Calcium and magnesium balance in 9-14-y-old children

Few data are available regarding calcium and magnesium absorption and endogenous fecal excretion in children. We used a multitracer stable isotope technique to assess calcium and magnesium balance in 12 boys and 13 girls aged 9-14 y (mean weight: 42 kg) maintained on relatively high calcium intakes (mean: 1310 +/- 82 mg/d). There were no significant differences in absorption of calcium or magnesium from milk between boys and girls. Calcium retention (balance) correlated positively with calcidiol (25-hydroxyvitamin D) concentration (r = 0.48, P = 0.02) and serum alkaline phosphatase activity (r = 0.44, P = 0.03). There was no significant relation between magnesium balance and concentration. When data from this study were combined with our previously reported data, an increase in total calcium absorption was seen for pubertal (Tanner stages 2-4) but not prepubertal (Tanner stage 1) white children over the range of intakes from approximately 750 to 1350 mg/d. Despite intakes similar to the 1989 recommended dietary allowance for magnesium (mean intake: 6.4 +/- 1.2 mg.kg-1.d-1), 11 of the 25 subjects (6 girls and 5 boys) were in negative magnesium balance. We conclude that benefits from higher calcium intakes, < or = 1350 mg/d, were most apparent in pubertal children. In addiction, higher magnesium intakes should be considered for children.     

Muscle strength and hormonal levels in adolescents: gender related differences

The purpose of the present investigation was to study muscle strength in adolescents and its relationship to serum levels of testosterone and growth hormone in both genders. Thirty active adolescents (15 boys; age range 11 -12 y/o) participated in the first study. Isokinetic muscle strength of the dominant knee extensors (KE) was determined at 0, 12, 20, 30, 120, 180 and 240 deg/sec using a Cybex 340 dynamometer. The assessment of pubertal status was accomplished using the criteria of Tanner. Serum levels of total testosterone (T) and growth hormone (GH) were determined using radioimmunoassay techniques. Boys had higher (p< 0.001) T levels but no differences in muscle strength were detected between genders. Fifty-seven additional subjects representing three age groups (11-12 y/o, n=18; 13-14, n=21; 17-18, n=18) participated in the second study. A significant increase in peak torque (absolute and corrected for body weight) with age was observed in both genders. There were no significant gender differences in strength for the two youngest age groups, but boys were stronger than girls in the oldest age group (group 3). Testosterone and GH levels increased with age in boys but not in girls. Gender related differences in T were found in groups 2 and 3. A positive correlation (r=0,64 boys; r=0.46 girls) between testosterone levels and absolute muscle strength was seen in both genders. Our results suggest that increases in anabolic hormones precede muscle strength gains in adolescent males. In addition, gender related differences in muscle strength during adolescents cannot be explained solely on the basis of difference in body size or T levels.     

Estimates of food and macronutrient intake in a random sample of Northern Ireland adolescents

Estimates of food consumption and macronutrient intake were obtained from a randomly selected population sample (2%) of 1015 adolescents aged 12 and 15 years in Northern Ireland during the 1990/1991 school year. Dietary intake was assessed by diet history with photographic album to estimate portion size. Reported median energy intakes were 11.0 and 13.1 MJ/d for boys aged 12 and 15 years respectively and 9.2 and 9.1 MJ/d for girls of these ages. Protein, carbohydrate and total sugars intakes as a percentage of total energy varied little between the age and sex groups and were approximately 11, 49 and 20% respectively of daily total energy intakes. Median dietary fibre intakes were approximately 20 and 24 g/d for boys aged 12 and 15 years respectively and 18 and 19 g/d for girls of these ages. Major food sources of energy (as a percentage of total energy intakes) were bread and cereals (15-18%), cakes and biscuits (12-14%), chips and crisps (13-14%), dairy products (9-11%), meat and meat products (9-11%) and confectionery (9%). Fruit and vegetable intakes were low at about 2.5% and 1.5% respectively of total energy intakes. Median fat intakes were high at 39% of total daily energy intakes. Major food sources of fat as a percentage of total fat intakes were from the food groupings: chips and crisps (16-19%), meat and meat products (14-17%), fats and oils (14-16%), cakes and biscuits (13-16%) and dairy products (12-15%). Median intakes of saturated fatty acids were also high at approximately 15% of daily total energy intake while intakes of monounsaturated fatty acids averaged 12% of daily total energy intake. Median polyunsaturated fatty acid (PUFA) intakes were low, comprising 5.2 and 5.5% of daily total energy intake for boys aged 12 and 15 years respectively and were lower than the PUFA intakes (5.9 and 6.3% of daily total energy intake) for girls of these ages. About 1.3% for boys and 1.4% for girls of daily total energy intake was in the form of n-3 PUFA. Ca and Mg intakes were adequate for both sexes. Based on these results, some concern about the dietary habits and related health consequences in Northern Ireland adolescents appears justified.     

