Background: It is presumed that free T4 and thyroid-stimulating hormone (TSH) levels are related to obesity, but the findings are inconsistent. In this study we evaluated T4 and TSH concentrations between normal children and those with obesity and possible correlations between body mass index (BMI) and these markers. Methods: In this prospective study, 190 children who were overweight and obese and 133 children without obesity of the same age and sex were evaluated. Thyroid function tests (TSH, total T4, free T4 and free T3) were measured in all subjects in both groups. Thyroid antibodies (thyroid peroxidase and thyroglobulin) were determined among those with elevated TSH levels. Results: Levels of TSH and total T4 were significantly higher in children with obesity compared with the control group. Subclinical hypothyroidism was significantly higher in children with obesity (14.7%) compared with normal subjects (6.8%, p = 0.02). Among children with obesity and increased TSH levels, 10.7% had positive thyroid peroxidase and thyroglobulin antibodies. There was significantly positive correlation between BMI z score and TSH level (r = 0.198, p < 0.001) and T4 level (r = 0.18, p = 0.001). Conclusion: TSH and total T4 levels are increased in children who are overweight or obese and are a common finding in these children, but the incidence of thyroid antibodies is low in these patients and so could not be accounted for by thyroid autoimmunity. Due to these findings it is possible that increased TSH and total T4 levels are a consequence of obesity and could be reduced by decreasing BMI.

Obesity subjects individuals into metabolic and endocrine disorders. Thus obesity may increase the risk of vitamin D deficiency. This text aims at studying the prevalence of vitamin D deficiency and secondary hyperparathyroidism in obese children. In a non-randomized case control study on 52 obese children (body mass index (BMI) >95th percentile) aged 4 to 16 years undertaken at the outpatient endocrine clinic of the Children Hospital at Tabriz University between 2009-2011. This study was conducted to compare the prevalence of vitamin D deficiency and secondary hyperparathyroidism in obese children compared with 57 non obese (BMI < 85th percentile). 109 children including 52 (50.5%) boys and 57 (49.5%) girls were studied. Most of case (76.9%) and control (42.1%) groups suffered from degrees of vitamin D deficiency. There was meaningful statistical difference between two groups considering to vitamin D deficiency and parathyroid hormone (p = 0.001). A negative relations was found between iPTH and vit D level (p < 0.001, r = -0.2), BMI and 25-OH vit D (p < 0.001, r = -0.2). A positive relation was observed between parathyroid hormone and BMI (p = 0.009, r = 0.1). Obese children are at high risk at vitamin D deficiency and secondary hyperparathyroidism. BMI appears to be an important risk factor for vitamin D deficiency.

AbstractsAim of the work To determine the extent and severity of the aforementioned obesity-related atherosclerotic risk factors among school aged children and adolescents. Subjects and methods The sample has included 98 obese (nonsyndromic) and 36 non obese control subjects aged 6-16 years. A questionnaire was filled to evaluate the daily and weekly PA calculated in hours, anthropometry was done and blood pressure was measured, together with assessment of serum lipid profile and levels of fasting blood sugar, ALT, UA, E-selectin and hs CRP. Results 55% of obese group have shown 4 or 5 atherosclerotic RFs. One or more features of abnormal lipid profile were found in 94% of obese group with 73% showing high cholesterol level. ALT and UA were significantly higher in the obese group, similarly E-selectin that was elevated in71% of obese and hs CRP were significantly higher among obese. FBS did not show similar significant elevations. Positive correlations were found between cholesterol, E-selectin and hs CRP with BMI and waist/hip ratio. Conclusion Most of obese children and adolescents do suffer from some risk factors that can lead to an earlier and greater risk for developing atherosclerosis.

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BackgroundPain control after surgery in children is very important. Despite having good analgesic effects, the use of opioids is, however, limited due to side effects.ObjectivesThis study was aimed to investigate the effect of transverse abdominis plane (TAP) block on the intensity and frequency of pain after appendectomy in children.MethodsIn a single-blinded clinical trial, 40 children aged from 4 to 16 years, candidates for the appendectomy, were divided randomly to intervention and control groups. The intervention group received ultrasound-guided TAP block using 0.25 mL/kg of 0.25% bupivacaine in the Petit triangle after general anesthesia. Postoperative pain was assessed within the first 24 hours after surgery based on the Wong-Baker FACES Pain Rating Scale (WBFP).ResultsThere was a reduction in WBFP scores at 2 hours after appendectomy in the intervention group compared with the control group (5.05 ± 2.83 vs 6.30 ± 2.2063). Also, the pain intensity within 24 hours after surgery in the intervention and control groups was 3.10 ± 1.33, and 3.60 ± 1.63 respectively according to WBFP scale (P > 0.05).ConclusionsThe TAP block was effective to reduce pain after appendectomy in children, however, there was no significant difference between intervention and control groups. Further studies with larger sample sizes are needed to be done in this area of research.