Hormone In Children Research Articles

A study of plasma proteins (serum total protein, serum albumin), and thyroid function in children with protein-energy malnutrition

Background: The study's objective was to evaluate and compare total serum protein, serum albumin, and thyroid hormones in children with PEM (protein-energy malnutrition) and healthy controls. Methods: In this cross-sectional study, 100 children with PEM served as cases, while an equal number of age and gender-matched healthy children served as controls. 4 ml of venous blood were taken (3 ml in a plain vial and 1 ml in an EDTA vial) and immediately submitted for further investigation. SPSS software (version 25) was used to analyze the data. A p value of ≤0.05 was considered statistically significant. Results: PEM children have lower serum total protein, albumin level, total T3 (TT3), and total T4 (TT4) levels compared to healthy controls (p<0.0001). Mean TSH levels in cases and controls were nearly similar. There was no significant difference between serum TSH concentrations in PEM children and the controls. Grade I PEM had the highest mean total protein, serum albumin, T3, and T4 levels, followed by grades II, III, and IV. When mean total protein, serum albumin, T3, and T4 levels of each grade of PEM were compared to controls, mean total protein, serum albumin, T3, and T4 levels were substantially lower in each grade of PEM (p<0.0001). Conclusions: PEM children have low serum total protein and albumin levels. This is probably due to decreased oral intake of proteins and reduced biosynthesis. Serum TT3 and TT4 levels are lower in children with PEM than in healthy controls, which is most likely due to reduction in circulating plasma proteins.

Assessment of erythroferrone levels in children with chronic kidney disease on regular hemodialysis

Anemia is a common comorbidity in children with chronic kidney disease (CKD) and is associated with adverse outcomes. Erythroferrone (ERFE) is a hepcidin inhibitor whose synthesis is stimulated by erythropoietin, which increases iron absorption and mobilization. Aim of the study: to assess the levels of ERFE hormone in children with CKD on regular hemodialysis. This case–control study was carried out at Menoufia University Hospital and included 70 subjects: 38 healthy individuals (controls) and 32 children with CKD on regular dialysis (cases). The study was approved by the Faculty of Medicine Ethics Committee at Menoufia University. All children were subjected to full history taking, complete clinical examination, blood tests such as complete blood count, reticulocyte count, serum iron, ferritin, and total iron binding capacity, liver and renal function tests, and an immunoassay to measure human ERFE. There was a statistically significant difference in the levels of ERFE between the cases and controls (p < 0.001). There was a significant, strong correlation between the levels of hemoglobin and serum iron and the level of ERFE (r = –0.655, p < 0.001). There was no significant correlation between the administered dose of exogenous erythropoietin and the level of ERFE (p = 0.460). Serum ERFE levels in the children with CKD on regular hemodialysis were significantly higher than in the controls and were negatively correlated with hemoglobin and iron levels. There was no significant correlation between ERFE levels and both serum ferritin and total iron binding capacity levels.

The influence of Epstein–Barr-associated infection upon pituitary-thyroid system in children at different periods of the disease

