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Lin Z, Sui X, Li L, Wang Y, Zhao J. The effect of metformin on low birth weight girls with precocious puberty: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29765. [PMID: 35776991 PMCID: PMC9239663 DOI: 10.1097/md.0000000000029765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In recent years, the role of metformin in girls with precocious puberty (PP) has been increasingly frequently studied. The objective of this present study is to assess the effect of metformin on low birth weight girls with precocious puberty (LBW-PP girls). METHODS We search the confirmed studies about circulating metformin and PP from the databases of EMBASE, PubMed, and Web of Science. Data were reported as weighted mean difference (WMD) and associated 95% confidence intervals (CIs). Analysis was performed by Review Manager 5.3 and Stata version 12.0. RESULTS A total of 205 cases (metformin group n = 102, untreated group n = 103) were included in this study. The meta-analysis of randomized controlled trials (RCTs) suggested that metformin had statistically significant effects on testosterone (P = .001), androstenedione (P = .022), bone mineral density (BMD; P = .151), triglycerides (P ≤ .001), body mass index Z score (BMI Z score; P ≤ .001), dehydroepiandrosterone-sulfate (DHEAS; P = .053), sex hormone-binding globulin (SHBG; P = .049), high-density lipoprotein (HDL) cholesterol (P ≤ .001), low-density lipoprotein (LDL) cholesterol (P = .021), fat mass (P ≤ .001), lean mass (P = .025), and fasting insulin (P = .002). CONCLUSION This meta-analysis provided evidence of the efficacy of metformin in girls with LBW-PP girls, which proved that metformin could improve metabolism and reduce weight. Metformin had a positive effect on preventing LBW-PP girls from developing into obesity and polycystic ovarian syndrome. In addition, this meta-analysis provided important reference opinions and directions for the treatment of LBW-PP girls.
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Affiliation(s)
- Zhiheng Lin
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiaohui Sui
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Lijuan Li
- Changchun University of Science and Technology, Changchun, Jilin, China
| | - Ying Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Junde Zhao
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- * Correspondence: Junde Zhao, Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, Shandong, China (e-mail: )
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Martín-Calvo N, Goni L, Tur JA, Martínez JA. Low birth weight and small for gestational age are associated with complications of childhood and adolescence obesity: Systematic review and meta-analysis. Obes Rev 2022; 23 Suppl 1:e13380. [PMID: 34786817 DOI: 10.1111/obr.13380] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 12/19/2022]
Abstract
In recent decades, the incidence of type 2 diabetes (T2D) has increased dramatically in children and adolescents, posing a real public health problem. Beyond unhealthy diets and sedentary lifestyles, growing evidence suggests that some perinatal factors, such as low birth weight (LBW), are associated with higher risk of T2D in adulthood. In this regard, it remains unclear whether the increased risk is already present in childhood and adolescence. We conducted a systematic review and meta-analysis to clarify the association of LBW or being small for gestational age (SGA) with insulin resistance in childhood and adolescence. The systematic review resulted in 28 individual studies, and those with the same outcome were included within two random-effects meta-analyses. Compared with children or adolescents born with adequate size for gestational age, those SGA had 2.33-fold higher risk of T2D (95% confidence interval [CI]: 1.05-5.17). Furthermore, LBW and being SGA were associated with 0.20 higher mean homeostasis model assessment of insulin resistance (HOMA-IR) values (95% CI: 0.02-0.38). Given the high prevalence of preterm babies, from a population perspective, these results may be of great importance as they point to the existence of a potentially vulnerable subgroup of children and adolescents that could benefit from screening tests and early preventive strategies.
