Shanghai Jiaotong University, China
Objectives: Obesity is reported closely relevant to early sexual development but the relationship between sexual precocity and obesity or central obesity is still inconsistent, especially in boys. We aimed to investigate the relationship between precocious puberty and obesity as well as central obesity.
Design: A large population-based cross-sectional study using multistage, stratified cluster random sampling.
Setting: Data from the Shanghai Childrenʼs Health, Education and Lifestyle Evaluation (SCHEDULE) study in June 2014.
Participants: 17,620 Chinese children aged 6–12 years.
Primary and secondary outcome measures: Obesity was defined by WHO Child Growth Standards. Central obesity was defined by sex-specific waist-to-height ratio (WHtR) cut-offs (WHtR ≥ 0.48 for boys, WHtR ≥ 0.46 for girls). Precocious puberty was identified by Tanner stage of breast, pubic hair and testicle. A chi-square test was performed to compare rates. Odds ratios (ORs) with 95% confident interval (CI) were calculated to assess the association between precocious puberty and general obesity and central obesity. Probit analysis was used for estimating the median age at entry into Tanner stage 2 or greater for breast, pubic hair and testicle development. Linear regression was utilized to compare the effects of WHtR and BMI on sex development indicators.
Results: 25.98% and 38.58% precocious boys were respectively accompanied by obesity (OR = 2.15, 95%CI = 1.31–3.50) or central obesity (OR = 2.10, 95%CI = 1.46–3.03); meanwhile, 13.86% and 29.42% precocious girls were respectively accompanied by obesity (OR = 9.00, 95%CI = 5.60–14.46) or central obesity (OR = 5.40, 95%CI = 4.10–7.12). The median ages of breast, pubic hair and testicle development decreased with BMI increased and median ages of thelarche and testicular rather than pubarche were earlier in children with central obesity.
Conclusions: Earlier pubertal development was positively associated with obesity and central obesity in Chinese children.
Biography:
Dr. Shijian Liu, Advisor, The director of Biobank in Shanghai Childrenʼs Medical Center and China National childrenʼs Medical Center, Professor of school of public health, Shanghai Jiao Tong University School of Medicine. Dr. Liu focus on the research in mechanism and association of obesity and precocious puberty, especial in the epidemiology and genetics of obesity in children. He Graduated from the Second Military Medical University, his major is epidemiology and biostatistics. He studied in the Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center as a visiting scholar from September 2013 to October 2014.
Hamad General Hospital and Qatar Metabolic Institute, Qatar
Obesity is a common complication after craniopharyngioma therapy, (75% of survivors), The hypothalamus is the anatomic seat of peripheral energy regulation. When the hypothalamus is damaged, a syndrome of intractable weight gain might occur “hypothalamic obesity,”
Hypothalamic obesity syndrome has also been reported in Pseudo tumor cerebri, Head Trauma and Infiltrative or inflammatory diseases of the hypothalamus.
Hypothalamic obesity due to craniopharyngioma can occur in response to any hypothalamic damage.
It can occur due to : Craniopharyngioma tumor itself, Surgery to extirpate it, subsequent radiation therapy. Extremely high frequency of hypothalamic obesity (30– 77%) has been documented after craniopharyngioma treatment. Pathogenesis of Hypothalamic obesity Syndrome is related to the Inability to transduce afferent hormonal signals of adiposity, in effect mimicking a state of CNS starvation.
Efferent sympathetic activity drops, resulting in malaise and reduced energy expenditure Increased vagal activity, resulting in increased insulin secretion and adipogenesis.
children with hypothalamic obesity exhibit weight gain, even in response to forced caloric restriction.
This seems paradoxical, as one would expect that if hyperphagia were the reason for the obesity, then caloric restriction would be effective in preventing further weight gain.
Best treatment is prevention, as Hypothalamus is extremely sensitive to both surgical intervention and/or external beam radiation.
Rather than employing gross total or subtotal resection as a primary therapy for some posterior fossa tumors, newer strategies have been developed which treat them more conservatively, using stereotactic biopsy and conformal irradiation.
The use of serotonin or norepinephrine reuptake inhibitors (e.g., fluoxetine) have only salutary efficacy. These medications work centrally to reduce food intake, but not energy expenditure, thus have limited value.
Dextro amphetamine 5mg PO bid, acts both centrally and peripherally, achieved weight stability.
Leptin therapy has been ineffective for weight loss but rather may show some success in weight maintenance
To enhance insulin action, somatostatinanalog “octreotide” was examined. Octreotide15 µg/kg/day subcutaneously resulted in insulin suppression and stabilization of BMI, decreased leptin, decreased caloric intake, increased spontaneous physical activity, and improvement in quality of life.
Recently, bariatric surgery (RYGB, LSG, and truncal vagotomy) have also been attempted with various success outcomes.
Biography:
Dr. Mohamed Aly Elsherif earned his master and doctorate degrees in internal medicine and diabetes at Tanta University, Egypt and continued his interest in endocrinology by earning master of endocrinology from the University of South Wales, UK. He completed his fellowship training in internal medicine at Tanta Medical School. He worked as specialist internist in health insurance hospital and consulted on endocrinology and diabetes in MDH hospital in Saudi Arabia. He chaired internal medicine department in 2 private hospitals is Saudi Arabia for 4 years and moved to Qatar to continue his interest in clinical management of metabolic and endocrinal disorders with special focus on diabetes and obesity management. Dr Elsherif has a clinical experience of more than twenty years in the field of endocrinology, diabetes and obesity management. He is internationally recognized by World Obesity Federation as a certified obesity health professional holding SCOPE certificate. Dr. Elsherif is now an associate consultant in bariatric endocrinology, working in bariatric and metabolic surgery department Hamad General Hospital and Qatar metabolic institute. He has a great interest in teaching as well as research activities and has several research studies published in high impact journals and presented in international conferences. Dr. Elsherif practiced his interest and experience in teaching and was selected by HMC medical education to be one of the instructors of communication skills and other educational courses, he was also invited as a speaker in local and international conferences
Surgical Center of Fort Lauderdale, USA
Obesity continues to be a worldwide epidemic impacting all aspects of healthcare including the perioperative period. According to CDC data the prevalence of obesity in the US (as defined by a BMI > 30) is almost 40 % and morbid obesity (BMI>40) is between 5-10%. One third of the general surgical population in the US is obese. Obese patients provide special challenges to the anesthesiologist. Locating veins, measuring blood pressure, ventilating the patient to ensure adequate oxygen delivery, placing a breathing tube can all be extremely challenging to the physician and can result in fatal complicationsfor the patient. Perioperative complications for obese patients include increased cardiovascular risk, pulmonary complications including hypoxia, increased thromboembolic events leading to stroke and increased postoperative infections. My talk will address the pathophysiology of the obese patient and the implications this has in the perioperative period.
Biography:
Dr. Natasha Singh currently serves as Chief of Anesthesiology at the Surgical Center of Fort Lauderdale. She received her MD degree from the Perelman School of Medicine at the University of Pennsylvania. She also has a PhD in Molecular Genetics from the University of Colorado, Boulder. She completed her residency in Anesthesiology at the University of Miami Jackson Memorial Hospital. She has worked in private practice for over 15 years. Her interest in obesity and its perioperative management arose out of her recognizing that over a third of her patients presenting for surgery were obese.
Contact us for any additional information - contact@madridge.org
Madridge Publishers is licensed under a Creative Commons Attribution 4.0 International License.