BACKGROUND: The interest in infectious mononucleosis caused by the EpsteinBarr virus (EBV) is currently apparent. EpsteinBarr virus reaches tropism for reticular and lymphoid tissues, does not eliminate from the body and causes an immunopathological process in which the endocrine system develops. Thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating hormone determinations are the most widely used diagnostic tests to assess thyroid function.
 AIM: To study changes in T3, T4, thyroid-stimulating hormone in children of older sex and age at the height and convalescence of infectious mononucleosis, the period of EpsteinBarr virus.
 MATERIALS AND METHODS: Under the supervision of the child were 94 aged from 1 to 17 years, among them from 1 to 5 years 22%, from 5 to 10 years 39%, from 10 to 15 years 27%, from 15 to 17 years 12% , diagnosed with EpsteinBarr virus mononucleosis, moderate severity. The diagnosis was made on the basis of clinical, anamnestic and laboratory data. The studies leading to the diagnosis were carried out in the laboratory of the Saint Petersburg State Pediatric Medical University. In addition to routine settings (clinical minimum), detection of M- and G- antibodies to EpsteinBarr virus, detection of the genome in the blood by PCR, determination of the levels of T3, T4, thyroid-stimulating hormone by enzyme-linked immunosorbent assay in blood serum.
 RESULTS: Regular changes in T3 concentrations were registered in both girls and boys of all three age groups: the concentration of T3, T4 in the period of the peak of the disease was reduced compared to the period of convalescence. Significant changes in thyroid-stimulating hormone were registered in girls and boys of all three age groups: the concentration of thyroid-stimulating hormone during the peak of the disease slightly decreased compared to the period of convalescence in boys and increased compared to the period of convalescence in girls.
 CONCLUSIONS: The changes in the levels of T3, T4, thyroid-stimulating hormone in children during the peak of infectious mononucleosis depends on the severity of the disease, the presence and nature of complications.

Long-acting PEGylated growth hormone in children with idiopathic short stature

Long-acting PEGylated growth hormone in children with idiopathic short stature

Effect of concurrent resistance-aerobic training on inflammatory factors and growth hormones in children with type 1 diabetes: a randomized controlled clinical trial

BackgroundExercise training is a major factor in controlling type 1 diabetes mellitus (T1DM) in children. The present study aimed to assess the effect of concurrent resistance-aerobic training on selected inflammatory factors and hormones related to blood glucose homeostasis in children with T1DM.MethodsIn this randomized controlled clinical trial, 40 children (with the mean age of 11.11 ± 2.29 years) were randomly assigned to an experimental (N = 20) or control group (N = 20). They underwent a 16-week training program, composed of concurrent resistance-aerobic training performed intermittently for 60 min three times a week. Before and after training, blood samples were analyzed for glucose homeostasis, selected inflammatory factors, and growth factors. Data were analyzed by paired t-test and analysis of covariance (ANCOVA) in IBM SPSS version 22.ResultsThe exercise training intervention reduced fasting blood sugar index (P = 0.002) and glycosylated hemoglobin significantly (P = 0.003). The growth hormone levels were increased significantly only in the experimental group (P = 0.037), whereas no significant difference was noted in the insulin-like growth factor-1 (P = 0.712). It was also found that interleukin-1β and high-sensitivity C-reactive protein did not change in the experimental or control group as compared to the pretest (P > 0.05).ConclusionAs it was shown, it seems that concurrent resistance-aerobic training may improve blood glucose homeostasis and growth hormone. Therefore, these findings may suggest the benefit from exercise training of moderate intensity in children with T1DM. Besides, we recommend undertaking further clinical trials to determine if the exercise training was effective.Trial registrationThis study was registered in the Iranian Registry of Clinical Trials under the code IRCT20150531022498N30: https://en.irct.ir/trial/41031. Registered on July 26, 2019. All experiments on the participants were following the Declaration of Helsinki.

Retracted: Effect of Vitamin D Combined with Recombinant Human Growth Hormone in Children with Growth Hormone Deficiency.

[This retracts the article DOI: 10.1155/2022/7461958.].

Association of perfluoroalkyl and polyfluoroalkyl substances with sex hormones in children and adolescents 6–19 Years of age