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Affiliation(s)
- Nerea Martín-Calvo
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Leticia Goni
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Josep A Tur
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS & IDISBA, Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBEROBN (Physiopathology of Obesity and Nutrition), Madrid, Spain.,Cardiometabolics Precision Nutrition Program, IMDEA Food, CEI UAM-CSIC, Madrid, Spain.,Center for Nutrition Research, University of Navarra, Pamplona, Spain
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Ma D, Chen Z, Wang Y, Yu X, Xin Q, Chen Y. Effects of rapid growth on fasting insulin and insulin resistance: a system review and meta-analysis. Eur J Clin Nutr 2020; 75:1193-1204. [PMID: 33328601 DOI: 10.1038/s41430-020-00831-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/31/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022]
Abstract
Infants with congenital deficiency have high risk of glucose metabolism disorder, and often experience rapid growth in early childhood. However, the role of rapid growth on glucose metabolism is controversial. We conducted a systematic review and meta-analysis to examine the association of rapid growth with fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). We searched EMBASE and Medline for English articles, and CNKI and WANFANG database for Chinese articles. Studies measuring the associations between rapid growth and insulin or HOMA-IR were included. Relevant information was extracted independently by two reviewers. Random effects model was adopted for combined and stratified analyses. At last, twenty-two relevant studies for insulin and 20 for HOMA-IR were identified. Rapid growth was associated with high insulin (weighted mean differences [WMD] 5.544, 95% confidence interval [CI] [1.436, 9.653], P = 0.008) and high HOMA-IR (WMD 0.194, 95% CI [0.098, 0.290], P < 0.001). This elevated association was statistically significant in rapid growth subjects that were >6 years old, full-term, and from developed countries. However, rapid growth among low birth weight subjects did not lead to high insulin and HOMA-IR, but decreased HOMA-IR among preterm children (WMD -0.305, 95% CI [-0.607, -0.004], P = 0.047). Follow-up age was positively correlated with HOMA-IR (r = 0.095, P < 0.001). This meta-analysis suggested that rapid growth would result in high insulin and HOMA-IR, especially for full-term infants. However, rapid growth is relatively harmless for subjects who are <6 years old, low birth weight or SGA, and is even protective for preterm subjects.
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Affiliation(s)
- Defu Ma
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zekun Chen
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ying Wang
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xue Yu
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Qinghua Xin
- Academy of Occupational Health and Occupational Medicine, Shandong, China
| | - Yunli Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Schulte S, Schreiner F, Plamper M, Kasner C, Gruenewald M, Bartmann P, Fimmers R, Hartmann MF, Wudy SA, Stoffel-Wagner B, Woelfle J, Gohlke B. Influence of Prenatal Environment on Androgen Steroid Metabolism In Monozygotic Twins With Birthweight Differences. J Clin Endocrinol Metab 2020; 105:5876852. [PMID: 32717093 DOI: 10.1210/clinem/dgaa480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/21/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Although low birthweight (bw) and unfavorable intrauterine conditions have been associated with metabolic sequelae in later life, little is known about their impact on steroid metabolism. We studied genetically identical twins with intra-twin bw-differences from birth to adolescence to analyze the long-term impact of bw on steroid metabolism. METHODS 68 monozygotic twin pairs with a bw-difference of <1 standard deviation score (SDS; concordant; n = 41) and ≥1 SDS (discordant; n = 27) were recruited. At 14.9 years (mean age), morning urine samples were collected and analyzed with gas chromatography-mass-spectrometry. RESULTS No significant differences were detected in the concordant group. In contrast, in the smaller twins of the discordant group, we found significantly higher concentrations not only of the dehydroepiandrosterone sulfate (DHEAS) metabolite 16α-OH-DHEA (P = 0.001, 656.11 vs 465.82 µg/g creatinine) but also of cumulative dehydroepiandrosterone and downstream metabolites (P = 0.001, 1650.22 vs 1131.92 µg/g creatinine). Relative adrenal (P = 0.002, 0.25 vs 0.18) and overall androgen production (P = 0.001, 0.79 vs 0.65) were significantly higher in the formerly smaller discordant twins. All twin pairs exhibited significant intra-twin correlations for all individual steroid metabolites, sums of metabolites, indicators of androgen production, and enzyme activities. Multiple regression analyses of the smaller twins showed that individual steroid concentrations of the larger co-twin were the strongest influencing factor among nearly all parameters analyzed. CONCLUSION In monozygotic twin pairs with greater intra-twin bw-differences (≥1 SDS), we found that bw had a long-lasting impact on steroid metabolism, with significant differences regarding DHEAS metabolites and relative androgen production. However, most parameters showed significant intra-twin correlations, suggesting a consistent interrelationship between prenatal environment, genetic background, and steroid metabolism.