Iron status, menarche, and calcium supplementation in adolescent girls

The effects of growth, menstrual status, and calcium supplementation on iron status were studied over 4 y in 354 girls in pubertal stage 2 who were premenarcheal at baseline (x+/-SD age: 10.8+/-0.8 y). Girls were randomly assigned to placebo or treatment with 1000 mg Ca/d as calcium citrate malate. Anthropometric characteristics, bone mass, and nutritional status were measured biannually; ferritin was measured annually; and red blood cell indexes were determined at 4 y. The simultaneous effects of iron intake and menstrual status on serum ferritin, after change in lean body mass (LBM) was controlled for, were evaluated in subjects in the upper and lower quartiles of cumulative iron intake. The average maximal accumulation of LBM (386 g/mo; 95% CI: 372, 399) occurred 0.5 y before the onset of menarche. Change in LBM was a significant predictor of serum ferritin (P < 0.0001), with a negative influence on iron status (t ratio=-4.12). The 2 fitted mathematical models representing ferritin concentrations of subjects in the upper and lower quartiles of cumulative iron intake were significantly different (P < 0.018). The regression line of the ferritin concentration in menstruating girls with high iron intakes had a less negative slope than the line fit to serum ferritin concentrations in girls with low iron intakes (NS). Serum ferritin concentrations at 0, 1, 2, 3, and 4 y were not significantly different between groups. In addition, there was no significant difference between groups in any of the red blood cell indexes. In summary, growth spurt and menstrual status had adverse effects on iron stores in adolescent girls with low iron intakes (<9 mg/d), whereas long-term supplementation with calcium (total intake: approximately 1500 mg/d) did not affect iron status.     

Leptin levels in children with central precocious puberty

Several studies have suggested that sufficient serum leptin levels may be involved in the initiation of puberty. To assess further the relationship between leptin and the onset of puberty in humans, we measured the serum leptin concentration in children with central precocious puberty (CPP). We studied 65 children with either idiopathic (IPP; n = 50 girls and 3 boys) or neurogenic central precocious puberty (NPP; n = 5 girls and 7 boys). The serum leptin levels in these patients were compared with normative data from healthy children and adolescents using SD scores that adjust for body mass index (BMI) and Tanner stage. The mean SD scores of IPP and NPP girls were +0.4 +/- 0.1 and +1.0 +/- 0.5, respectively, compared with that of age-matched prepubertal girls and +0.7 +/- 0.2 and +1.6 +/- 0.6 compared with that of girls matched for pubertal stage. The CPP girls with lower BMIs contributed larger SD scores, such that the leptin SD score was negatively correlated with BMI. A similar, modest increase in leptin levels in the CPP girls was evident when additional normative data were considered. The mean leptin SD scores of IPP and NPP boys were -0.9 +/- 0.5 and +0.7 +/- 0.3, respectively, compared with that of normal boys at Tanner stage 3-4. Serum leptin levels in the boys with CPP were not different from those in healthy boys in any of the normative studies. These data should be interpreted cautiously, but they suggest that girls with CPP have modestly elevated serum leptin concentrations compared with those in healthy children and adolescents. In addition, the negative correlation between the leptin SD score and BMI suggests that sufficient leptin levels may be associated with initiation of puberty in girls.     

Relation of race, age, and sex hormone differences to serum leptin concentrations in children and adolescents

We explored the effects of race, age, and sex hormones on the serum leptin concentrations in 203 white and 88 black children and adolescents (ages 9.3-20.5 years). A significant sex by race interaction on serum leptin levels (p = 0.0301) was observed with lower serum leptin concentrations, adjusted for subscapular thickness and age, in black boys than in white boys. Girls had serum leptin levels that were on average 2.15 times those of boys (p < 0.0001). There was an age by sex interaction (p < 0.0001) with serum leptin concentrations decreasing in boys but not in girls with age. A strongly inverse relationship of serum testosterone levels with serum leptin levels in boys (p = 0.0067) appeared to explain this effect of age. In conclusion, the serum leptin concentration is slightly lower in black boys. A higher testosterone level in boys appears to account for an age-related decline in serum leptin in boys and the overall lower levels in boys than in girls.     

