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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Childhood obesity is prevalent and linked to the development of Type 2 diabetes mellitus (DM) and poor bone health. Some PUFA enhance bone mass and thus may improve bone health in obese children. The study objective was to determine the effects of dietary (n-6) compared with (n-3) essential PUFA and long-chain PUFA (LCPUFA) on bone in an obese and insulin-resistant state. Male fa/fa (n = 48) and lean Zucker rats (n = 48) were fed diets containing safflower oil [SO, high (n-6) PUFA], flaxseed oil [FXO, high (n-3) PUFA], or menhaden oil [MO, high (n-3) LCPUFA] for 9 wk. Measurements included the following: femur bone area (BA), mineral content (BMC), density (BMD), morphometry and ex vivo release of prostaglandin E(2) (PGE(2)); plasma osteocalcin and C-terminal telopeptides of type I collagen. Differences among groups were detected using 2-way ANOVA. Genotype effects in the fa/fa rats included lower femoral weight, length, BA, and BMC, as well as femoral head and proximal epiphysis widths compared with the lean rats, but BMD was not affected. Femur BA, BMC, and BMD did not differ among the dietary groups, but diaphysis width was elevated in the MO group and PGE(2) release was reduced by the FXO and MO diets. No genotype x diet interactions were observed. These data indicate that the fa/fa Zucker rat is at risk for low bone mass and that dietary (n-3) FA effectively reduce PGE(2) release. Whether reduced PGE(2) will support optimal peak bone mass during childhood and conserve bone mass with aging warrants investigation.
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PMID:(n-3) fatty acids reduce the release of prostaglandin E2 from bone but do not affect bone mass in obese (fa/fa) and lean Zucker rats. 1573 84

The slipped capital femoral epiphysis (SCFE) is defined as a nontraumatic epiphyseal separation and slipping of the proximal femoral epiphysis, which usually occurs during the adolescent growth spurt. Slipping of the upper femoral epiphysis may be classified as acute, chronic, and acute on chronic. The etiology of the disease is still not fully understood but seems to be multifactorial. The typical SCFE during puberty has to be differentiated from the atypical form, which may be associated with an endocrinological disorder or with its therapy. The typical SCFE may be found in male patients, with increased height and weight. It is likely that the growth rate is slightly accelerated before slippage. Obesity is often associated with a decreased femoral anteversion accounting for abnormal mechanical shear forces at the growth plate. SCFE is treated surgically. Surgical methods are administered according to the degree of disease. Because of possible alterations of blood supply to the femoral head, acute SCFE is an emergency. Following SCFE, complications such as chondrolysis and avascular necrosis are feared.
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PMID:[Slipped capital femoral epiphysis and overweight]. 1591 60

Slipped capital femoral epiphysis (SCFE) is the most common hip disorder of adolescents and is known to be strongly associated with obesity. The use of Body Mass Index (BMI) as an assessment of obesity has been shown to be a very efficient technique. The Centers for Disease Control & Prevention has recently developed BMI-for-age percentile growth charts that have been shown to effectively evaluate obesity in the pediatric population. In the current study, the investigators provide a retrospective review, looking at the association between SCFE and obesity based on BMI. One hundred six subjects with radiographically diagnosed SCFE were compared with 46 controls without radiographic evidence of SCFE. In the SCFE group, 81.1% of individuals had a BMI above the 95th percentile; for the control group, the corresponding figure was only 41.3% (P < 0.0001). Multiple linear regression analysis controlling both for sex and age confirmed an equally significant difference (P < 0.0001) between SCFE patients and controls with regard to BMI. Based on pediatric obesity criteria designating a weight above the 95th percentile as obese and a weight between the 85th and 95th percentile as "at risk" for obesity, clinicians can use BMI to define obesity, a highly modifiable risk factor for SCFE. Early intervention and lifestyle modifications may reduce the incidence of not only SCFE but other illnesses related to obesity as well.
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PMID:Relationship between Body Mass Index and slipped capital femoral epiphysis. 1629 29

