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Dr. Seema Kumar
Mayo Clinic, Rochester, MN 55905, USA

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0 Bariatric Surgery
0 Cardiovascular
0 Childhood Obesity
0 Hyperlipidemia
0 Type 2 Diabetes

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Childhood Obesity
Cardiovascular
Type 2 Diabetes
Bariatric Surgery
Hyperlipidemia

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Review
Published: 23 June 2021 in Clinical Endocrinology
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Background We sought to evaluate the association between vitamin D deficiency and severity of COVID-19 infection. Methods Multiple databases from January 1st, 2019 to December 3rd, 2020 were searched for observational studies evaluating the association between vitamin D deficiency and severity of COVID-19 infection. Independent reviewers selected studies and extracted data for the review. The main outcomes of interest were mortality, hospital admission, length of hospital stay and intensive care unit admission. Results 17 observational studies with 2,756 patients were included in the analyses. Vitamin D deficiency was associated with significantly higher mortality (OR: 2.47, 95% CI: 1.50 to 4.05; 12 studies; HR: 4.11, 95% CI: 2.40 to 7.04; 3 studies), higher rates of hospital admissions (OR: 2.18, 95% CI: 1.48 to 3.21; 3 studies); and longer hospital stays (0.52 days; 95% CI: 0.25 to 0.80; 2 studies) as compared to non-vitamin D deficient status. Subgroup analyses based on different cut offs for defining vitamin D deficiency, study geographic locations and latitude also showed similar trends. Conclusions Vitamin D deficiency is associated with greater severity of COVID-19 infection. Further studies are warranted to determine if vitamin D supplementation can decrease severity of COVID-19.

ACS Style

Zhen Wang; Avni Joshi; Kaitlyn Leopold; Sarah Jackson; Stephanie Christensen; Tarek Nayfeh; Khaled Mohammed; Ana Creo; Peter Tebben; Seema Kumar. Association of Vitamin D Deficiency with COVID‐19 Infection Severity: Systematic Review and Meta‐analysis. Clinical Endocrinology 2021, 1 .

AMA Style

Zhen Wang, Avni Joshi, Kaitlyn Leopold, Sarah Jackson, Stephanie Christensen, Tarek Nayfeh, Khaled Mohammed, Ana Creo, Peter Tebben, Seema Kumar. Association of Vitamin D Deficiency with COVID‐19 Infection Severity: Systematic Review and Meta‐analysis. Clinical Endocrinology. 2021; ():1.

Chicago/Turabian Style

Zhen Wang; Avni Joshi; Kaitlyn Leopold; Sarah Jackson; Stephanie Christensen; Tarek Nayfeh; Khaled Mohammed; Ana Creo; Peter Tebben; Seema Kumar. 2021. "Association of Vitamin D Deficiency with COVID‐19 Infection Severity: Systematic Review and Meta‐analysis." Clinical Endocrinology , no. : 1.

Journal article
Published: 20 May 2021 in Nutrients
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The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated a need for further understanding of these weight-loss motivators in the context of SDT. The current study findings highlight the importance of addressing motivational factors and family influences in research and practice related to promoting healthy dietary habits and weight management strategies among adolescents with obesity.

ACS Style

Bridget Biggs; Dawn Wilson; Mary Quattlebaum; Seema Kumar; Alicia Meek; Teresa Jensen. Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity. Nutrients 2021, 13, 1729 .

AMA Style

Bridget Biggs, Dawn Wilson, Mary Quattlebaum, Seema Kumar, Alicia Meek, Teresa Jensen. Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity. Nutrients. 2021; 13 (5):1729.

Chicago/Turabian Style

Bridget Biggs; Dawn Wilson; Mary Quattlebaum; Seema Kumar; Alicia Meek; Teresa Jensen. 2021. "Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity." Nutrients 13, no. 5: 1729.

