Task Force Report on High Blood Pressure in Children and Adolescents. Influence of family history of type 2 diabetes on insulin sensitivity in prepubertal children. Jiang X, Srinivasan SR, Webber LS, Wattigney WA, Berenson GS . Increased incidence of non-insulin dependent diabetes mellitus among adolescents. Other investigations needed are fasting lipoprotein profile, fasting glucose, fasting insulin, hemoglobin and alanine aminotransferase for obesity associated AN and radiological investigations (plain radiography, ultrasonography, magnetic resonance imaging/computerized tomography) for malignancy associated AN. J Pediatr 2001; 138 : 474–480.
It is velvety to the touch, and can be either benign or malignant. Sinha R, Fisch G, Teague B, Tabborlane WV, Banyas B, Allen K, Savoye M, Rieger V, Taksali S, Barbetta G, Sherwin RS, Caprio S . The prevalence of insulin resistance was significantly higher in the patients in Tanner stages IV–V and II–III than in Tanner stage I (88.7 and 82.1%, respectively Impaired insulin sensitivity was defined as a QUICKI of <0.339, based mainly on adult reference standards, and was present in 199 patients (77.7%), with a significantly higher prevalence in girls than boys (60.8 The GF/IF ratio decreased significantly from Tanner stage I to stage IV–V in both genders (Association between the GF/IF ratio and Tanner stage (Patients with insulin resistance or impaired insulin sensitivity had a significantly higher prevalence of obesity complications than those with normal insulin resistance indexes (49.5 There was a low, albeit significant, correlation between HOMA-B% and BMI (In all, 26 patients (13.5%) had IGT. Accordingly, Katz IGF was found in only two of our patients with IGT, suggesting that fasting hyperglycemia is indicative of a more advanced stage of impaired glucose metabolism. Silent diabetes was diagnosed in one adolescent girl (0.5%). Clinical features and management of non-HIV related lipodystrophy in children: a systematic review.
American Diabetes Association. Insulin resistance syndrome in childhood: associations of the euglycemic insulin clamp and fasting insulin with fatness and other risk factors. Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus: prospective studies of Pima Indians. Edelstein SL, Knowler WC, Bain RP, Andres R, Barrett-Connor EL, Dowse GK, Haffner SM, Pettitt DJ, Sorkin JD, Muller DC, Collins VR, Hamman RF .
Moran A, Jacobs DR, Steinberger J, Hong CP, Prineas R, Luepker RV, Sinaiko AR . Arner P .
Caprio S, Plewe G, Diamond MP, Simonson DC, Boulward SD, Sherwin RS, Tamborlane V . Lesions are unilateral along lines of Blaschko and may become evident during infancy, childhood, or adulthood. Pinhas-Hamiel O, Dolan LM, Daniels SR .
To obtain Longitudinal studies are needed to identify the metabolic precursors and the natural history of the development of type 2 diabetes in these patients.Fueled by changes in food consumption and health habits that have evolved over the last three decades, the prevalence of obesity in children and adolescents has reached epidemic proportions in both developed and developing countries.Obesity leads to insulin resistance and increased circulating insulin concentrations over time, thereby decreasing insulin sensitivity and impairing pancreatic Studies in adults have shown that type 2 diabetes develops over a long period, and most patients initially have impaired glucose tolerance (IGT), which is an intermediate stage in the natural history of type 2 diabetesIn children and adolescents, however, although severe obesity plays a prominent pathogenetic role in type 2 diabetes, whether it is a risk factor for IGT in this population, remains unclear.
Acanthosis nigricans (AN) is characterized by dark, coarse and thickened skin with a velvety texture, being symmetrically distributed on the neck, the axillae, antecubital and popliteal fossae, and groin folds, histopathologically characterized by papillomatosis and hyperkeratosis of the skin. Longitudinal changes in risk variables of insulin resistance syndrome from childhood to young adulthood in offspring of parents with type 2 diabetes: The Bogalusa Heart Study.
Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study.
Obesity and insulin resistance in humans: a dose response study. Marshall WA, Tanner JM . Non-insulin dependent diabetes mellitus—a genetically programmed failure of the beta cell to complete for insulin resistence.
Prevalence and trends in overweight among US children and adolescents, 1999–2000. Prevalence and concomitants of glucose intolerance in European obese children and adolescents.
Polonsky KS, Sturis J, Bell GI . We assumed that insulin resistance and sensitivity indexes are similar among the Caucasian population, and therefore we relied mainly on adult reference standards from published data.In summary, given the peak incidence of type 2 diabetes in adolescence and the known decrease in insulin sensitivity during puberty, the assessment of insulin sensitivity in obese children and adolescents has clinical relevance for identifying subjects at high risk of type 2 diabetes and cardiovascular disease. Screening for type 2 diabetes. Barlow SE, Dietz WH . Indices of insulin action, disposal, and secretion derived from fasting samples and clamps in normal glucose-tolerant black and white children. Comparison between Goran MI, Ball GDC, Cruz ML .
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