Annals of Pediatric Endocrinology & Metabolism最新文献

{"title":"Maternal calcium deficiency and offspring programming: mechanistic and translational insights.","authors":"Junji Takaya","doi":"10.6065/apem.2652056.028","DOIUrl":"https://doi.org/10.6065/apem.2652056.028","url":null,"abstract":"<p><p>Maternal calcium deficiency during pregnancy and lactation may predispose offspring to metabolic, skeletal, and cardiovascular disorders in the context of the Developmental Origins of Health and Disease (DOHaD) paradigm. Experimental evidence from rodent models under severe or extreme calcium restriction, particularly studies by Takaya and colleagues, indicates that such conditions can induce insulin resistance, impair bone metabolism, and produce sex-specific cardiometabolic phenotypes in offspring. These effects appear to involve impaired placental calcium transport, altered expression of plasma membrane Ca-ATPase (PMCA) isoforms, and changes in parathyroid hormone, vitamin D, and calcium-sensing receptor signaling, together with persistent epigenetic modifications in hepatic 11β-hydroxysteroid dehydrogenase type 1 (Hsd11b1) and related genes. In humans, however, active placental calcium transport and maternal homeostatic adaptations generally keep fetal calcium concentrations higher than maternal concentrations, and direct evidence that modest maternal calcium deficiency alone causes fetal hypocalcemia remains limited. Nonetheless, observational studies and supplementation trials in populations with low calcium intake, including Gambian cohorts and WHO-endorsed preeclampsia-prevention studies, support the importance of adequate maternal calcium, often together with vitamin D, for maternal health and possibly for offspring growth and blood pressure regulation. This mini-review synthesizes mechanistic, epidemiological, and micronutrient-DOHaD evidence to inform preventive and research strategies.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central Precocious Puberty in a Boy with Klinefelter Syndrome and Congenital Adrenal Hyperplasia.","authors":"Jae Hyuk Oh, Min Hyung Cho, Young Suk Shim, Hae Sang Lee","doi":"10.6065/apem.2652032.016","DOIUrl":"https://doi.org/10.6065/apem.2652032.016","url":null,"abstract":"","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of treatment responses across three etiologies of short stature.","authors":"Pinar Zeybek, Huseyin An Korkmaz, Nilufer Uyar, Asli Kantar, Betul Pehlivan Zorlu, Nida Dincel, Erkin Serdaroglu","doi":"10.6065/apem.2652068.034","DOIUrl":"https://doi.org/10.6065/apem.2652068.034","url":null,"abstract":"<p><strong>Purpose: </strong>While recombinant human growth hormone (rhGH) therapy improves growth velocity in pediatric patients with chronic kidney disease (CKD), a comparative analysis across different etiologies of short stature may further elucidate variations in the insulin-like growth factor (IGF) axis response.</p><p><strong>Methods: </strong>This prospective observational cohort study included 86 children with short stature (height SDS < -2): 15 with stage 3-5 CKD, 20 born small for gestational age (SGA), and 51 with idiopathic growth hormone deficiency (IGHD). All patients received rhGH therapy (0.05 mg/kg/day) for 12 months with standardized monitoring every 3 months. The primary outcomes were height velocity and height SDS.</p><p><strong>Results: </strong>All three groups exhibited significant improvements in height velocity after 12 months of rhGH therapy (CKD: 3.73 to 8.74 cm/year, p<0.001; SGA: 4.07 to 7.78 cm/year, p<0.001; IGHD: 3.55 to 8.06 cm/year, p<0.001). Group comparisons revealed no significant differences in height SDS gains (ANCOVA, p=0.700). CKD patients showed no significant change in insulin-like growth factor 1 (IGF-1) SDS (median change +1.83, p=0.173) despite significant improvements in growth, whereas the SGA (median change +2.24, p=0.002) and IGHD (median change +2.31, p<0.001) groups demonstrated significant increases in IGF-1 SDS. The between-group comparison of IGF-1 SDS change was not statistically significant (p=0.240). Changes in insulin-like growth factor binding protein 3 (IGFBP-3) SDS were statistically significant in the CKD group (median change +2.73, p=0.017), but not in the SGA group (median change +0.50, p=0.054) or the IGHD group (median change +0.45, p=0.180). The between-group comparison of IGFBP-3 SDS change was not statistically significant (p=0.362).