Sanae Kanazawa

Association of low‐density lipoprotein particle size distribution and cardiovascular risk factors in children

Aim: The objective of this study was to investigate whether the presence of small, dense lipoproteins, which are thought to be related to the metabolic syndrome caused by insulin resistance, can be predicted by routine serum lipid profiling. Methods: The relationship between low‐density lipoprotein (LDL) particle size and serum lipid levels was analysed in 284 school children (148 boys and 136 girls), aged 7 to 13 y old. LDL particle size was determined by gradient gel electrophoresis. Results: The LDL particle diameter was significantly correlated with the serum levels of high‐density lipoprotein cholesterol (HDL‐C) (r= 0.437, p > 0.001) and triglycerides (TG) (r= 0.432, p 0.001), and with the atherogenic index (AI) [total cholesterol/HDL‐C] (r= 0.450, p > 0.001), while only weak correlations were observed with the serum levels of total cholesterol, apolipoprotein A1 and apolipoprotein B. No significant relationship was observed between LDL particle diameter and the serum LDL‐C level.

Systemic effects of transdermal testosterone for the treatment of microphallus in children

Abstract Objectives : To elucidate the metabolic effects of topical testosterone for the treatment of microphallus in children.

Precocious Puberty Resulting from Congenital Hypothalamic Hamartoma: Persistent Darkened Areolae After Birth as the Hallmark of Estrogen Excess

C entral precocious puberty due to congenital hypothalamic hamartoma may cause isosexual precocity from early infancy. Failure to recognize the physical findings occasionally delays the diagnosis of the disease until the patient is more than 1 to 2 years old.14 This delay may reduce the patients potential for adult height because of remarkably advanced skeletal age that is induced by the bone-maturing action of estrogen.5-7 To emphasize the importance of early diagnosis of this disease, we present a patient in whom persistent darkened areolae from birth, a hallmark of estrogen excess, was overlooked.

Discrepancies between Physician and Parent Perceptions of Psychosocial Problems of GHD Children Undergoing GH Therapy in Japan

This study examined discrepancies between the perceptions of physicians treating short children with GH deficiency (GHD) using GH replacement therapy (GHRT) and the perceptions of the parents of these children and identified the major causes of parental anxiety. Three attending pediatric endocrinologists and the parents of 31 GHD children participated in this study. The physicians and parents completed a specially designed questionnaire to rate the types and degrees of psychosocial problems that GHD children might experience. For 6 of the first 11 questions, the physicians rated psychological problems differently than the parents did, tending to over- or underestimate parental concerns. This discrepancy did not disappear with treatment. However, the difference in the perception of anxiety between the physicians and parents changed for issues regularly discussed between them. Physicians and nurses were ranked as the most reliable providers of information. The parents of children who had previously undergone GHRT were a highly desired source of information. Psychosocial problems remain largely unaddressed by endocrinologists. Endocrinologists treating short stature are encouraged to be more involved in understanding parents’ anxieties, evaluation of misperceptions concerning parents’ expectations, and addressing these issues in future communication with parents. Support by experienced psychologists may help endocrinologists with this issue.

Effect of testosterone on bone mineral gain: observations of male patients with growth hormone deficiency and normal gonadotropin secretion.

Growth hormone (GH) and sex steroids are the major determinants of bone mineral density (BMD). Over the past several years, the dominant role of androgens in male bone physiology has been increasingly questioned as data have emerged suggesting an important role for estrogens in male skeletal development and homeostasis, but some reports elucidate the effects of androgen on skeletal development and maintenance (1,2,3,4). We consider that more clinical evidence on the effects of androgens on actual bone growth is needed to clarify their possible physiological roles in the regulation of bone formation and mineralization (5). Recently, we encountered three pubertal boys with complete isolated GH deficiency (IGHD) whose cases had been detected and diagnosed after the patient had reached puberty. An analysis of the bone mineral status in these patients allowed us to determine the extention to which testosterone contributes to bone mineral gain in GH deficient children.