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have raised concerns regarding sex hormones homeostasis disruption in critical windows including childhood and adolescence, but epidemiological evidence is limited. We aimed to explore the associations of total testosterone (TT), estradiol (E2), and sex hormone binding globulin (SHBG) in children and adolescents with PFAS in 921 participants 6–19 years of age from NHANES 2013 to 2016. Multiple linear regression models and Bayesian Kernel Machine Regression (BKMR) models stratified by sex-age and sex-puberty-status groups were performed to explore the associations of the associations of individual or mixture of PFAS with sex hormone levels, respectively. Inverse associations were observed between n-PFOA and SHBG in female adolescents when the exposure was modeled as continuous (β = −0.20, 95% CI −0.33, −0.07) or categorized variable (P for trend = 0.005). In children, inverse associations were observed by BKMR in 6–11-year-old girls of high concentration, and in boys of low concentration of the PFAS mixture with TT. A positive association of PFAS mixture with SHBG was observed in boys. PFOS and PFNA were identified as major contributors to the associations in girls and boys, respectively. Although the 95% credible intervals included the null in adolescents, suggestive negative associations of PFAS mixture with TT and SHBG levels in adolescents aged 12–19 years were found by BKMR. Results by sex-puberty status presented a similar pattern, where significantly inverse associations between PFAS mixture and E2 were observed in the pubertal. Our findings suggested the associations of either individual or mixture PFAS with decreased TT levels, and increased SHBG levels in U.S. children and adolescents, and with decreased E2 levels in pubertal individuals. The associations were evident in children.

Multiple exposures to heavy metals and changes in steroid hormones production in 4-year-old children.

Prenatal exposure to multiple heavy metals can interfere with early neurodevelopment, lead to changes in sex hormone concentrations in children, and affect female reproductive health. To date, the influence of prenatal exposure to heavy metals on the endocrine system of children in Chinese electronic waste (e-waste) recycling areas has not been elucidated. Four weeks after delivery, 10 mL of human milk was collected for analysis of three heavy metals (lead (Pb), cadmium (Cd), and mercury (Hg)) via inductively coupled plasma mass spectrometry (ICP-MS). Four serum steroid hormones, including progesterone, testosterone, androstenedione (A-dione), and dehydroepiandrosterone (DHEA), were analyzed in 4-year-old children (25 boys and 17 girls). A multiple linear regression (MLR) model was implemented to investigate the association between each individual metal and serum steroid hormone. The exposure-response relationships were explored by generalized additive models (GAMs). Additionally, a Bayesian kernel machine regression (BKMR) model was used to assess the effects of multiple heavy metal exposures on each steroid hormone. The MLR results show a significant positive association between a natural log unit increase in Hg and DHEA levels after adjusting for confounders (β = 65.50, 95% confidence interval (CI) = 4.37, 126.62). According to the GAM, the univariate exposure-response relationship of Hg on DHEA was almost linear. However, this association was attenuated based on the multiple metal MLR and BKMR results after accounting for multiple heavy metal exposures. Prenatal Hg exposure may affect sex hormones in children by affecting DHEA levels. Prenatal maternal exposure to Hg may have long-term effects on the next generation. Hence, regulatory measures to reduce Hg exposure and long-term monitoring of children's health in e-waste areas are needed.

Identifying elevated plasma free triiodothyronine levels: age-adapted reference intervals for pediatrics.

Elevated free T3 (FT3) is an important feature for the early diagnosis of several diseases among which Grave's disease or Allan-Hernon-Dudley syndrome. However, there is a lack of age-adapted reference intervals for plasma thyroid hormones in children. We conducted a study to define reference values of peripheral FT3 in children using a commonly used automated immunoassay. All thyroid function test (TFT) results from our lab collected during 9 months were extracted anonymously, and reference intervals establishment followed recommendations validated by International Federation of Clinical Chemistry (IFCC). We defined five reference intervals covering the whole pediatric period. Overall, 26.1% of peripheral FT3 measured in children with normal TSH are out of the adult reference range, and 22.2% are upper it leading to misinterpretation. In a 9-month old patient with severe neurodevelopmental disorders, a pathological elevated FT3 has been securely interpreted using the newly established interval. The study highlights the poor relevance of adult intervals in pediatric cares, as it confirms that plasmatic FT3 is higher during the whole pediatric period. This work reports useful age-adapted reference intervals for free T3 in pediatrics using a widely used electrochemiluminescent Immunoassay (ECLIA) kit.