Slipped capital femoral epiphysis (SCFE) is a rare complication of growth hormone (GH) therapy. Here, we report three patients who developed SCFE during GH therapy. The first two patients had hypopituitarism and had started GH therapy at the age of 15 years 6 months and 13 years 9 months, respectively. SCFE developed 4 years and 1 year after GH therapy, respectively. The third patient had Prader-Willi syndrome with obesity and hypogonadism and began GH therapy at the age of 12 years and 11 months. SCFE developed 2 months after starting GH therapy. Pain over the hip joints or over the knees is an early sign of SCFE. Despite recommendation, none of the three patients continued GH therapy. A high index of suspicion during GH therapy in patients at high risk of SCFE is important for early diagnosis and appropriate management.
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PMID:Slipped capital femoral epiphysis as a complication of growth hormone therapy. 1749 96

Measurement of the Southwick's anteroposterior (AP) angle (shaft epiphysis proximal femoral AP angle) is not only a useful tool for planning the surgical treatment of deformities caused by slipped capital femoral epiphysis, but seems to be also important for recognizing the risk of epiphysiolysis development in obese patients (increased AP angle) or to confirm the diagnosis of slipped capital femoral epiphysis (decreased AP angle). To establish normal reference values of the Southwick's AP angle, we studied 97 normal nonobese adolescents (42 females, 55 males), with ages ranging between 8 and 16 years. The mean (SD) AP angle was 151.2 (5.0), ranging from 140 to 164. The limits for the first (p25) and third (p75) quartiles were 148 and 155, respectively. No difference was observed in the AP angle in males when compared with females. The AP angle was evaluated according to sex, chronological age, bone age, weight, height, and pubertal stage of development. We observed an inverse correlation of the AP angle with chronological age (r=-0.57) and bone age (r=-0.52). A weak inverse correlation was also found with stature (r=-0.33). Only a tendency toward an inverse correlation with weight (r=-0.27) or body mass index (r=-0.26) was observed. No significant correlation with the pubertal stage was found. When chronological and bone ages were divided into intervals, a significant reduction of the AP angle was observed only in patients older than 14 years compared with those younger than 10 years of age. In this study, we propose that the AP angle should be considered to be normal if it varies between 148 and 155. We conclude that the normal AP angle does not depend on sex; however, it tends to decrease with stature, and chronological and bone ages. In the normal weight range also, the AP angle decreases, contrasting with our previous findings in obese adolescents, in which the AP angle increases with the severity of obesity.
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PMID:Normal reference values of Southwick's anteroposterior angle in prepubertal and pubertal normal adolescents. 1790 34

Slipped upper femoral epiphysis (SUFE) is a multifactorial condition usually affecting adolescents. Obesity is one risk factor, and as this is increasing the incidence of SUFE is likely to rise. Diagnosis and treatment are usually straightforward and carried out by orthopaedic surgeons. However, the recognition of post-treatment complications poses a much greater challenge. This article focuses on possible complications of surgical treatment of SUFE particularly. Chondrolysis, avascular necrosis, as well as other complications of treatment and conditions leading to premature osteoarthritis are discussed. Checklists for a systematic approach to post-treatment imaging are provided.
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PMID:Slipped upper femoral epiphysis: imaging of complications after treatment. 1806 88

Obesity is thought to be an aetiological factor for slipped capital femoral epiphysis (SCFE). We analysed changes in the incidence of SCFE in Scotland over the last two decades. During this period rates of childhood obesity have risen substantially and evidence for a relationship between these changes and the incidence of SCFE was sought. We found that the incidence of SCFE increased from 3.78 per 100,000 children in 1981 to 9.66 per 100,000 in 2000 (R(2) = 0.715): a two and a half times increase over two decades. It was seen at a younger age, with a fall in the mean age at diagnosis from 13.4 to 12.6 years for boys (p = 0.007) and 12.2 to 11.6 for girls (p = 0.047). More children under eight years old were seen with SCFE in Scotland in the decade to 2000 than in the previous decade (p = 0.002, R(2) = 0.346). A close correlation was observed between rising childhood obesity over the last 20 years in Scotland and an increasing incidence of SCFE.
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PMID:Changing incidence of slipped capital femoral epiphysis: a relationship with obesity? 1816 May 7