</p><p><strong>Conclusion: </strong>This study reaffirms that recombinant human growth hormone (rhGH) therapy is an effective treatment for growth failure in pediatric patients with chronic kidney disease (CKD) and those born small for gestational age (SGA). The decoupling of total circulating insulin-like growth factor-1 (IGF-1) from growth outcomes in patients with CKD highlights the role of growth hormone (GH) resistance-driven primarily by reduced bioavailability of free IGF-1 rather than absolute total IGF-1 levels-and underscores that total circulating IGF-1 alone is an insufficient surrogate for treatment efficacy in this population. Growth parameters-height velocity and height SDS-should remain the primary endpoints for monitoring rhGH response in children with CKD.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Height growth trajectory in precocious puberty treated with gonadotropin-releasing hormone agonist.","authors":"Feixiang Zhou, Taowei Zhong, Simin He, Guiyan Yang, Xianglong Ding, Gang Tian, Shiting Xiang, Shan Tan, Shan Zhao, Yan Yan","doi":"10.6065/apem.2652074.037","DOIUrl":"https://doi.org/10.6065/apem.2652074.037","url":null,"abstract":"<p><strong>Purpose: </strong>Height growth is a critical prognostic indicator in children with precocious puberty receiving gonadotropin-releasing hormone agonist (GnRHa) treatment, yet it requires continuous monitoring and remains difficult to predict prospectively. We aimed to identify height growth trajectories in children with precocious puberty receiving GnRHa treatment and develop explainable prediction models using machine learning.</p><p><strong>Methods: </strong>This longitudinal study included 1,561 children with precocious puberty who received GnRHa treatment at a children's hospital in Hunan Province. Trajectory modeling was used to identify height growth patterns. Logistic regression analysis was used to assess the associations between baseline characteristics and height growth trajectories. Ten machine learning methods were used to construct prediction models.</p><p><strong>Results: </strong>Two distinct height growth trajectories were identified as declining (n=1,161) and rising (n=400). When the declining trajectory was used as the reference group, multivariable logistic regression analysis revealed that age (OR = 1.19, 95% CI: 1.02-1.39), estradiol >13.5 pg/mL (OR = 1.58, 95% CI: 1.15-2.17), basal follicle-stimulating hormone >2.75 mIU/mL (OR = 2.15, 95% CI: 1.57-2.95), recombinant human growth hormone (rhGH) treatment (OR = 5.10, 95% CI: 3.44-7.58), and other medications (OR = 1.55, 95% CI: 1.18-2.05) were independently associated with the rising trajectory. Among the machine learning models, the neural network demonstrated optimal predictive performance with AUCs of 0.764 (training set) and 0.762 (validation set).</p><p><strong>Conclusion: </strong>Our findings provide a predictive framework to help achieve a trajectory consistent with the expected height growth for children with precocious puberty during GnRHa treatment. The height growth trajectories constructed using height Z-scores in this study cannot be used to capture final adult height.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are intensive care settings essential in the management of diabetic ketoacidosis in children?","authors":"Fatma Akgul, Emel Ulusoy, Anıl Er, Fikriye Baki, Tarık Kırkgöz, İlker Günay, Behzat Özkan, Hurşit Apa","doi":"10.6065/apem.2652036.018","DOIUrl":"10.6065/apem.2652036.018","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes in children and is frequently managed in pediatric intensive care units (PICUs). This study aimed to evaluate the feasibility and safety of managing DKA in the pediatric emergency department (PED).</p><p><strong>Methods: </strong>A retrospective analysis was conducted of pediatric patients presenting with DKA between 2017 and 2024 at a tertiary care hospital. Patients were categorized according to DKA severity and evaluated for demographic characteristics, risk factors, clinical findings, laboratory parameters, complications, and outcomes. All patients were managed using a standardized institutional treatment protocol. Clinical characteristics of patients admitted to the PICU were compared with those managed in the PED.</p><p><strong>Results: </strong>A total of 169 patients were included (mean age, 10.3 ± 4.4 years). Most patients were managed in the PED until resolution of DKA (95.3%). Moderate and severe DKA accounted for 71% of cases. Complications occurred in 27 patients (15.9%). Although tachycardia, respiratory abnormalities, decreased Glasgow Coma Scale scores (≤14), and electrolyte abnormalities were more frequent among patients admitted to the PICU, most patients with these findings were successfully managed in the PED. Patients requiring PICU admission had significantly lower pH levels, lower bicarbonate concentrations, more frequent neurologic impairment, and a higher rate of electrolyte abnormalities.