운동생리학 : Detraining이 비만 중학생의 혈중 leptin과 인슐린 농도 변화에 미치는 영향

김은정(EunJungKim) 한국체육학회 2004 한국체육학회지 Vol.43 No.3

The purpose of this study was to examine the efforts of B weeks periods of aerobic training and same periods of detraining on plasma fasting leptin and insulin concentration in obese pre-pubertal children. The subjects of present study were divided by two groups 20 obese pre-pubertal children group(OB; age:14.2±0.22yrs, height:160.1±6.17cm, weight:76.2±3.4kg. % body fat:35.2±4.9 %, BMI(weight(kg)/height(m2):29.8±5.46) and 20 non-obese pre-pubertal children group(NO; age:l4.1±0.18yrs, height:168.0±6.03cm, weight:56.1±5.90kg, % body fat:15.0±4.45 %, BMI(weight(kg)/height(m2) :19.9±3.21). Both OB and NO participated in HR max test to calculate their 60% HR max exercise intensity. All subjects engaged in aerobic training for 2-months and then ceased the aerobic training for next 2 month. The mean plasma fasting leptin concentration of OB group following the training and detraining period was higher than that of NO group, and there were significant differences between OB and NO groups(p〈.05). The mean plasma fasting insulin concentration of NO group following the training and detraining period was lower than that of OB group, and so there were significant differences between NO and OB groups(p〈.05).In conclusion, the results of this study confirm that aerobic training and detraining played a major role in the increased insulin sensitivity and decreased insulin resistance in non obese and obese prepubertal children. Also, insulin might be involved in the training and detraining effect of plasma leptin concentration in obese pre-pubertal children. but it dose not appear to relate plasma leptin in non obese pre-pubertal children.

소아 Graves병의 임상적 고찰 : 사춘기 이전군과 사춘기군의 비교

김현미,윤주연,정민호,서병규,이병철,Kim, Hyun Mi,Yoon, Ju Yun,Jung, Min Ho,Suh, Byung Kyu,Lee, Byung Churl 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.1

