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Children
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Management of Metabolic Disorders in Adolescence Update
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Management of Metabolic Disorders in Adolescence Update

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Endocrinology & Diabetes".

Deadline for manuscript submissions: closed (5 December 2023) | Viewed by 10461

Special Issue Editor

Dr. Albina Tummolo

E-Mail Website
Guest Editor
Department of Metabolic Diseases and Clinical Genetics and Diabetology, Giovanni XXIII Children Hospital, Azienda Ospedaliero-Universitaria Consorziale, 70126 Bari, Italy
Interests: pediatrics; clinical genetics; inherited metabolic disorders; newborn screening; phenylketonuria
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The management of metabolic disorders in adolescence is increasingly challenging.  The important changes that characterize this period may significantly impact the outcome of chronic diseases such as metabolic disorders, requiring profound adjustment of healthcare and promotion of networking that involve hospital, family, school, and institutions.

This Special Issue will discuss how the physical, psychological, and social characteristics of adolescents may affect management of metabolic disorders. Special emphasis will be given to elements such as overweight tendency, food behavior disturbances, body image dissatisfaction, psychologic instability, refusal of rules, influence of social networks and internet technologies, and tendency toward anxiety and depressive disorders. The impact of the above factors on several metabolic disorders will be expanded.

It will be also emphasized how management of metabolic disorders in adolescence should include a multidisciplinary team to promote the role of adaptations of health facilities, clinical approaches, and decision making in adolescent characteristics.

Dr. Albina Tummolo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • adolescence
  • metabolic diseases
  • multidisciplinary team
  • networking
  • overweight
  • food behavior disturbances
  • body image dissatisfaction
  • social networks
  • internet technologies
  • anxiety and depression

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Published Papers (4 papers)