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Affiliation(s)
- Sandra Schulte
- Children's University Hospital Bonn, Department of Paediatric Endocrinology and Diabetology, Bonn, Germany
| | - Felix Schreiner
- Children's University Hospital Bonn, Department of Paediatric Endocrinology and Diabetology, Bonn, Germany
| | - Michaela Plamper
- Children's University Hospital Bonn, Department of Paediatric Endocrinology and Diabetology, Bonn, Germany
| | - Charlotte Kasner
- Children's University Hospital Bonn, Department of Paediatric Endocrinology and Diabetology, Bonn, Germany
| | - Mathias Gruenewald
- Children's University Hospital Bonn, Department of Paediatric Endocrinology and Diabetology, Bonn, Germany
| | - Peter Bartmann
- Children's University Hospital Bonn, Department of Neonatology, Bonn, Germany
| | - Rolf Fimmers
- University Hospital Bonn, Institute of Medical Biometry, Informatics and Epidemiology (IMBIE),, Bonn, Germany
| | - Michaela F Hartmann
- Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Division of Paediatric Endocrinology and Diabetology, Steroid Research and Mass Spectrometry Unit, Giessen, Germany
| | - Stefan A Wudy
- Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Division of Paediatric Endocrinology and Diabetology, Steroid Research and Mass Spectrometry Unit, Giessen, Germany
| | - Birgit Stoffel-Wagner
- University Hospital Bonn, Institute of Clinical Chemistry and Clinical Pharmacology, Bonn, Germany
| | - Joachim Woelfle
- Children's University Hospital Bonn, Department of Paediatric Endocrinology and Diabetology, Bonn, Germany
- Children's University Hospital Erlangen, Erlangen, Germany
| | - Bettina Gohlke
- Children's University Hospital Bonn, Department of Paediatric Endocrinology and Diabetology, Bonn, Germany
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Ibáñez L, Barouti K, Markantes GK, Armeni AK, Georgopoulos NA. Pediatric endocrinology: an overview of the last decade. Hormones (Athens) 2018; 17:439-449. [PMID: 30293227 DOI: 10.1007/s42000-018-0067-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/30/2018] [Indexed: 02/06/2023]
Abstract
Over the past decade, considerable progress has been made in the field of pediatric endocrinology. However, there is still a long way to go regarding the exploration of novel avenues, such as epigenetics, the changing views on the pathophysiology and derived therapy of specific disorders, and the prevention of prevalent diseases. The next decade will hopefully bring the consolidation of most of those achievements and the development of new pathways for further progress.
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Affiliation(s)
- Lourdes Ibáñez
- Pediatric Research Institute Sant Joan de Deu, University of Barcelona, Esplugues, Barcelona, Spain & CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.
- Hospital Sant Joan de Déu, University of Barcelona, 08950 Esplugues, Barcelona, Spain.
| | - Konstantina Barouti
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras, Greece
| | - Georgios K Markantes
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras, Greece
| | - Anastasia K Armeni
- Pediatric Research Institute Sant Joan de Deu, University of Barcelona, Esplugues, Barcelona, Spain & CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras, Greece
| | - Neoklis A Georgopoulos
- Pediatric Research Institute Sant Joan de Deu, University of Barcelona, Esplugues, Barcelona, Spain & CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras, Greece
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Castanys-Muñoz E, Kennedy K, Castañeda-Gutiérrez E, Forsyth S, Godfrey KM, Koletzko B, Ozanne SE, Rueda R, Schoemaker M, van der Beek EM, van Buuren S, Ong KK. Systematic review indicates postnatal growth in term infants born small-for-gestational-age being associated with later neurocognitive and metabolic outcomes. Acta Paediatr 2017; 106:1230-1238. [PMID: 28382722 PMCID: PMC5507303 DOI: 10.1111/apa.13868] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/01/2017] [Accepted: 04/03/2017] [Indexed: 12/22/2022]
Abstract
We systematically reviewed papers published in English between 1994 and October 2015 on how postnatal weight gain and growth affect neurodevelopment and metabolic outcomes in term‐born small‐for‐gestational‐age (SGA) infants. Two randomised trials reported that enriched infant formulas that promoted early growth also increased fat mass, lean mass and blood pressure (BP), but had no effect on early neurocognitive outcomes. Meanwhile, 31 observational studies reported consistent positive associations between postnatal weight gain and growth with neurocognitive outcomes, adiposity, insulin resistance and BP. Conclusion: Few intervention studies exist, despite consistent positive associations between early growth and neurocognition in term‐born SGA infants.