Relation between serum β-endorpin, neuropeptide Y and thyroid hormone in children with anorexia.

The purpose of this study was to investigate whether serum β-endorpin and neuropeptide Y were associated with changes in levels of thyroid hormones in children suffering from anorexia. One hundred and five anorexic children admitted to Xianning City Central Hospital, China, from August 2019 to July 2021, were selected as case group, while 105 normal children were selected as normal control group. Serum β-endorpin and neuropeptide Y levels in the case group were lower than those in the normal control group (both p<0.001), and serum triiodothyronine and thyroxine levels were also lower (both p<0.001). Serum β-endorpin and neuropeptide Y levels in the case group were positively correlated with triiodothyronine and thyroxine. There is a reduced level of serum β-endorpin, neuropeptide Y, and thyroid hormones in anorexic children, and it is possible that they are connected and work together in regulating ingestion.

Long-acting PEGylated growth hormone in children with idiopathic short stature: time to reconsider our diagnostic and treatment policy?

Idiopathic short stature (ISS) is a diagnosis of exclusion, and therefore each child with short stature or slow growth referred to a paediatrician deserves a full medical history and physical examination, as well as radiological and laboratory screening tests. In patients with an increased likelihood of a genetic cause, genetic testing is indicated. Idiopathic short stature is an approved indication for recombinant human growth hormone (rhGH) in the USA but not in most other parts of the world. In a recent article published in this journal, Luo et al reported on the 1-year's results of a multicentre randomized controlled trial (n = 360) on the efficacy and safety of two dosages of long-acting PEGylated rhGH (PEG-rhGH, Jintrolong®) (0.1 or 0.2 mg/kg body weight per week, respectively) in children with ISS compared with an untreated control group. The growth response to the higher dosage was similar to reported data on daily rhGH. In this commentary, we discuss whether the recent data on genetic causes of short stature in children who initially were labelled ISS, and data on the long-term safety of daily rhGH, may influence the balance between risks and benefits of rhGH treatment in children with ISS. We further discuss the pharmacokinetic and -dynamic profile of PEG-rhGH and its potential consequences for long-term safety.

Independent and combined effects of exposure to organophosphate esters on thyroid hormones in children and adolescents.

Toxicological studies suggest that organophosphate esters (OPEs) may impair thyroid function. Epidemiological evidence, related to children and adolescents, has not been reported, and little is known about the combined effects of exposure to OPE mixtures. In this study, we collected information of 1156 children and adolescents (aged 6-18years, 48.4% males) from a cross-sectional study in Liuzhou, China, and measured the levels of 15 urinary OPE metabolites and 5 serum thyroid hormones. Multivariate linear regression and quantile g-computation (QGC) approach were used to examine the associations which adjusted for demographic and lifestyle characteristics. Few participants had levels of triiodothyronine (T3) and free thyroxine (FT4) outside age-specific pediatric ranges. QGC analyses showed that individuals in the second, third, and fourth quartiles (Q2-Q4) of exposure had 3.93% (2.14%, 5.75%), 8.01% (4.32%, 11.8%), and 12.3% (6.54%, 18.3%) higher T3 than those in the first quartile (Q1), with similar pattern for free triiodothyronine (FT3). Individuals in Q2 and Q3 had higher thyroid-stimulating hormone (TSH) than those in Q1, but no differences were observed in TSH between Q1-Q4. In contrast, compared to the lowest quartile, FT4 was lower for those in Q2 (- 1.54%; 95% CI: - 3.02%, -0.04%), Q3 (-3.07%; 95% CI: -5.95%, -0.09%), and Q4 (-4.56%; 95% CI: - 8.80%, - 0.13%). These associations were consistent with the results from multivariate linear regression. When stratified by sex, OPE exposure (individual or mixtures) was associated with increased T3 and FT3 in males and decreased FT4 in females. This study provides the first evidence to characterize the thyroid-disrupting effects of OPE exposure in children and adolescents.