Review
Published: 10 January 2021 in Children
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The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents is on the rise, and the increase in prevalence of this disorder parallels the modern epidemic of childhood obesity worldwide. T2DM affects primarily post-pubertal adolescents from ethnic/racial minorities and those from socioeconomically disadvantaged backgrounds. Youth with T2DM often have additional cardiovascular risk factors at diagnosis. T2DM in youth is more progressive in comparison to adult onset T2DM and shows lower rates of response to pharmacotherapy and more rapid development of diabetes-related complications. Lifestyle modifications and metformin are recommended as the first-line treatment for youth with T2DM in the absence of significant hyperglycemia. Assessment of pancreatic autoimmunity is recommended in all youth who appear to have T2DM. Pharmacotherapeutic options for youth with T2DM are limited at this time. Liraglutide, a GLP-1 agonist, was recently approved for T2DM in adolescents 10 years of age and older. Several clinical trials are currently underway with youth with T2DM with medications that are approved for T2DM in adults. Bariatric surgery is associated with excellent rates of remission of T2DM in adolescents with severe obesity and should be considered in selected adolescents.

ACS Style

Sachi Singhal; Seema Kumar. Current Perspectives on Management of Type 2 Diabetes in Youth. Children 2021, 8, 37 .

AMA Style

Sachi Singhal, Seema Kumar. Current Perspectives on Management of Type 2 Diabetes in Youth. Children. 2021; 8 (1):37.

Chicago/Turabian Style

Sachi Singhal; Seema Kumar. 2021. "Current Perspectives on Management of Type 2 Diabetes in Youth." Children 8, no. 1: 37.

Research article
Published: 01 January 2021 in Journal of Primary Care & Community Health
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Introduction/Objectives Childhood obesity develops as the result of the interplay between individual and environmental factors. Community based participatory research (CBPR) is an effective tool for improving health of communities. There is limited research on CBPR for facilitating healthy lifestyle in community schools with an alternative learning environment. The objective of the study was to explore student and staff perspectives via focus groups on barriers and facilitators for healthy eating and physical activity in a community school with alternative learning environment and to prioritize, design, and implement suggested interventions to improve healthy lifestyle. Methods We conducted qualitative research through 8 focus groups of middle and high school students (n = 40) and 2 focus groups of school staff (n = 8). The school community and research team subsequently identified and implemented interventions for facilitating healthy lifestyle in students within the school environment. Results Barriers identified for healthy lifestyle included lack of motivation, lack of healthy food options at school, inadequate knowledge about healthy lifestyle and insufficient opportunities for physical activity. Facilitators for healthy lifestyle were support and motivation from mentors and knowledge about healthy nutrition. Key strategies implemented were addition of healthier food options, educational materials for healthy eating, creation of a walk path, standing desks in classrooms and additional equipment in the school gymnasium. Conclusions Formative feedback from students and staff was helpful in the implementation of strategies for facilitating healthy lifestyle among students within a community school with an alternative learning environment.

ACS Style

Valeria Cristiani; Ashok Kumbamu; Gladys B. Asiedu; Shirley K. Johnson; Janna Rae Gewirtz O’Brien; Gordon Ziebart; Melissa R. Mogen; Brian Lynch; Seema Kumar. Use of Community Based Participatory Research to Design Interventions for Healthy Lifestyle in an Alternative Learning Environment. Journal of Primary Care & Community Health 2021, 12, 1 .

AMA Style

Valeria Cristiani, Ashok Kumbamu, Gladys B. Asiedu, Shirley K. Johnson, Janna Rae Gewirtz O’Brien, Gordon Ziebart, Melissa R. Mogen, Brian Lynch, Seema Kumar. Use of Community Based Participatory Research to Design Interventions for Healthy Lifestyle in an Alternative Learning Environment. Journal of Primary Care & Community Health. 2021; 12 ():1.

Chicago/Turabian Style

Valeria Cristiani; Ashok Kumbamu; Gladys B. Asiedu; Shirley K. Johnson; Janna Rae Gewirtz O’Brien; Gordon Ziebart; Melissa R. Mogen; Brian Lynch; Seema Kumar. 2021. "Use of Community Based Participatory Research to Design Interventions for Healthy Lifestyle in an Alternative Learning Environment." Journal of Primary Care & Community Health 12, no. : 1.