Behavioral symptoms of children and adolescents in Germany, the Netherlands and USA. A cross-cultural study with the Child Behavior Checklist

The goal of the study was a cross-cultural comparison of the parent ratings of behavior problems of children and adolescents aged 4-18 years in Germany, The Netherlands and the United States using the Child Behavior Checklist (CBCL). The analyses were undertaken in a German community sample (n = 1622) and a Dutch community sample (n = 2076). The results were compared with the data published by Achenbach for the national US sample. The analyses were based on the scales of the 1991 CBCL version and were performed for four age and sex groups (4- to 11-year-old boys/girls and 12- to 18-year-old boys/girls). In general, relatively minor differences could be detected between the three random samples. The range in the different samples was between -0.04 and 0.35, which is in line with other cross-cultural analyses using the CBCL. As long as no representative norms for Germany are available, the American norms can serve as an orientation for German studies using the CBCL.     

Pressure-flow studies: an evaluation of within-testing reproducibility--validity of the measured parameters

Growth and maturation during adolescence has not been well described in rural African populations, although it may represent the missing link between high levels of preschool stunting and nearly 'normal' adult heights. In 1995 the homes of subjects aged 10.3-17.5 years, living in a rural area of Senegal, were visited, and all adolescents present, 1527 boys and 1126 girls, were included in the analysis. A number of girls were absent because they worked in the capital city Dakar. Resident girls (n = 705) had significantly higher means than boys for all anthropometric variables (weight, body mass index, arm circumference and muscle arm circumference, triceps and subscapular skinfolds), except for height and head circumference. Girls who had just returned from seasonal migration to Dakar (n = 415) were, on average, 2 kg heavier, but not taller, than resident girls (p < 0.0001). The girls fell off in height from 11 to 13 years compared to the NCHS reference and then 'caught up' until the age of 17, while boys fell off during the entire age span. Mean age at menarche was estimated at 16.1 years (95% fiducial CI: 15.8-16.4) from status quo data by probit analysis. No significant difference was found between residents and migrants. Postmenarcheal girls had better nutritional status than premenarcheal girls in terms of height, weight, body mass index, percentage body fat and arm muscle circumference (p < 0.0001). In conclusion, puberty, as assessed by age at menarche, is delayed by about 3 years in this population, probably due to malnutrition.     

Alterations in growth and body composition during puberty: III. Influence of maturation, gender, body composition, fat distribution, aerobic fitness, and energy expenditure on nocturnal growth hormone release

We examined the relationships among gender, sexual maturation, four-compartment model estimates of body composition, body fat distribution (magnetic resonance imaging for abdominal visceral fat and anthropometrics), aerobic fitness, basal and total energy expenditure, and overnight GH release in an ultrasensitive chemiluminescence assay in healthy prepubertal and pubertal boys (n = 18 and 11, respectively) and girls (n = 12 and 18, respectively). Blood samples were withdrawn every 10 min from 1800-0600 h to determine the area under the serum GH-time curve (AUC), sum of the GH peak heights (sigma GH peak heights), and the mean nadir GH concentration. GH release was greater in the pubertal than prepubertal subjects due to an increase in sigma GH peak heights (43.8 +/- 3.6 vs. 24.1 +/- 3.5 ng.mL-1, P = 0.0002) and mean nadir (1.7 +/- 0.2 vs. 0.7 +/- 0.2 ng.mL-1, P = 0.0002), but not peak number (4.3 +/- 0.2 vs. 4.5 +/- 0.2). The girls had a greater sigma GH peak heights (39.0 +/- 3.5 vs. 28.8 +/- 3.6 ng.mL-1, P = 0.05) and mean nadir concentration (1.4 +/- 0.2 vs. 0.9 +/- 0.2 ng.mL-1, P = 0.05) than the boys. Significant inverse relationships existed between sigma GH peak heights (r = -0.35, P = 0.06) or mean nadir (r = -0.39, P = 0.04) and four-compartment percent body fat for all boys but not for all girls or when combining all subjects. For all girls, significant inverse relationships existed between sigma GH peak heights (r = -0.39, P = 0.03) or mean nadir (r = -0.37, P = 0.04) and waist/hip ratio. Similar inverse relationships in all boys or all subjects were not significant. Forward stepwise regression analysis determined that bone age (i.e. maturation, primary factor) and gender were the significant predictors of AUC, sigma GH peak heights, and mean nadir. The influence of maturation reflects rising sex steroid concentrations, and the gender differences appear to be because of differences in estradiol concentrations rather than to body composition or body fat distribution.     