Study of Erythroferone Hormone in Children with Beta Thalassemia Major

Study of Erythroferone Hormone in Children with Beta Thalassemia Major

Independent and combined associations of urinary arsenic exposure and serum sex steroid hormones among 6-19-year old children and adolescents in NHANES 2013–2016

Arsenic exposure may disrupt sex steroid hormones, causing endocrine disruption. However, human evidence is limited and inconsistent, especially for children and adolescents. To evaluate the independent and combined associations between arsenic exposure and serum sex steroid hormones in children and adolescents, we conducted a cross-sectional analysis of data from 1063 participants aged 6 to 19 years from the 2013–2016 National Health and Nutrition Examination Survey (NHANES). Three urine arsenic metabolites were examined, as well as three serum sex steroid hormones, estradiol (E2), total testosterone (TT), and sex hormone-binding globulin (SHBG). The ratio of TT to E2 (TT/E2) and the free androgen index (FAI) generated by TT/SHBG were also assessed. Linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were used to evaluate the associations of individual or arsenic metabolite combinations with sex steroid hormones by gender and age stratification. Positive associations were found between total arsenic and arsenic metabolites with TT, E2, and FAI. In contrast, negative associations were found between arsenic metabolites and SHBG. Furthermore, there was an interaction after gender-age stratification between DMA and SHBG in female adolescents. Notably, based on the WQS and BKMR model results, the combined association of arsenic and its metabolites was positively associated with TT, E2, and FAI and negatively associated with SHBG. Moreover, DMA and MMA dominated the highest weights among the arsenic metabolites. Overall, our results indicate that exposure to arsenic, either alone or in mixtures, may alter sex steroid hormone levels in children and adolescents.

Abstract 102

Treatment of short stature in children born small for gestational age (SGA) requires daily growth hormone (GH) injections that can be burdensome for patients and caregivers. Once-weekly somapacitan is a long-acting GH in phase 3 development for replacement therapy in children with GH deficiency. We report the 52-week results of the first phase 2, multinational, randomised, open-label, controlled, dose-finding trial (NCT03878446) investigating efficacy and safety of somapacitan as treatment for short stature in children born SGA compared with daily GH (Norditropin®, Novo Nordisk A/S). Sixty-two (62; 35.5% female) GH-treatment-naïve, prepubertal children received 0.16, 0.20 or 0.24 mg/kg/week subcutaneous (s.c.) somapacitan, or 0.035 or 0.067 mg/kg/day s.c. GH. All children were subsequently included in a long-term safety extension trial. At week 52, the observed mean height velocity (HV) was 8.5, 10.3 and 10.6 cm/year for 0.16 (n = 12), 0.20 (n = 13) and 0.24 mg/kg/week (n = 12) somapacitan, respectively, versus 9.4 and 11.2 cm/year for 0.035 (n = 11) and 0.067 mg/kg/day (n = 13) GH, respectively. The effect of the three somapacitan doses vs. GH on HV was not statistically significantly different. A similar pattern as seen for HV was observed for changes from baseline in height standard deviation score (SDS) and HV SDS. Dose-dependent increases in IGF-I SDS were observed with somapacitan and GH, and significant exposure-response relationships to HV were established for somapacitan. Among the somapacitan doses investigated, 0.24 mg/kg/week provided an IGF-I response most similar to that of 0.067 mg/kg/day GH. All somapacitan doses were well tolerated; no safety concerns were identified. Reported AEs were mild to moderate; most were evaluated as unlikely related to treatment by the investigator. The tolerability profile was favourable and consistent with that of GH. Low-titre non-neutralizing hGH anti-drug antibodies were detected in one child in the GH 0.067 mg/kg/day arm; none were detected in other treatment arms. One patient treated with somapacitan 0.20 mg/kg/week developed type 1 diabetes mellitus. This event was evaluated as not related to the treatment. Otherwise, there were no clinically relevant findings with respect to glucose metabolism. In conclusion, these data support that 0.24 mg/kg/week somapacitan appears most efficacious of the somapacitan doses investigated in short children born SGA after 52 weeks of treatment. Furthermore, the safety and tolerability profiles of this dose are similar to those of 0.067 mg/kg/day GH.