Journal article
Published: 28 December 2020 in Endocrine Practice
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To examine the main factors that influenced the decision to choose pediatric endocrinology as a career among pediatric endocrinologists. To also assess their work satisfaction/stress level, and suggested strategies to increase interest in subspecialty training in pediatric endocrinology. A workforce survey was distributed to 1470 members of the Pediatric Endocrine Society. The response rate was 37.4%, with 550 members responding. The most common reasons for respondents choosing pediatric endocrinology were intellectual stimulation (79%), exposure to endocrinology during residency (57%) or medical school (43%) and ability to establish relationships with patients with chronic disorders (54%). 97% considered intellectual stimulation as the most favorable aspect of the specialty. 84% considered financial compensation as the most unfavorable aspect of pediatric endocrinology. Majority (77%) were satisfied or very satisfied with their work environment. Mean work- related stress score [0 (none) to 10 (worst)] was 5.7, SD 2.1, median 6(Q1, Q3: 4, 7). Increased financial compensation for services and loan payment/forgiveness options were the top strategies suggested to enhance interest amongst residents for training in the subspecialty. One third (37%) felt that decreasing the duration of the fellowship to two years would increase interest in training in pediatric endocrinology. Pediatric endocrinologists report overall excellent career satisfaction indicating the potential to attract high quality doctors to the specialty. Improving reimbursement and loan forgiveness were the top strategies suggested for increasing interest in subspecialty training in pediatric endocrinology.

ACS Style

Seema Kumar; Ambika P. Ashraf; Aida Lteif; Jane Lynch; Tandy Aye. Pediatric Endocrinology: Perspectives of Pediatric Endocrinologists Regarding Career Choice and Recruitment of Trainees. Endocrine Practice 2020, 27, 743 -748.

AMA Style

Seema Kumar, Ambika P. Ashraf, Aida Lteif, Jane Lynch, Tandy Aye. Pediatric Endocrinology: Perspectives of Pediatric Endocrinologists Regarding Career Choice and Recruitment of Trainees. Endocrine Practice. 2020; 27 (7):743-748.

Chicago/Turabian Style

Seema Kumar; Ambika P. Ashraf; Aida Lteif; Jane Lynch; Tandy Aye. 2020. "Pediatric Endocrinology: Perspectives of Pediatric Endocrinologists Regarding Career Choice and Recruitment of Trainees." Endocrine Practice 27, no. 7: 743-748.

Journal article
Published: 27 June 2020 in Children
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Background: Childhood obesity is associated with dyslipidemia, fatty liver disease, and type 2 diabetes. Expert guidelines recommend screening for these conditions in children with obesity. Aims and objectives: The objective of the study was to compare rates of laboratory screening for dyslipidemia, fatty liver disease, and type 2 diabetes in children with obesity prior to and following implementation of a point-of-care decision support tool. Methods: We performed a retrospective record review of children with body mass index (BMI) ≥95th percentile for age and gender (age 7–18 years) undergoing well-child/sports examination visits. Multivariable logistic regression models were used to adjust for patient and provider confounders. Results: There was no increase in the rates of screening following implementation of the point-of-care decision support tool. Tests were more likely to be recommended in children with severe obesity and in females. Conclusions: The implementation of a point-of-care decision support tool was not associated with improvement in screening rates for dyslipidemia, fatty liver disease, and type 2 diabetes for children with obesity. Further strategies are needed to improve rates of screening for obesity-related comorbid conditions in children with obesity.

ACS Style

Tara K. Kaufman; Natalie Gentile; Seema Kumar; Marian Halle; Brian A. Lynch; Valeria Cristiani; Karen Fischer; Rajeev Chaudhry. Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity. Children 2020, 7, 67 .

AMA Style

Tara K. Kaufman, Natalie Gentile, Seema Kumar, Marian Halle, Brian A. Lynch, Valeria Cristiani, Karen Fischer, Rajeev Chaudhry. Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity. Children. 2020; 7 (7):67.

Chicago/Turabian Style

Tara K. Kaufman; Natalie Gentile; Seema Kumar; Marian Halle; Brian A. Lynch; Valeria Cristiani; Karen Fischer; Rajeev Chaudhry. 2020. "Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity." Children 7, no. 7: 67.

Review
Published: 01 February 2020 in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
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Neonatal diabetes mellitus (DM) is defined by the onset of persistent hyperglycemia within the first six months of life but may present up to 12 months of life. A gene mutation affecting pancreatic beta cells or synthesis/secretion of insulin is present in more than 80% of the children with neonatal diabetes. Neonatal DM can be transient, permanent, or be a component of a syndrome. Genetic testing is important as a specific genetic mutation can significantly alter the treatment and outcome. Patients with mutations of either KCNJ11 or ABCC8 that encode subunits of the KATP channel gene mutation can be managed with sulfonylurea oral therapy while patients with other genetic mutations require insulin treatment.