Non-milk extrinsic sugars in the diets of pre-school children: association with intakes of micronutrients, energy, fat and NSP

Concern has been expressed that high dietary concentrations of non-milk extrinsic sugars (NMES) may potentially compromise nutrient intakes in population groups with low energy intakes (Department of Health, 1991). The objective of the present study was to examine data from the National Diet and Nutrition Survey of Children Aged 1.5 to 4.5 years (Gregory et al. 1995) for evidence of an inverse association between energy from NMES and micronutrient intakes, and if possible to quantify a level of NMES-energy at which micronutrient intakes may, theoretically, be compromised. Energy and nutrient intakes were compared across quintiles of NMES-energy for boys (n 848) and girls (n 827). As the concentration of NMES increased, energy intake rose (in boys only) while percentage energy from fat fell from 40 to 32% across quintiles 1 to 5. Intakes of most micronutrients also fell, while intakes of vitamin C rose. Mean intakes of most micronutrients (Ca, thiamin, riboflavin, niacin, folate and vitamin C) were adequate in comparison with dietary reference values. However, intakes of Fe, Zn and vitamin D were low at all levels of NMES-energy and fell below the estimated average requirement for Fe and Zn for NMES concentrations exceeding 24% of energy. Lower Intakes of milk, meat, bread and vegetables, and higher intakes of fruit juice largely explain the observed trends in micronutrient intake. It is concluded that the inverse association of NMES with micronutrient intakes is of most significance for the 20% of children with diets highest in NMES. However, further work is required to establish whether the associations observed have biological significance with regard to micronutrient status.     

Co-occurring delinquency and depressive symptoms of adolescent boys and girls: A dual trajectory modeling approach.

Co-occurring trajectories of delinquent behavior and depressive symptoms and their correlates were examined in a longitudinal sample of 985 middle-adolescent boys and girls (mean age = 15.54 years at Time 1). Dual trajectory analysis was used to identify the co-occurring trajectories. For boys (n = 472), 4 delinquency and 4 depression trajectory groups were found. For girls (n = 513), 3 delinquency and 3 depression trajectory groups were identified. The linkage between co-occurring trajectories was higher for girls than for boys. Stressful life events and childhood precursors of the outcomes predicted trajectory group membership for both genders fairly consistently. Findings suggest heterogeneity in developmental courses of delinquent behavior and depressive symptoms across adolescent boys and girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bronchial asthma: do boys or girls have the highest incidence?

The aim of the study was to assess the gender related prevalence of asthma and asthma symptoms in schoolchildren. The survey was performed using standardized ISAAC questionnaire in two age groups: 6-7 yr. (n = 2281; girls 49.7%) and 13-14 yr. (n = 4849; girls 49.8%). It was revealed that in older group the prevalence of ever diagnosed asthma was lower in girls than in boys (2.0% versus 3.3%; odds ratio [OR] = 0.58; p = 0.004). But the prevalence of symptoms: wheeze ever (OR = 1.16; p = 0.056), current wheeze (last 12 mo) (OR = 1.26; p = 0.029), current exercise wheeze (OR = 1.40; p = 0.0008), current night cough (OR = 1.67; p = 0.0001) were higher in girls than in boys. However, in younger group of schoolchildren the prevalence of ever diagnosed asthma and asthma symptoms were higher in boys (5.1% male versus 3.5% female). The girls in comparison to boys revealed lower risk of ever asthma diagnosis (OR = 0.66; p = 0.056) and symptoms: wheeze ever (OR = 0.63; p = 0.0001), current wheeze (OR = 0.69; p = 0.003), current exercise wheeze (OR = 0.59; p = 0.008) and current night cough (OR = 0.70; p = 0.0003).     

Initiating moderate to heavy alcohol use predicts changes in neuropsychological functioning for adolescent girls and boys.