</p><p><strong>Conclusion: </strong>Most pediatric patients with DKA can be safely managed outside the PICU when standardized protocols and close clinical monitoring are implemented. A selective PICU admission strategy based on clinical indicators of deterioration may therefore help optimize the use of limited intensive care resources while maintaining patient safety.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of exclusive breastfeeding duration, body mass index trajectories, and cardiometabolic risk in preschool children.","authors":"Man-Chin Hua, Tsung-Chieh Yao, Ming-Han Tsai, Kuan-Wen Su, Sui-Ling Liao, Li-Chen Chen, Kuo-Wei Yeh, Jing-Long Huang","doi":"10.6065/apem.2652034.017","DOIUrl":"https://doi.org/10.6065/apem.2652034.017","url":null,"abstract":"<p><strong>Purpose: </strong>This prospective cohort study aimed to examine the associations among exclusive breastfeeding duration, body mass index (BMI) growth trajectories, and cardiometabolic risk in children at 5 years of age.</p><p><strong>Methods: </strong>Maternal pre-pregnancy BMI, infant feeding practices, and anthropometric measurements were prospectively collected at regular intervals. At 5 years of age, the children's cardiometabolic risk z-scores were calculated using five metabolic components. One-way analyses of variance and logistic regression analysis were performed to assess associations between exclusive breastfeeding duration, children's BMI trajectories, and metabolic variables, as well as to identify predictors of high cardiometabolic risk z-scores.</p><p><strong>Results: </strong>In total, 242 children with 5-year follow-up were included, of whom 35.1% had ≥1 metabolic risk factor. Longer exclusive breastfeeding duration was associated with slower increases in BMI z-scores from 0 to 5 years and lower body fat percentages at outcome assessments; however, these associations were no longer significant after adjustment for confounders. Logistic regression analyses showed that maternal pre-pregnancy overweight or obesity (adjusted OR = 3.12, P = 0.007) and greater BMI z-score gain between 1 and 3 years (adjusted OR = 1.90, P = 0.001) and 3-5 years of age (adjusted OR = 3.04, P < 0.001) were independent predictors of high cardiometabolic risk.</p><p><strong>Conclusion: </strong>Maternal pre-pregnancy overweight or obesity and greater BMI z-score gain after 1 year of age were associated with a higher cardiometabolic risk at 5 years. Evidence supporting the protective effect of longer exclusive breastfeeding on cardiometabolic risk in preschool-aged children is insufficient, and further studies are warranted.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of leptin, ghrelin, and nesfatin levels in growth hormone deficiency and idiopathic short stature before and after growth hormone therapy.","authors":"Hong-Je Cho, Eu-Seon Noh, Hye Young Jin, Il-Tae Hwang","doi":"10.6065/apem.2652020.010","DOIUrl":"https://doi.org/10.6065/apem.2652020.010","url":null,"abstract":"","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal analysis of catch-up growth pattern in low birth weight infants up to 5 years in a nationwide Korean cohort.","authors":"Nayoung Kim, In Wook Lee, Jinjoo Choi, Jahye Ahn, Hyuna Kim, Jinsoo Kim, Yun Jin Kim, Seung Yang, Hyun Ju Lee","doi":"10.6065/apem.2550516.258","DOIUrl":"https://doi.org/10.6065/apem.2550516.258","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate catch-up growth (CUG) patterns in low-birth-weight infants (LBW) and identify factors associated with growth trajectories from birth to 5 years, focusing on the relationship between early growth status groups (no early CUG for height only, weight only, or both height and weight, and the normal reference group) and subsequent growth outcomes.</p><p><strong>Methods: </strong>We conducted a longitudinal analysis of 15,235 infants with low birth weight using nationwide data from the South Korean National Health Insurance Service (NHIS). No early CUG was defined at 4-6 months as height or weight below the 10th percentile based on the 2017 Korean growth charts. Growth outcomes at 1, 2, 3, and 5 years were assessed using logistic and linear regression models. Analyses were adjusted for demographic and clinical factors, including socioeconomic status (SES) and feeding type.