Slipped capital femoral epiphysis (SCFE) is rare in children aged less than 10 years, and its management in this age group raises a number of different considerations. We present a series of 10 children aged less than 10 years who presented with SCFE to our institution between 1993 and 2005. Case notes and radiographic review were carried out. There were six boys and four girls, with an age range of 5.2-9.9 years. Mean follow-up was 50 months (22-90). The mean duration of symptoms was 54 days (1-196). Five cases were bilateral. The second slip occurred at a mean interval of 14 months (11-22) after the first slip. There were 12 stable and three unstable slips. One child had hypothyroidism and another oculocutaneous albinism. The remaining children had normal genetic and endocrine profiles. Six children were severely obese, one obese, two overweight, and one within the normal range. Multiple pins were used in nine hips and a single cannulated screw was used in six hips. Complications include loss of fixation in five hips treated with multiple pins, which were revised between 2 months and 2 years from the initial surgery, and one superficial wound infection. There were no cases of avascular necrosis or chondrolysis. In conclusion, obesity is closely related to the development of SCFE in younger children. A technique that preserves physeal growth should be used for in-situ fixation. Multiple pins preserve capital femoral physeal growth, but at the cost of a high complication rate. Strong consideration for prophylactic pinning of the contralateral hip is recommended.
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PMID:Slipped capital femoral epiphysis in children aged less than 10 years. 1973 10

Adolescents are especially prone to develop slipped capital femoral epiphysis (SCFE). Hormonal changes in puberty, obesity, and hypogonadism suggest that endocrine dysfunction is a contributing factor. SCFE may be one of the most common disorders affecting the hip, yet the diagnosis is often missed or delayed as a result of inappropriate initial evaluation, as occurred in this report of a 13-year-old boy. Timely recognition and, typically, surgical intervention are critical to forestall progression and to prevent further complications.
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PMID:Slipped capital femoral epiphysis in an obese teenager. 2008 74

With an increasing spectrum of indications for growth hormone (GH), knowledge of the short- and long-term safety of this treatment is essential. In this chapter we review the main adverse effects that have been demonstrated or discussed after long-term GH treatment in children. It is well recognized that plasma insulin concentrations increase during GH treatment. The incidence of type 2 diabetes is raised during GH treatment, especially in subjects with other risk factors. Recommendations include assessing glucose tolerance by measuring plasma glucose and HbA1c before and during treatment. There is no consensus on the indications for insulin measurement and/or oral glucose tolerance tests. Other recognized short-term complications of GH treatment include pseudo-tumour cerebri, otitis media (Turner syndrome), and orthopaedic problems such as worsening of scoliosis and slipped femoral epiphysis. There are reports of sudden death within the first 6 months of treatment in children with Prader-Willi syndrome, mostly associated with severe obesity. Large cohort follow-up studies suggest that children treated with GH following childhood cancer treatment do not have a greater number of relapses, but there may be a higher incidence of second primary tumours in the early years of GH therapy. A cohort treated with human pituitary GH showed a higher incidence of tumours, and a GH effect on tumorigenesis has been seen in follow-up studies of acromegaly raising the question of whether de novo cancer risk may be increased. A new prospective pan-European safety surveillance study (SAGhE) has been launched to address these essential questions. The role of monitoring the IGF-1 response (total or free concentrations) to GH treatment to predict long-term safety is unclear at present. Attempts to target IGF-1 levels within the normal range may result in the use of excessive doses of GH. In general, higher dosage GH regimens may be associated with supraphysiological IGF-1 levels.
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PMID:Safety of recombinant human growth hormone. 2052 16


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