[Correction Notice: An erratum for this article was reported in Vol 24(1) of Psychology of Addictive Behaviors (see record 2010-05354-012). The affiliation San Diego University/University of San Diego should have read San Diego State University/University of San Diego. Additionally, in the author note M. Alejandra Infante’s affiliation is listed incorrectly. Dr. Infante is affiliated only with VA San Diego Healthcare System.] This study prospectively examines the influence of alcohol on neuropsychological functioning in boys and girls characterized prior to initiating drinking (N = 76, ages 12–14). Adolescents who transitioned into heavy (n = 25; 11 girls, 14 boys) or moderate (n = 11; 2 girls, 9 boys) drinking were compared with matched controls who remained nonusers throughout the ~3-year follow-up period (N = 40; 16 girls, 24 boys). For girls, more past year drinking days predicted a greater reduction in visuospatial task performance from baseline to follow-up, above and beyond performance on equivalent measures at baseline (R2Δ = 10%, p     

Two approaches to the measurement of adaptive style: comparison of normal, psychosomatically ill, and delinquent adolescents

OBJECTIVE: This project evaluated the discriminant validity of two self-report measures of adaptive styles. METHOD: The Weinberger Adjustment Inventory, which assesses distress, restraint, denial, and repressive defensiveness, and the Bond Defense Style Questionnaire, which assesses immature, neurotic, and mature defenses, were administered to 272 adolescents: normal comparison group boys (n = 63), normal comparison group girls (n = 68), girls with psychosomatic disorders (n = 75), and incarcerated delinquent boys (n = 66). Multivariate analyses of covariance, analyses of covariance, and discriminant analyses (with socioeconomic status and age as covariates) were conducted. RESULTS: Adaptive styles from the Defense Style Questionnaire differentiated the adolescent groups better than did the Weinberger Adjustment Inventory styles. CONCLUSION: Measurement of adaptive style by the Defense Style Questionnaire may be a useful adjunct to other measures of psychopathology and can assist in assessment of risk, treatment planning, and treatment progress.     

Head posture and cervicovertebral anatomy as mandibular growth predictors

In this study, the separate and the combined influence of head posture and cervicovertebral anatomy on mandibular growth direction was analysed. The subjects, 20 boys and 16 girls, were a subsample of 12-year-old Chinese children in Hong Kong, all with initial and 2-5-year follow-up lateral cephalometric radiographs recorded in natural head position (NHP). Postural variables were measured in terms of craniovertical, craniocervical, and cervicohorizontal angulations. Morphological variables of the craniocervical junction region were measured in terms of intervertebral space and atlantoaxial dimensions. Mandibular growth was estimated as the direction of displacement of prognathion in relation to the sella nasion line when superimposing on stable cranial base structures. The data were analysed with a multiple regression model, separately for boys and girls. In both sexes the height of the atlas dorsal arch showed a statistically significant correlation (P < 0.01) with mandibular growth direction (boys r = 0.54 and girls r = 0.62), while the craniovertical angulation correlated significantly only for the boys (NSL/VER r = 0.59, P < 0.01; C1/VER r = 0.49, P < 0.05). However, atlas dorsal arch height (DORS C1) combined with cervicohorizontal angulation (OPT/HOR) in girls and with craniovertical angulation (NSL/VER; C1/VER) in boys, displayed a significantly (P < 0.05) increased correlation (r = 0.76 and 0.71, respectively). Combination of atlas morphology and head posture predicts mandibular growth direction better than either variable alone.     

Serum urate levels between ages 10 and 14: changes in sex trends

Urate levels were assayed in sera of 292 subjects between 10 and 14 years of age identified through a probability sample of a natural population. The sex trends in serum urate concentrations characteristic of childhood were seen to continue into early adolescence, with girls maintaining slightly higher means. Between 10 and 14 years there was first an overlap of male and female values followed by a reversal of trends, with much higher means in boys. Serum urate concentrations peaked in girls at age 11 and gradually stabilized at lower levels. Boys, on the other hand, showed little age variation in serum urate at 10 and 11 years but by age 12 showed sharp upward trends which continued throughout adolescence. Since age and body weight are known to be important covariates of serum urate, boys were matched to girls of the same age and body weight. Significant sex differences in urate levels persisted (after matching) only for 14-year-old adolescents and thus at this age could not be ascribed to weight differentials. The study highlights a peripubertal phenomenon whose mechanism might be endocrine related.     

"Initiating moderate to heavy alcohol use predicts changes in neuropsychological functioning for adolescent girls and boys": Correction to Squeglia et al. (2009).