목 적 : 소아 Graves병의 진단 시 발병 연령에 따른 갑상선 기능, 임상 양상, 갑상선 항체가 및 치료 기간 등이 어떻게 다른지 알아보고자 본 연구를 시도하였다. 방 법 : 1989년 1월 1일부터 1995년 12월 31일까지 7년간 가톨릭대학교 의과대학 성모병원과 강남성모병원 소아과에서 Graves병으로 진단 받고 3년 이상 추적관찰이 가능하였던 환아 52명을 대상으로 Tanner의 성 성숙도를 기준으로 사춘기 이전에 발병한 군(사춘기전군)과 사춘기 시작 후 발병한 군(사춘기군)으로 나누어 갑상선 기능상태, 갑상선 항체, TSH 수용체 항체, 치료 후 갑상선 기능검사치가 정상화되는 시기 및 치료 기간 등을 조사하였다. 결 과 : 1) 전체 52명 중 남녀간의 성비는 1 : 12로 주로 여아에서 발병하였다. 2) 사춘기전군은 14명(남아 2명), 사춘기군은 38명(남아 2명)으로 각각 평균연령은 $7.2{\pm}0.9$세, $12.4{\pm}1.5$세이었다. 3) 치료 전 사춘기전군과 사춘기군에서 $T_3$는 $3.98{\pm}1.70$과 $3.82{\pm}1.63ng/mL$, $T_4$는 $17.49{\pm}5.56$과 $19.23{\pm}6.01{\mu}g/dL$, TSH는 $0.07{\pm}0.11$과 $0.07{\pm}0.24mIU/L$ 등으로 서로 유의한 차이가 없었다. 4) 치료 전 사춘기전군과 사춘기군에서 AMA 양성률은 85%와 89%이었고, 평균 항체가는 사춘기군이 사춘기전군보다 유의하게 높았다(P<0.01). ATA 양성율은 각각 57.1%와 72.2%였으나 평균 항체가의 차이는 없었으며 TBII의 양성율은 각각 92.9%와 84.2%였고 평균 항체가는 사춘기전군에서 사춘기군보다 유의하게 높았다(P<0.05). 5) 치료 후 사춘기전군과 사춘기군에서 $T_3$, $T_4$, TSH, TBII가 정상화되는 소요되는 기간은 $T_3$는 각각 $6.8{\pm}5.0$과 $5.4{\pm}13.2$개월, $T_4$는 각각 $2.3{\pm}1.9$와 $2.1{\pm}2.2$개월, TSH는 각각 $14.6{\pm}11.0$과 $6.8{\pm}7.8$개월, TBII는 각각 $26.7{\pm}24.0$과 $20.8{\pm}12.1$개월로 사춘기전군에서 TSH가 정상화되는 기간이 사춘기군보다 더 길었다(P<0.05). 두 군 모두 $T_4$, $T_3$, TSH, TBII 순으로 정상화되었다. 6) 치료 기간은 사춘기전군($53.3{\pm}19.3$개월)이 사춘기군($37.9{\pm}16.3$개월)보다 유의하게 길었다(P<0.01). 7) 약물 치료 3년 동안 관해는 사춘기전군에서 8례(57.1%), 사춘기군에서 26례(68.4%)였고 재발율은 각각 6례(75%) 및 17례(65.3%)였다. 8) Graves병의 진단 시 연령과 치료 기간 사이에는 역상관관계가 있었다(P=0.03). 결 론 : 소아에서 사춘기 이전에 발병하는 Graves병은 사춘기 이후에 발병하는 경우보다 항갑상선제 치료기간이 더 필요하다는 사실을 알 수 있었으며 앞으로 더 많은 환자를 대상으로 장기간의 연구가 필요하다고 생각된다. Purpose : The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. Methods : A retrospective chart review of 14 prepubertal(PREPUB, $7.2{\pm}0.9yr) and 38 pubertal (PUB, $12.4{\pm}1.5yr$) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. Results : There were no significant differences in $T_3$, $T_4$, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor $11,727.3{\pm}22,888.4$) than did the PREPUB group($2,111.5{\pm}2,285.0$, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, $62.5{\pm}39.6$) than did the PUB group($44.9{\pm}10.4$, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group($T_3:6.8{\pm}5.0$ vs. $5.4{\pm}13.2$, $T_4:2.3{\pm}1.9$ vs. $2.1{\pm}2.2$, $TBII:26.7{\pm}24.0$ vs. $20.8{\pm}12.1$), especially that of TSH was significantly longer in the PREPUB group($14.6{\pm}11.0$ vs. $6.8{\pm}7.8$, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group($52.3{\pm}19.3$ vs. $37.9{\pm}16.3months$, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). Conclusion : Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.

Gender specific effect of major dietary patterns on the metabolic syndrome risk in Korean pre-pubertal children

Soo Jin Park,Seung Min Lee,Seon Mee Kim,Myoungsook Lee 한국영양학회 2013 Nutrition Research and Practice Vol.7 No.2

There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.

성 성숙 속도가 다른 사춘기 아동의 성장 발달과 식행동 비교

이유신(You-Sin Lee),이심열(Sim-Yeol Lee) 동아시아식생활학회 2013 동아시아식생활학회지 Vol.23 No.5

The purpose of this study was to make a comparative analysis of dietary habits, snacks, eating out and fast-food intake between students with a relatively early sexual maturity and others with a relatively late sexual maturity in a bid to grasp the impact of dietary behaviors on sexual maturity. The subjects in this study were 565 boys and girls who resided in Seoul and Gyeonggi province. They included fifth- and sixth-grade school children and seventh-grade middle school students. To classify the selected students according to the level of sexual maturity, the students of the same month age were divided into two groups in consideration of the stage of their sexual maturity and that of the other age groups. The early mature group was significantly taller and weighed more than the late mature group irrespective of gender. According to Tanner stages, the boys of the early mature group reached a 3.03 stage of sexual maturity when the sexual organs were taken into account, and those of the late mature group reached a 1.50 stage of sexual maturity. The girls of the early mature group reached a 3.43 stage of sexual maturity on the basis of breast, and those of the late mature group reached a 2.73 stage of sexual maturity. Concerning eating out, the early mature group ate out more frequently than the late mature group. In regard to snacks, the early mature group had a snack more often. The findings of the study indicated that there were differences in physical development and some dietary behaviors according to sexual maturity. The early mature group had a snack and ate out relatively more often than the late mature group, which showed that some dietary behaviors had an impact on the sexual maturity of the teens who arrived at the age of puberty.