Effects of new antiseizure medication on bone metabolism and bone mineral density in children: A meta-analysis.

To explore the effect of new antiseizure medication on bone metabolism and bone mineral density in children. The Chinese and English databases (PubMed, EMBASE, Cochrane Library, CNKI, Wanfang and VIP) were systematically searched for observational studies evaluating the effects of new antiseizure medication on bone metabolism and bone mineral density in children with epilepsy. The effects of new antiseizure medication on serum calcium, phosphorus, alkaline phosphatase, bone alkaline phosphatase, parathyroid hormone, 25-hydroxyvitamin D and bone mineral density in children were systematically evaluated. After systematic retrieval and screening, 12 studies with high literature quality (including 629 epileptic children and 627 control subjects) were included in the systematic evaluation. Meta-analysis showed that new antiseizure medication decreased bone mineral density (MD: -0.05, 95%CI, -0.09, -0.02; P = 0.004). From different kinds of antiseizure medication, levetiracetam can reduce blood phosphorus concentration in children (MD: -0.04; 95%CI, -0.07, -0.01). Oxcarbazepine increased serum alkaline phosphatase in children (MD:17.98; 95%CI, 10.43,25.53; P < 0.00001), and the increase intensity was significantly higher than that of levetiracetam (MD: 7.66; 95%CI, 0.29, 15.02; P = 0.04). In addition, oxcarbazepine can cause a significant increase in parathyroid hormone in children (MD: 7.52; 95%CI, 3.37,11.66; P = 0.0004), and 25 - hydroxyvitamin D was reduced, and the difference was statistically significant (MD:-2.18; 95%CI, -3.23, -1.13; P = 0.00006). However, the effects of new antiseizure medication on serum calcium and bone alkaline phosphatase in children were not statistically significant. New antiseizure medication have different effects on bone metabolism and bone mineral density in children with epilepsy, and the effects of different types of new antiseizure medication are different.

ТАКСОНОМИЧЕСКАЯ ХАРАКТЕРИСТИКА МИКРОБИОТЫ ТОЛСТОГО КИШЕЧНИКА И ЕЕ ВЗАИМОСВЯЗЬ С ЭНДОКРИННОЙ СИСТЕМОЙ У ДЕТЕЙ И ПОДРОСТКОВ С ИЗБЫТОЧНОЙ МАССОЙ ТЕЛА И ОЖИРЕНИЕМ

