Objective: Turner syndrome (TS) patients are at high risk of cardiometabolic disorders. Cardiometabolic risk factors are more commonly related to visceral rather than total body adiposity. Adipocytokines have been explored as a potential link between obesity and obesity related cardiometabolic dysfunction. This study explored the validity of epicardial fat-thickness (EFT) and perihepatic fat-thickness (PHFT) measurement as cardiometabolic-risk predictors in TS-girls in relation to standard obesity-indices and metabolic syndrome (MetS) components. Methods: Forty-six TS girls and twenty-five controls (10-16 years) were subdivided into two age-groups (10 to less than 13 and 1316). Participants were assessed for body mass index (BMI) Z-scores, waist circumference (WC), total-fat mass (FM) and trunk-FM by bioimpedance-technique, EFT and PHFT by cardiovascular magnetic resonance, lipid-profile, homeostasis model assessment of insulin resistance (HOMA-IR), and serum chemerin. MetS was defined according to International Diabetes Federation criteria. Results: Overweight/obesity and MetS were detected in 45.7% and 37% of TS-girls respectively. BMI Z-score, WC, total-FM, trunk-FM, EFT and PHFT values were significantly higher in TS-age groups compared to age-matched control groups, being more pronounced in the older group when TS-girls had been exposed to estrogen. Dyslipidemia, higher HOMA-IR, chemerin, EFT and PHFT values were observed in lean-Turner compared to BMI-Z-matched controls. EFT and PHFT were significantly correlated with chemerin and several components of MetS. EFT at a cut-off-value of 6.20 mm (area under the curve=0.814) can predict MetS in TS-girls. Conclusion: TS-girls displayed an adverse cardiometabolic profile during late childhood and adolescence. EFT and PHFT are emerging cardiometabolic risk predictors in TS-patients. Excess EFT rather than total body adiposity may contribute to altered metabolic profile among lean-Turner patients.

Eating disorders (EDs) are complex medical conditions that pose a considerable health burden for individuals with type 1 diabetes mellitus (T1DM). EDs in individuals with T1DM are linked to poor metabolic control, which heightens the risk of diabetes complications. Consequently, regular screening for EDs is essential. This study investigates the prevalence of EDs in adolescents with T1DM, investigating the associations with diabetes duration, pubertal stage, glycemic control, and diabetes-related complications. In this cross-sectional study, 350 adolescents (155 males, 195 females) with T1DM, aged 12–18, were recruited from Mansoura University Children’s Hospital. Participants completed the Diabetes Eating Problem Survey-Revised (DEPS-R) questionnaire, with scores ≥ 20 prompting clinical interviews to confirm EDs. Clinical data, including HbA1c, BMI, and body composition, were analyzed. Socioeconomic status (SES) and family factors were assessed. The prevalence of EDs was 22.6%, including other specified feeding or eating disorders (OSFED) (68.4%), binge eating (11.4%), bulimia nervosa (7.6%), avoidant restrictive (7.6%), and anorexia nervosa (5.1%). Binary logistic regression analysis showed that the significant predictors of ED in the study cohort were diabetes duration (OR = 1.75 (1.66–1.84), p < 0.001), and HbA1c (OR = 5.94 (2.4–14.6), p < 0.001). Conclusions: Adolescents with EDs had higher (SES), more family conflicts, longer diabetes duration, and were more prone to diabetic nephropathy and poor glycemic control. Screening for EDs is recommended from pre-adolescence through early adulthood. What Is Known: •  Adolescents with T1DM are more vulnerable to develop EDs compared to their peers without T1DM What Is New: •  The DEPS-R and DSM-V were useful clinical tools for screening and for diagnosis of EDs respectively among  adolescents with T1DM •  We advise to screen for EDs in adolescents with T1DM who aged around 13.6 years, at Tanner stage 3, with duration of T1DM >5 years, and/or with HbA1c >7.5%

This study aims to determine the incidence, clinical course, and risk factors of hypothyroidism following cardiac catheter (CC) in infants with congenital heart diseases (CHD). This prospective study involved 115 patients with CHD, all aged 3 years or younger, who underwent CC, as well as 100 healthy age- and sex-matched controls. Baseline thyroid function tests (TFTs) were conducted for both the patients and controls. In the CHD cohort, TFTs were reassessed 4 weeks after the CC, and for those with abnormal TFT values at this time, the tests were repeated after 2 weeks. Levothyroxine was started for patients with persistent abnormal TFTs, at 4 weeks and 6 weeks assessments after CC. Four weeks after CC, 12% of the studied group exhibited hypothyroidism. Univariate analysis identified significant predictors of hypothyroidism following CC: aortic stenosis (RR = 10.0 (1.49–66.99), P = 0.018), duration of fluoroscopy during CC (RR = 2.12 (0.99–4.26), P = 0.05), and total iodinated contrast media (iCM) during CC (RR = 2.5 (1.35–3.55), P = 0.019). Multivariate analysis indicated that iCM dose was the sole significant predictor of developing hypothyroidism (RR = 2.10 (1.01–3.23), P = 0.04). ROC curve analysis showed that the cut-off point of iCM dose for prediction of hypothyroidism evolution is 8.7 gm/kg, (sensitivity: 83%, specificity: 65%), while the cut-off point of fluoroscopy duration which predicts the development of hypothyroidism is 24 min (sensitivity: 83%, specificity: 66%). Acquired hypothyroidism after CC persisted in 4% of this cohort for 6 months. Conclusion: Higher doses of iCM and longer duration of fluoroscope during CC are risk factors for the evolution of hypothyroidism post-CC. We recommend assessing thyroid profile 4 weeks after CC, particularly in patients who received an iCM dose greater than 8.7 gm/kg and/or exposed to fluoroscopy for more than 24 min. What is known: • The use of excess iodine leads to transient inhibition of thyroid hormones biosynthesis via the Wolff-Chaikoff effect. • Infants with congenital heart diseases (CHD) are more prone to hypothyroidism due to higher frequency of abnormal thyroid morphology and routine exposure to supraphysiological doses of iodine. What is new: • Exposure to a total dose of iodinated contrast media more than 8.7 gm/kg and a fluoroscopy duration more than 24 min during cardiac catheter are risk factors for the evolution of thyroid hypofunction following cardiac catheter.