Reports an error in "Initiating moderate to heavy alcohol use predicts changes in neuropsychological functioning for adolescent girls and boys" by L. M. Squeglia, et al. (Psychology of Addictive Behaviors, 2009[Dec], Vol 23[4], 715-722). The affiliation San Diego University/University of San Diego should have read San Diego State University/University of San Diego. Additionally, in the author note M. Alejandra Infante’s affiliation is listed incorrectly. Dr. Infante is affiliated only with VA San Diego Healthcare System. (The following abstract of the original article appeared in record 2009-24023-019.) This study prospectively examines the influence of alcohol on neuropsychological functioning in boys and girls characterized prior to initiating drinking (N = 76, ages 12–14). Adolescents who transitioned into heavy (n = 25; 11 girls, 14 boys) or moderate (n = 11; 2 girls, 9 boys) drinking were compared with matched controls who remained nonusers throughout the ~3-year follow-up period (N = 40; 16 girls, 24 boys). For girls, more past year drinking days predicted a greater reduction in visuospatial task performance from baseline to follow-up, above and beyond performance on equivalent measures at baseline (R2Δ = 10%, p     

A three-day weighed food record and a semiquantitative food-frequency questionnaire are valid measures for assessing the folate and vitamin B-12 intakes of women aged 16 to 19 years

The purpose of this study was to validate a food-frequency questionnaire (FFQ) and a 3-d weighed food record (3d-WFR) by comparing nutrient intakes estimated using these methods with serum folate, RBC folate and serum vitamin B-12 concentrations in 105 females aged 16-19 y. During an early morning clinic visit, subjects completed a self-administered, 116-item FFQ, blood was collected and they were trained to complete a 3d-WFR. Folate intakes as determined by the 3d-WFR (r = 0.65, P < 0.01) exhibited a stronger association with serum folate than did intakes from the FFQ (r = 0.48, P < 0.01) (P = 0.017). The correlations between folate intakes and RBC folate as determined by the FFQ (r = 0.42, P < 0.01) and 3d-WFR (r = 0.50, P < 0.01) methods did not differ. Vitamin B-12 intakes showed only a modest association with serum vitamin B-12 when supplement users were included in the analyses (FFQ, r = 0.25, P < 0.05; 3d-WFR, r = 0.32, P < 0.05). After excluding supplement users from the analyses, the relationship between vitamin B-12 intakes as determined by FFQ and serum vitamin B-12 was no longer significant. Median daily folate intakes (346 vs. 212 microgram) and vitamin B-12 (4.9 vs. 1.9 microgram) estimated from the FFQ were higher than those obtained from the 3d-WFR. In sum, these data suggest that both the FFQ and 3d-WFR are valid measures of assessing the folate intake of young women, and both appear to be useful in determining vitamin B-12 intake when supplemental users are included. The markedly different conclusions about absolute folate and vitamin B-12 intakes obtained using these two dietary methodologies should be taken into consideration when making recommendations about optimal folate intakes in relation to disease prevention.     

Same-sex and cross-sex help exchanges in the classroom.

For this study, we combined interviews and naturalistic observations of the same children to examine same-sex and cross-sex help exchanges in reading and math classes among third- and fifth-grade boys and girls. Overall, girls were perceived by their classmates to be more academically competent and more likable as helpers than were boys. Nevertheless, girls were not the targets of cross-sex help seeking more than boys were. Both boys and girls sought help more frequently from same-sex than from opposite-sex classmates. When help seeking occurred between opposite-sex classmates, girls were more likely than boys to report liking these helpers as much as their same-sex helpers. The implications of these findings for children's learning and peer status are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tumor-related arthrodesis. Reconstruction of the shoulder contour using a free TRAM (Transverse Rectus Abdominis Musculocutaneous) flap]

We evaluated growth hormone binding protein (GHBP) activity in a group of obese children (12 boys and 12 girls, age 3.1-14.7 years, BMI 21.1-33.3, 11 prepubertal and 13 early pubertal) and in 26 age-matched normal weight children (14 boys and 12 girls, age 2.1-16.0 years, BMI 14.2-21.4, 18 prepubertal and 8 early pubertal). All children were of normal stature. GHBP activity was significantly higher in the obese (39.1 +/- 1.1%) than in the control children (28.3 +/- 1.0%, p < 0.0001). Mean serum GHBP was not different between boys and girls or between prepubertal and pubertal subjects. A positive correlation was found between BMI and GHBP levels only in the normal weight children (r = 0.425, p < 0.05). Baseline insulin concentrations in the obese children were 97.6 +/- 7.9 pmol/l (normal values, 45.0 +/- 18.6 pmol/l), and the mean insulin AUC following OGTT in the obese was 811.3 +/- 160.7 pmol/l (normal values, 373.1 +/- 150.1 pmol/l). Serum GHBP activity in the obese was not correlated with baseline serum insulin concentrations or with the insulin AUC following OGTT. In conclusion, we found that obese children have elevated GHBP activity, and speculate that this phenomenon may serve to compensate for their reduced GH secretion and accelerated GH clearance.