Composition of the intestinal microbiota and its influence on human metabolism, including hormone synthesis, has been studied in many research works, but the data obtained as yet does not allow forming the general idea of microbiota composition in overweight and obese individuals. The purpose of the research was to determine the internal microbiota composition and its relationship with certain hormones in children against the background of weight gain. A single-stage single-center comparative study was carried out in parallel groups in Dec. 2018 - May 2021, which included 74 children, of which 38 (51.3%) boys and 36 (48.6%) girls, median age 12.1 [10.8; 14.6] years old, with overweight and constitutional-exogenous obesity (CEO) of different grades compared to 44 healthy children (26 (59.09%) boys and 18 (40.9%) girls, median age 13.1 [10.5; 13.8] years old). The anthropometric assessment included: measuring height with 1-millimeter accuracy; body weight with 100-gram accuracy (without shoes and outerwear on the scales). The calculation of BMI SDS and height SDS was carried out using the software developed by the WHO, “AnthroPlus,” for children aged 6 to 19 years old with the BMI SDS formula used as follows: (x-X)/SD, where x is the patient's BMI, X is the average BMI for a given age and gender, SD is the standard deviation of the BMI index for a given age and gender. The investigation of the intestinal microbiota using the DNA metagenomic sequencing of stool samples (sequencing the V4 region of 16S ribosomal RNA (rRNA) gene) was carried out using the QIAamp® PowerFecal® DNA Kit by QIAGEN in accordance with the manufacturer's instructions at the laboratory facilities of the “Knomics” microbiome research company (Skolkovo, Moscow, Russia). The levels of leptin, insulin, irisin, resistin, GLP-1 and GLP-2 were evaluated in blood serum by ELISA using the laboratory kits from the CLOUD-CLONE CORP. (CCC, USA) using the enzyme immunoassay reactions analyzer UNIPLAN (Russia). The information about the following taxonomic composition of the intestinal microbiota was obtained during the research: the level of Firmicutes demonstrated the absence of a statistically significant difference in the groups (p=0.645); the level of Actinobacteriota and Euryarchaeota was statistically significantly higher in group 1 (in overweight and obese children and adolescents) than in group 2 (p=0.002 and p=0.002, respectively); the level of Bacteroidota was statistically significantly lower in group 1 than in group 2 (p&lt; 0.001); statistically significantly lower level of certain hormones in group 1 compared to group 2 (glucagon (p=0.001), resistin (p=0.019), GLP-1 (p&lt;0.001), and GLP-2 (p&lt; 0.001)); statistically significantly higher concentration of insulin (p=0.001) and leptin (p=0.008). Statistically significantly higher levels of the following bacterial genus were revealed in microbiota in children from group 1 compared to the control group 2: Bifidobacterium (p=0.007); Agathobacter (p=0.002); Dorea (p=0.001); Blautia (p=0.016); Lachnoclostridium (p=0.012); Roseburia (p=0.012); Collinsella (p&lt;0.001); and Holdemanella (p=0.034), while statistically significantly lower levels of: Faecalibacterium (p&lt;0.001); Subdoligranulum (p&lt;0.001); Bacteroides_vulgatus (p=0.042); Bacteroides (p=0.001); Bacteroidesmassiliensis (p=0.002); Bacteroides_eggerthii, Alistipes (p&lt;0.001); and Parabacteroides_merdae (p=0.002). The data on the average multidirectional and insignificant correlations of microbiota composition and hormone levels in obese children compared to the children and adolescents from healthy group have been obtained as well, which requires further studying. The decrease in the strength of the relationship between specific representatives of the intestinal microbiota and the level of certain hormones in overweight and obese children obtained in this research is probably associated with an imbalance in the “microbiota-metabolism” axis.

Short-term efficacy and safety of a lower dose of polyethylene glycol recombinant human growth hormone in children with growth hormone deficiency: A randomized, dose-comparison study.

Objective: Polyethylene glycol recombinant human growth hormone (PEG-rhGH, Jintrolong®) is the first long-acting rhGH preparation that is approved to treat children with growth hormone deficiency (GHD) in China. Clinical experience with dose selections of PEG-rhGH is scarce. The present study compared the efficacy and safety of a lower dose to increase dosing regimens of PEG-rhGH treatment. Methods: A multicenter, randomized, open-label, dose-comparison clinical study was conducted to compare the improvements in the height standard deviation score (Ht SDS), height velocity (HV), insulin-like growth factor-1 (IGF-1) SDS, and safety profiles of children with GHD who are treated with 0.2 mg/kg/week of PEG-rhGH dose or 0.14 mg/kg/week for 26 weeks. Results: Ht SDS, HV, and IGF-1 SDS increased significantly after PEG-rhGH treatment in the two dose groups (p < 0.05). The improvements of Ht SDS, HV, and IGF-1 SDS were more significant in the high-dose group than in the low-dose group (p < 0.05). Ht SDS improvement in low-dose group was not non-inferiority to that in the high-dose group (p = 0.2987). The incidences of adverse events were comparable between the two groups. Conclusion: The improvements of Ht SDS, HV, and IGF-1 SDS were more significant in the high-dose group than in the low-dose group (p < 0.05). PEG-rhGH at the dose of 0.14 mg/kg/week was effective and safe for children with GHD. Clinical Trial Registration: clinicaltrials.gov, identifier NCT02908958.