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Affiliation(s)
| | - Kathy Kennedy
- UCL Great Ormond Street Hospital Institute of Child Health; London UK
| | | | | | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität Munich; Dr. von Hauner Children's Hospital; University of Munich Medical Center; München Germany
| | - Susan E. Ozanne
- Metabolic Research Laboratories & MRC Metabolic Diseases Unit; Institute of Metabolic Science; University of Cambridge; Cambridge UK
| | | | | | - Eline M. van der Beek
- Nutricia Research; Danone Nutricia Early Life Nutrition; Utrecht The Netherlands
- Department of Pediatrics; University Medical Center Groningen; Groningen The Netherlands
| | - Stef van Buuren
- Netherlands Organisation for Applied Scientific Research TNO; Leiden The Netherlands
- University of Utrecht; Utrecht The Netherlands
| | - Ken K. Ong
- MRC Epidemiology Unit; University of Cambridge; Cambridge UK
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Schulte S, Wölfle J, Schreiner F, Stoffel-Wagner B, Peter M, Bartmann P, Gohlke B. Birthweight Differences in Monozygotic Twins Influence Pubertal Maturation and Near Final Height. J Pediatr 2016; 170:288-94.e1-2. [PMID: 26794471 DOI: 10.1016/j.jpeds.2015.12.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/16/2015] [Accepted: 12/08/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the influence of unfavorable intrauterine conditions and catch-up growth, we analyzed growth and pubertal maturation in monozygotic twins with significant intra-twin birthweight differences. STUDY DESIGN Prospective longitudinal clinical study of 30 twin pairs at birth, prepubertally at ages 2.1, 4.0, 10.0 years, and mid-/postpubertally at age 14.6 years; 14 pairs were concordant (birthweight difference <1 SDS), 16 discordant (birthweight difference >1 SDS). RESULTS In 19/30 (63%) pairs, the initially smaller twin started pubertal maturation before the co-twin. In 7/8 (88%) female discordant twin pairs, the initially smaller twin experienced menarche first. Among discordant pairs, highly significant intra-twin differences for height SDS were observed up to 10 years of age, with a further decline between ages 10.0 and 14.6 years. At 10.0 years of age, significant intra-twin differences in mean dehydroepiandrostenedione sulfate were observed in all twin pairs (870.3 vs 1054 ng/mL in the smaller twin, P = .045). This was pronounced in the discordant group: 856.7 vs 1138.2 ng/mL, P = .009. In all twin pairs, highly significant intra-twin correlations were found for gonadotropins during puberty (luteinizing hormone: r = 0.67, P < .001. follicle stimulating hormone: r = 0.70, P < .001) with no significant intra-twin differences for gonadotropins, estradiol, and testosterone before or during puberty. CONCLUSIONS Birthweight has an impact on growth and pubertal maturation. The already decreased height in some low birthweight infants may be further impacted by an early start and fast progression of puberty. The high intra-twin correlation coefficients in our study suggest that puberty and sexual steroids are genetically determined. However, the observed adrenal androgen hypersecretion of the smaller twin during late childhood could have effected pubertal maturation and further decreased near final height.
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Affiliation(s)
- Sandra Schulte
- Department of Pediatric Endocrinology and Diabetology, University Hospital Bonn, Bonn, Germany
| | - Joachim Wölfle
- Department of Pediatric Endocrinology and Diabetology, University Hospital Bonn, Bonn, Germany
| | - Felix Schreiner
- Department of Pediatric Endocrinology and Diabetology, University Hospital Bonn, Bonn, Germany
| | | | | | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Bettina Gohlke
- Department of Pediatric Endocrinology and Diabetology, University Hospital Bonn, Bonn, Germany.
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Uçar A. Age-related serum dehydroepiandrosterone sulphate (DHEAS) levels per se should not be considered a reliable surrogate parameter for clinical presentation of adrenarche. Clin Endocrinol (Oxf) 2015; 82:912-3. [PMID: 25488489 DOI: 10.1111/cen.12689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ahmet Uçar
- Paediatric Endocrinology & Diabetes Unit, Children's State Hospital of Sanliurfa, Sanliurfa, Turkey.
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