ACS Style

Amanda Dahl; Seema Kumar. Recent Advances in Neonatal Diabetes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2020, ume 13, 355 -364.

AMA Style

Amanda Dahl, Seema Kumar. Recent Advances in Neonatal Diabetes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2020; ume 13 ():355-364.

Chicago/Turabian Style

Amanda Dahl; Seema Kumar. 2020. "Recent Advances in Neonatal Diabetes." Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy ume 13, no. : 355-364.

Journal article
Published: 18 January 2020 in Children
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Adverse childhood experiences (ACE) have been associated with a greater prevalence of risky behaviors and chronic health conditions, such as diabetes in adulthood. While adolescents with risk taking behaviors experience worsening of diabetic metabolic control, it is yet to be determined whether glycemic management in children and adolescents is negatively and independently influenced by ACEs. This study examines the relationship between ACEs in children and adolescents with type 1 diabetes (T1DM) and glycemic control, BMI and lipids. For such children, we hypothesized that hemoglobin A1c (HbA1c) is positively correlated with ACE scores. Parents of children (age 2–18 years) with T1DM completed a validated ACE questionnaire. The associations between parent and child ACE score and HbA1c, lipids and BMI z-scores were assessed using linear regression. The prevalence of any ACE was 27.9% among children and 49.0% among parents. HbA1c was significantly higher in children who had exposure to three or more ACEs (β:0.63 (4.5 mmol/mol); p = 0.02), in those who had a parent exposed to four or more ACEs (β:0.87 (7.2 mmol/mol); p = 0.03), in children who had exposure to household incarceration (β:0.62 (4.4 mmol/mol); p = 0.05) and children who witnessed or had been victim of violence in the neighborhood (β:0.71 (5.4 mmol/mol); p = 0.02). ACEs were highly prevalent among children with T1DM and had a positive association with glycemic control.

ACS Style

Anoop Mohamed Iqbal; Seema Kumar; Janet Hansen; Mary Heyrman; Rebecca Spee; Aida Lteif. Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes. Children 2020, 7, 8 .

AMA Style

Anoop Mohamed Iqbal, Seema Kumar, Janet Hansen, Mary Heyrman, Rebecca Spee, Aida Lteif. Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes. Children. 2020; 7 (1):8.

Chicago/Turabian Style

Anoop Mohamed Iqbal; Seema Kumar; Janet Hansen; Mary Heyrman; Rebecca Spee; Aida Lteif. 2020. "Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes." Children 7, no. 1: 8.

Validation study
Published: 11 July 2019 in Eating Behaviors
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This study developed and provided initial validation for the Support for Healthy Lifestyle (SHeL), a set of scales designed to measure adolescent-perceived social support of healthy eating and physical activity. Item pool development utilized a prior focus group study of adolescents' perceptions of socially supportive behavior and a review of the literature on social support for health behavior change in adolescents. Exploratory factor analysis of the item pool completed by 220 adolescents, internal consistency estimates, and expert review of items and consensus resulted in 9 scales for the SHeL: Family Healthy Eating Support, Family Physical Activity Support, Family Hypocritical Control, Peer Health Eating Support, Peer Physical Activity Support, Peer Undermining, Professional Healthy Eating Support, Professional Physical Activity Support, and Professional General Support. Scale internal reliability estimates were α = 0.73–0.96. Supporting construct validity, the SHeL showed a pattern of stronger correlations between measures of the same source (parent/peer) and target behavior (healthy eating/physical activity) and stronger correlations with corresponding Sallis scales vis-à-vis other Sallis scales, with exceptions related to peer support for healthy eating. Divergent validity was somewhat limited, including in two instances, the SHeL scale was more strongly correlated with another SHeL scale. Supporting criterion validity, often the SHeL scales were correlated with related health behaviors. This study provided important psychometric information for a new measurement of social support for health behavior for adolescents. Further research with larger, more diverse, and treatment-seeking populations is needed to provide further validation of the SHeL and to begin to establish normative scores.

