong>Results: </strong>No significant correlation was found between MDA and HOMA-IR (r = 0.064, p = 0.661). No significant difference in HOMA-IR was observed between the DS group and the CG (p = 0.822), although 44% of DS subjects showed elevated HOMA-IR. In contrast, MDA levels were significantly higher in the DS group compared to the CG (p &lt; 0.001), but remained within the normal range.</p><p><strong>Conclusions: </strong>IR in DS appears to be mainly driven by adiposity rather than the syndrome itself, while OS is elevated but largely independent of IR.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 2","pages":"86-95"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium-chain acyl-CoA dehydrogenase deficiency in the neonatal period: a case report.","authors":"Aleksandra Wądołowska, Magdalena Alicja Suda-Całus, Ewa Matylda Gulczyńska","doi":"10.5114/pedm.2026.163264","DOIUrl":"10.5114/pedm.2026.163264","url":null,"abstract":"<p><p>Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is the most prevalent inherited disorder of fatty acid metabolism. The symptoms of MCADD typically present in infancy and may lead to adverse outcomes for the newborn, requiring urgent medical intervention. This study aimed to describe the pathogenetic mechanism, clinical presentation, diagnosis, and treatment through a case study of a newborn diagnosed with MCADD.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"219-222"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid ultrasonography versus scintigraphy for establishing a stepwise imaging approach in pediatric patients with thyroid dysgenesis in resource-limited settings.","authors":"Noha Arafa, Shimaa Atef, Nehad Kamal Hamed Elshwimy, Marwa Mohamed Mohamed Onsy, Samah Ahmed Hassanein","doi":"10.5114/pedm.2026.163205","DOIUrl":"10.5114/pedm.2026.163205","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid scintigraphy and ultrasonography are the two primary imaging modalities widely used for thyroid visualization in pediatric patients with congenital hypothyroidism (CH). These modalities provide complementary information. In resource-limited settings, adopting a stepwise approach for selecting the initial imaging modality is essential.</p><p><strong>Aim of the study: </strong>To compare the diagnostic performance of thyroid ultrasonography, thyroid scintigraphy, and combined modalities in categorizing the type of thyroid dysgenesis.</p><p><strong>Material and methods: </strong>This cross-sectional study included 56 patients with CH due to thyroid dysgenesis. 99mTc thyroid scintigraphy was performed in all patients at diagnosis. Participants underwent thyroid ultrasonographic examination.</p><p><strong>Results: </strong>Ultrasonography showed the highest sensitivity in diagnosing thyroid hypoplasia (75%) but lacked sensitivity in detecting ectopic thyroid. Thyroid scintigraphy sensitivity was highest for diagnosing ectopic glands and agenesis (100%) but less sensitive for hypoplasia (54.5%). Combining both imaging modalities demonstrated a sensitivity and accuracy of 100% across all types of dysgenesis.</p><p><strong>Conclusions: </strong>Combined thyroid scintigraphy and ultrasonography demonstrated superior diagnostic accuracy, enabling precise characterization of thyroid dysgenesis. If the combined approach is not feasible, initiating thyroid scintigraphy is recommended as the first-line imaging modality and neck ultrasonography serves as a complementary second line imaging technique.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"172-180"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of adipocyte dysfunction in pediatric obesity: a narrative review.","authors":"Isabela Sallati, Sanna Cristina Barbosa de Sousa, Giovanna Degasperi","doi":"10.5114/pedm.2026.161340","DOIUrl":"10.5114/pedm.2026.161340","url":null,"abstract":"<p><p>Obesity is a significant inflammatory disease that has become increasingly prevalent among children from different ethnic groups. Lifestyle choices, diet, and maternal obesity are key contributors to its development. This condition is associated with metabolic diseases, including cardiovascular disease and type 2 diabetes, due to chronic low-grade inflammation, even in children. Adipose tissue contributes to this inflammatory profile through increased infiltration of immune cells and the secretion of pro-inflammatory cytokines. In this narrative review, we summarize the current and limited understanding of adipose tissue development and expansion in children, as well as emerging evidence suggesting that maternal obesity may significantly influence the offspring's metabolic profile.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 2","pages":"121-128"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the gut microbiota in obesity-related metabolic diseases in the pediatric population.","authors":"Kamila Koszykowska, Artur Bossowski, Barbara Głowińska-Olszewska","doi":"10.5114/pedm.2026.162606","DOIUrl":"10.5114/pedm.2026.162606","url":null,"abstract":"<p><p>Childhood obesity is currently a major global health challenge affecting a growing proportion of pediatric patients. Increasing consumption of highly processed foods, excess calorie intake, and reduced physical activity are considered major contributing factors. In recent years, research has focused on other factors, one of which is the influence of gut microbiota composition. The purpose of our study was to summarize the current knowledge regarding the relationship between gut microbiota composition and