Food preferences and thyroid hormones in children and adolescents with obesity.

BackgroundThyroid hormones profoundly affect energy metabolism but their interrelation with food preference, which might contribute to childhood obesity development, are much less understood. In this study, we investigated if thyroid hormone levels are associated with specific modulation of food preference and potentially linked to the level of obesity in children and adolescents.MethodsInterrelations between food preference and peripheral thyroid activity were examined in a population of 99 non-obese and 101 obese children and adolescents (12.8 ± 3.6 years of age, 111/89 F/M) randomly selected from the patients of the Obesity and Metabolic Disease Out-patient Research Unit at National Institute for Children's Diseases in Bratislava in a period between December 2017 and March 2020.ResultsChildren and adolescents with obesity had a lower preference for food rich in high sucrose and high-complex carbohydrates, while the preference for protein and fat-containing food and that for dietary fibers did not differ between obese and nonobese. In adolescents with obesity, free thyroxine (FT4) correlated positively with the preference for a high protein and high fat-rich diet, irrespective of the fatty acid unsaturation level. Moreover, FT4 correlated negatively with the preference for dietary fibers, which has been also exclusively found in obese adolescents. Individuals with obesity with higher FT4 levels had higher systemic levels of AST and ALT than the population with lower FT4. Multiple regression analysis with age, sex, BMI-SDS, and FT4 as covariates revealed that FT4 and male gender are the major predictors of variability in the preference for a diet high in protein, fat, and monounsaturated fatty acids. FT4 was the sole predictor of the preference for a diet containing saturated and polyunsaturated fatty acids as well as for a diet low in fiber.ConclusionThe link between free thyroxin levels and dietary preference for food rich in fat and protein is present exclusively in individuals with obesity. Higher serum FT4 was linked with elevated AST and ALT in children and adolescents with obesity, and FT4 was the best predictor for preference for food rich in fat and low in fiber. This may indicate that FT4 could contribute to the development of childhood obesity and its complications by modulating food preference.

Effect of Vitamin D Combined with Recombinant Human Growth Hormone in Children with Growth Hormone Deficiency.

Objective Growth hormone deficiency (GHD) refers to the complete or partial lack of pituitary growth hormone synthesis and secretion. This study is aimed at investigating the efficacy of vitamin D and recombinant human growth hormone (rhGH) in children with GHD. Methods A total of 100 children with GHD at our hospital were included between 1st January 2018 and 31st October 2020. The patients were divided into a study group (n = 70, received vitamin D combined with rhGH) and a control group (n = 30, received rhGH). The growth and development (bone age, growth rate, and height), bone metabolism (bone alkaline phosphatase (BAP), β-collagen degradation product (β-CTX), osteocalcin (OC), and amino-terminal propeptide type I procollagen (PINP)), insulin-like growth factor 1 (IGF-1), ghrelin, and adverse reactions in the two groups were measured before and 12 months after treatment. Results There were no significant differences in the bone age, growth rate, and height between the two groups before treatment. After 12 months of treatment, the bone age, growth rate, and height of the study group were significantly higher than those of the control group. After 12 months of treatment, the levels of serum BAP, PINP, and OC in the study group were significantly higher than those in the control group, while the levels of β-CTX in the study group were significantly lower than those in the control group. The serum IGF-1 level in the study group was significantly higher than that in the control group, while the ghrelin level in the study group was lower. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Combined rhGH and vitamin D treatment can promote growth and development, improve bone metabolism, and regulate IGF-1 and ghrelin levels.