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Research

9 pages, 265 KiB  
Article
Sex Hormone-Binding Globulin (SHBG) Reduction: The Alarm Bell for the Risk of Non-Alcoholic Fatty Liver Disease in Adolescents with Polycystic Ovary Syndrome
by Flavia Urbano, Mariangela Chiarito, Crescenza Lattanzio, Angela Messa, Marco Ferrante, Mariantonietta Francavilla, Irsida Mehmeti, Giuseppe Lassandro, Paola Giordano and Maria Felicia Faienza
Children 2022, 9(11), 1748; https://doi.org/10.3390/children9111748 - 15 Nov 2022
Cited by 6 | Viewed by 3079
Abstract
Polycystic ovary syndrome (PCOS) represents an endocrine condition affecting 5–18% of adolescents, frequently in association with obesity, metabolic alterations, and liver dysfunction. In this study, we aimed to evaluate the prevalence and risk factors for developing non-alcoholic fatty liver disease (NAFLD) in a [...] Read more.
Polycystic ovary syndrome (PCOS) represents an endocrine condition affecting 5–18% of adolescents, frequently in association with obesity, metabolic alterations, and liver dysfunction. In this study, we aimed to evaluate the prevalence and risk factors for developing non-alcoholic fatty liver disease (NAFLD) in a cohort of PCOS adolescents. Thirty-two girls were assessed for anthropometric and biochemical markers: total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), glucose, insulin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (γGT). In addition, LH, FSH, 17β-Estradiol (E2), prolactin, testosterone (T), free testosterone, delta 4-androstenedione (D4 A), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding protein (SHBG) were also evaluated. All subjects underwent liver ultrasound to detect NAFLD. Our data demonstrated that PCOS adolescents complicated with NAFLD accounted for 37.5%, and those with obesity and lower SHBG were more predisposed to developing NAFLD. Moreover, SHBG showed a negative correlation with several parameters such as blood pressure, body mass index, waist circumference, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR). Our results demonstrated that the assessment of SHBG may allow the identification of PCOS adolescents at risk for developing NAFLD and metabolic alterations. Full article
(This article belongs to the Special Issue Management of Metabolic Disorders in Adolescence Update)
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12 pages, 586 KiB  
Article
Body Composition in Adolescent PKU Patients: Beyond Fat Mass
by Albina Tummolo, Rosa Carella, Giulia Paterno, Nicola Bartolomeo, Massimo Giotta, Annamaria Dicintio, Donatella De Giovanni and Rita Fischetto
Children 2022, 9(9), 1353; https://doi.org/10.3390/children9091353 - 4 Sep 2022
Cited by 2 | Viewed by 1822
Abstract
There is a lack of evidence on the impact on body composition of high protein intake and types of protein substitutes in PKU patients—particularly in adolescents, who are more inclined to dietary transgressions. In this observational, cross-sectional study, PKU patients were observed during [...] Read more.
There is a lack of evidence on the impact on body composition of high protein intake and types of protein substitutes in PKU patients—particularly in adolescents, who are more inclined to dietary transgressions. In this observational, cross-sectional study, PKU patients were observed during prepubertal age (p) or after the pubertal spurt (P), assessing body composition and bone quality and correlating these parameters with dietary compliance and types of protein substitutes. Anthropometric and dietary data were evaluated together with bioelectrical impedance analysis (BIA), quantitative ultrasound (QUS) and branched-chain amino acids (BCAAs). A total of 36 patients (16 males, 17 prepubertal and 19 post-pubertal; mean ± SD age 11.4 ± 3.9 years) were included. A higher BMI was observed in adolescents (p-value: 0.018). The BIA revealed a significant increase in total body water (TBW) and muscle mass (MM) in P subjects either compliant (p-value: 0.001) or non-compliant with the diet (p-value: 0.001). MM content correlated with increased Phe intake (r = 0.63; p < 0.001). In the subgroup of five patients taking L-AAs and glycomacropeptides (GMPs), BCAA values tended to be lower than those taking only L-AA mixtures, with a significant trend for valine. Maintenance of body composition parameters within the normal range—for both fat and muscle mass—and levels of BCAAs can be helpful in reducing the risk of becoming overweight in adulthood. Further studies are needed to confirm these findings. Full article
(This article belongs to the Special Issue Management of Metabolic Disorders in Adolescence Update)
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9 pages, 279 KiB  
Article
Is the Leptin/Adiponectin Ratio a Better Diagnostic Biomarker for Insulin Resistance than Leptin or Adiponectin Alone in Adolescents?
by César Agostinis-Sobrinho, Sofia E. de Castro Ferreira Vicente, Sigute Norkiene, Alona Rauckienė-Michaelsson, Justina Kievisienė, Viney Prakash Dubey, Arturas Razbadauskas, Luís Lopes and Rute Santos
Children 2022, 9(8), 1193; https://doi.org/10.3390/children9081193 - 9 Aug 2022
Cited by 16 | Viewed by 2384
Abstract
Background: Recently, the leptin/adiponectin (L/A) ratio has been suggested as a novel predictor of cardio-metabolic and other chronic diseases. Aim: To evaluate the ability of leptin (L), adiponectin (A), and the L/A ratio in identifying high risk of insulin resistance IR in adolescents, [...] Read more.
Background: Recently, the leptin/adiponectin (L/A) ratio has been suggested as a novel predictor of cardio-metabolic and other chronic diseases. Aim: To evaluate the ability of leptin (L), adiponectin (A), and the L/A ratio in identifying high risk of insulin resistance IR in adolescents, adjusted by cardiorespiratory fitness, adherence to the Mediterranean diet, and body fat percentage. Subjects and methods: This is a cross-sectional analysis with 529 adolescents aged 12–18 years-old. Blood samples were taken to analyze glucose, insulin, leptin, and adiponectin levels. IR (homeostasis model assessment of insulin resistance (HOMA-IR) was estimated from fasting serum insulin and glucose). Results: Adiponectin, leptin, and L/A ratio were accurate to predict IR among adolescents. The optimal L/A cut-off value to indicate risk of IR development was >0.35 in boys and >0.97 in girls. Logistic analyses showed that the suggested cut-off points for adiponectin (girls: OR: 2.87 (1.26–6.53); p = 0.012); leptin (boys: OR: 5.23 (1.16–7.14) p = 0.006; girls: OR: 2.99 (1.10–8.09) p = 0.031), and the L/A ratio (boys: OR: 8.38 (2.6–26.8) p < 0.001; girls: OR: 6.1 (2.1–17.0) p < 0.001), were significant predictors of IR, after adjustments for age, pubertal stage, adherence to the Mediterranean diet, cardiorespiratory fitness, and body fat percentage. Conclusion: Leptin and L/A ratio were associated with IR risk, after adjustments for confounders in both sexes and adiponectin in girls. The L/A ratio seems to have a higher diagnostic accuracy to identify IR risk than adiponectin or leptin, in both sexes. Full article
(This article belongs to the Special Issue Management of Metabolic Disorders in Adolescence Update)
10 pages, 812 KiB  
Article
Multidisciplinary Treatment for Childhood Obesity: A Two-Year Experience in the Province of Naples, Italy
by Francesca Gallè, Giuliana Valerio, Ornella Daniele, Valentina Di Mauro, Simone Forte, Espedita Muscariello, Roberta Ricchiuti, Serena Sensi, Mario Balia, Giorgio Liguori and Pierluigi Pecoraro
Children 2022, 9(6), 834; https://doi.org/10.3390/children9060834 - 4 Jun 2022
Cited by 8 | Viewed by 2625
Abstract
Childhood obesity must be faced through an integrated multi-level preventive approach. This study was aimed at assessing the adherence and the outcomes of an outpatient service for childhood obesity treatment activated in the province of Naples, Italy, throughout a 2-year follow-up period. At [...] Read more.
Childhood obesity must be faced through an integrated multi-level preventive approach. This study was aimed at assessing the adherence and the outcomes of an outpatient service for childhood obesity treatment activated in the province of Naples, Italy, throughout a 2-year follow-up period. At first visit (T0), weight, height, waist circumference, and body composition of children were assessed, together with sociodemographic features and physical activity levels of children and parents. Anthropometric and body composition parameters of children were measured at 6 ± 3 months (T1) and 12 ± 3 months (T2). A total of 451 non-related children who accessed the service were analyzed: 220 (48.7%) of them returned at least once (attrition rate 51.3%). Returner outpatients showed higher age (p = 0.046) and father’s educational level (p = 0.041) than non-returner ones. Adherence to the treatment was found to be related to father’s (Rho = 0.140, p = 0.005) and mother’s (Rho = 0.109, p = 0.026) educational level. All the outcomes improved between T0 and T1 (p < 0.001), while only body mass index (BMI) decreased significantly at T2. Changes in BMI-SDS were associated with baseline value (OR 0.158, 95%CI 0.017–0.298, p = 0.029). The multidisciplinary approach seems to be promising to treat childhood obesity in this geographic context. Lower parents’ educational level should be considered as an attrition determinant. Full article
(This article belongs to the Special Issue Management of Metabolic Disorders in Adolescence Update)
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