</p><p><strong>Results: </strong>Approximately 82% of infants achieved CUG in height by 6 months of corrected age. No early CUG in height and weight group had the lowest average birth weight, and inadequate CUG in height was most prevalent at one year of age, persisting across all periods and consistently showing the highest prevalence at five years of age. Height and weight z-scores at the first screening visit (4-6 months of corrected age) highlighted the greater influence of initial height on later height.</p><p><strong>Conclusion: </strong>This study highlights the importance of early-life conditions and interventions in shaping the growth trajectories of LBW infants, emphasizing the significance of height catch-up.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guidelines for congenital hypothyroidism in Korean children and adolescents: 2025.","authors":"Ji Hyun Kim, Aram Yang, Inhyuk Jung, Yonghee Hong, Eungu Kang, Jisun Park, Kyungchul Song, Junghwan Suh, Jungmin Ahn, Eun Byoul Lee, Hyejin Lee, Minji Lim, Soyoon Jung, Wonkyung Jo, Younglim Shin, Eun-Gyong Yoo, Young-Jun Rhie, Jin Ho Choi, Jieun Lee","doi":"10.6065/apem.2652002.001","DOIUrl":"https://doi.org/10.6065/apem.2652002.001","url":null,"abstract":"<p><p>Congenital hypothyroidism remains one of the most preventable causes of neurodevelopmental impairment. Population-based newborn screening has substantially improved outcomes; however, optimal practice requires appropriate timing of screening, special attention to high-risk subgroups, prompt initiation of levothyroxine, and structured long-term follow-up including re-evaluation for transient disease, transition to adult care, genetic evaluation, and monitoring of neurodevelopment and health-related quality of life. This review summarizes the 2025 Korean clinical practice guideline in 10 key questions and 28 recommendations, integrating international consensus recommendations and the latest domestic evidence across five domains: newborn screening, diagnostic evaluation, levothyroxine treatment, monitoring, and re-evaluation/transition with long-term follow-up.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the relationship between automated software-derived bone health index and dual-energy x-ray absorptiometry-measured bone mineral density in chinese children with chronic illness.","authors":"Joanna Yuet-Ling Tung, Pakanut Pitupan, Sarah Wing-Yiu Poon, Gloria Shir-Wey Pang, B T Kung, Joyce Chan, Elaine Kan","doi":"10.6065/apem.2550464.232","DOIUrl":"https://doi.org/10.6065/apem.2550464.232","url":null,"abstract":"<p><strong>Purpose: </strong>Children with chronic illness are vulnerable to compromised bone health. Dual-energy X-ray absorptiometry (DXA) is commonly used for assessment but has limitations related to body size adjustments and positioning, highlighting the need for accessible alternatives. This study evaluated the correlation between the Bone Health Index (BHI), derived from automated hand radiograph analysis, and areal bone mineral density (BMD) measured by DXA in Chinese children with chronic illness.</p><p><strong>Methods: </strong>In this retrospective study, Chinese children undergoing simultaneous DXA and hand radiography were included. Correlations between BHI metrics and DXA-derived BMD Z-scores were assessed.</p><p><strong>Results: </strong>A total of 327 patients were analyzed. Absolute BHI values showed negligible correlation with DXA-derived BMD at the lumbar spine (LS) (r = 0.10, p = 0.05) and total body less head (TBLH) (r = 0.00, p = 0.35). BHI standard deviation scores (SDS) exhibited moderate positive correlations with DXA BMD Z-scores (LS: r = 0.42, p <0.001; TBLH: r = 0.43, p <0.001). In steroid-treated patients, these correlations were weaker (LS: r = 0.30, p =0.007; TBLH: r = 0.30, p 0.001). Conversely, steroid-naïve patients exhibited stronger correlations (LS: r = 0.48, p<0.001; TBLH: r = 0.53, p<0.001).</p><p><strong>Conclusion: </strong>In steroid-treated patients, BHI SDS correlated weakly with DXA-derived BMD Z-scores, whereas steroid-naïve patients exhibited moderate correlations. This highlights that BHI and DXA BMD assess distinct bone properties that are differentially influenced by systemic treatment like glucocorticoids. Consequently, BHI should be regarded as a complementary tool rather than serving as a direct surrogate for DXA.</p>","PeriodicalId":44915,"journal":{"name":"Annals of Pediatric Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}