metabolic diseases in the pediatric population. We searched the PubMed and Scopus databases, primarily for studies published between 2020 and 2026. The analysis showed that alterations in the composition of the gut microbiota have been reported in overweight or obese children with associated type 2 diabetes, type 1 diabetes, or hyperlipidemia. It was found that the composition of the gut microbiota also varies according to non-modifiable factors such as gender, age, and ethnicity. The limitations of the analyzed studies primarily include small research groups and the lack of consideration of coexisting diseases and other factors influencing the results. Despite these limitations, the evidence available indicates that the gut microbiota may contribute to the development and progression of obesity in children. Further research in this area is necessary to identify potential therapeutic approaches and preventive strategies targeting the gut microbiota and its composition in order to reduce the risk and progression of obesity in children.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 2","pages":"141-149"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of a higher hypoglycemic threshold in the insulin tolerance test for children with short stature.","authors":"Ach Taieb, Omrani Maissa, Ammar Asma, Nassim Ben Haj Slama, Aycha Ghachem, Halloul Imen, Saafi Wiem, ElFekih Hamza, Saad Ghada, Yosra Hasni","doi":"10.5114/pedm.2026.159674","DOIUrl":"10.5114/pedm.2026.159674","url":null,"abstract":"<p><p>The insulin tolerance test (ITT) is the most reliable method for diagnosing growth hormone deficiency (GHD). Our study aimed to determine a new glycemic threshold that allows for an adequate growth hormone (GH) response without increasing the risk of deleterious outcomes. This study was conducted retrospectively on children who were suspected of GHD. There were two groups of children: group 1 (G1) consisted of children who underwent an ITT and reached a hypoglycemic level of 2.2 mmol/l, and group 2 (G2) included those who did not reach biochemical hypoglycemia but exhibited clinical hypoglycemic symptoms, which led to cessation of the test. Our population consisted of 129 patients. The mean nadir blood glucose level was 1.798 ±0.25 mmol/l in G1, significantly lower than in G2, at 2.57 ±0.28 mmol/l (p < 10-3). GH in G1 reached a mean peak of 4.71 ±3.20 ng/ml, significantly lower than in G2 (8.56 ±5.99 ng/ml) (p = 0.01). Among G1, 86% of the patients presented a GHD, compared to 55.6% in G2. The proportion of somatotrophic deficiency was significantly higher in G1 compared to G2 (p = 0.01). Receiver operating characteristic curve analysis revealed a threshold of 2.44 mmol/l with a sensitivity of 90% and a specificity of 60% (area under the curve = 0.915; confidence interval 95% (0.87-0.96). Based on our findings, we recommend implementing this new threshold when hypoglycemic symptoms are present. This higher threshold offers several benefits, including reduced risk to patients, while maintaining accurate interpretation of the test with good sensitivity and specificity.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of physical activity, central adiposity, and fast-food consumption with 2-hour plasma glucose in adolescent girls at a boarding school in East Java.","authors":"Aditya Primadana, Adelia Lavenialita Hermanto, Rayi Kurnia Perwitasari, Yuni Hisbiyah, Nur Rochmah, Muhammad Faizi","doi":"10.5114/pedm.2026.159872","DOIUrl":"10.5114/pedm.2026.159872","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (T2DM) is increasingly reported among adolescents and is associated with modifiable factors such as central obesity, physical inactivity, and frequent intake of fast food. Boarding schools offer a structured environment to assess these behaviours.</p><p><strong>Aim of the study: </strong>To examine the correlation between physical activity, central adiposity, fast-food consumption, and 2-hour plasma glucose (2-hPG) in adolescent girls at a boarding school.</p><p><strong>Material and methods: </strong>A cross-sectional study was conducted among 127 adolescent girls in East Java. Physical activity was assessed using the Physical Activity Questionnaire for Adolescents. Adiposity was measured using body mass index (BMI) and waist circumference. Fast-food consumption frequency was recorded through a structured questionnaire. Blood glucose was measured using a 2-hPG test after oral glucose intake. Urine dipstick screening was also performed.</p><p><strong>Results: </strong>Most participants had normal BMI, though 11.8% were overweight or obese. In total, 12.6% showed impaired glucose tolerance (IGT, 2-hPG 140-199 mg/dl) and had significantly larger waist circumference (p = 0.03). Waist circumference showed a non-significant correlation with 2-hPG (r = 0.041; p = 0.643); also, BMI showed no significant association with 2-hPG (r = 0.032; p = 0.723). Significant correlations were found between physical activity and 2-hPG (r = 0.205; p = 0.021), and between fast-food intake and BMI (r = -0.208; p = 0.020), although fast-food intake was not associated with 2-hPG (r = 0.038; p = 0.674).</p><p><strong>Conclusions: </strong>Early indicators of T2DM risk were identified. Although most associations were modest, increased waist circumference and reduced physical activity were associated with IGT, supporting the need for school-based lifestyle interventions.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"165-171"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}