ACS Style

Bridget K. Biggs; Michele Tsai Owens; Jennifer Geske; Jocelyn Lebow; Seema Kumar; Kelly Harper; Karen B. Grothe; Megan L. Cunningham; Teresa B. Jensen; Matthew M. Clark. Development and initial validation of the Support for Healthy Lifestyle (SHeL) questionnaire for adolescents. Eating Behaviors 2019, 34, 101310 -101310.

AMA Style

Bridget K. Biggs, Michele Tsai Owens, Jennifer Geske, Jocelyn Lebow, Seema Kumar, Kelly Harper, Karen B. Grothe, Megan L. Cunningham, Teresa B. Jensen, Matthew M. Clark. Development and initial validation of the Support for Healthy Lifestyle (SHeL) questionnaire for adolescents. Eating Behaviors. 2019; 34 ():101310-101310.

Chicago/Turabian Style

Bridget K. Biggs; Michele Tsai Owens; Jennifer Geske; Jocelyn Lebow; Seema Kumar; Kelly Harper; Karen B. Grothe; Megan L. Cunningham; Teresa B. Jensen; Matthew M. Clark. 2019. "Development and initial validation of the Support for Healthy Lifestyle (SHeL) questionnaire for adolescents." Eating Behaviors 34, no. : 101310-101310.

Journal article
Published: 27 May 2019 in Journal of Pediatric Endocrinology and Metabolism
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Background Severe obesity is associated with a number of cardiometabolic risk factors. Thyroid-stimulating hormone (TSH) levels are often slightly increased in children with obesity. The clinical significance of the mild elevation in TSH in children with obesity is unclear. Objective To examine the association between TSH and lipids in children with severe obesity. Methods We performed a retrospective analysis of records of children with severe obesity with simultaneous measurements of TSH and lipids. Children with TSH Results The study included 834 children (age 13.8 ± 4.1 years, males 46%, body mass index [BMI]: 36.9 ± 7.6 kg/m2; BMI z-score 2.6 ± 0.4). Seventy-four (8.9%) children had TSH between 5 and Conclusions TSH levels were positively associated with non-HDL cholesterol in children with severe obesity. Males with mildly elevated TSH had higher total cholesterol and non-HDL cholesterol compared to males with normal TSH. Further studies are warranted to determine if levothyroxine therapy would result in improvement in total cholesterol or non-HDL cholesterol in children with severe obesity with mildly elevated TSH.

ACS Style

Anoop Mohamed Iqbal; Aida N. Lteif; Seema Kumar. Association between mild hyperthyrotropinemia and hypercholesterolemia in children with severe obesity. Journal of Pediatric Endocrinology and Metabolism 2019, 32, 561 -568.

AMA Style

Anoop Mohamed Iqbal, Aida N. Lteif, Seema Kumar. Association between mild hyperthyrotropinemia and hypercholesterolemia in children with severe obesity. Journal of Pediatric Endocrinology and Metabolism. 2019; 32 (6):561-568.

Chicago/Turabian Style

Anoop Mohamed Iqbal; Aida N. Lteif; Seema Kumar. 2019. "Association between mild hyperthyrotropinemia and hypercholesterolemia in children with severe obesity." Journal of Pediatric Endocrinology and Metabolism 32, no. 6: 561-568.

Multicenter study
Published: 07 March 2019 in The Journal of Pediatrics
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To describe treatment outcomes of children and adolescents enrolled in the Pediatric Obesity Weight Evaluation Registry, a consortium of multicomponent pediatric weight management programs in the US. This multicenter prospective observational cohort study, established in 2013, includes youth (2-18 years of age) with obesity enrolled from 31 Pediatric Obesity Weight Evaluation Registry (POWER) sites over a 2-year period and followed up to 12 months. Weight status was evaluated by the percentage of the 95th percentile for body mass index (%BMIp95). Associations of weight status outcomes with patient characteristics and program exposure were analyzed with multivariable mixed effects modeling. We included 6454 children and adolescents (median age, 11 years; IQR, 9-14 years; 53% white, 32% Hispanic; 73% with severe obesity) who were enrolled in POWER. Median changes in %BMIp95 for this cohort were −1.88 (IQR, −5.8 to 1.4), −2.50 (IQR, −7.4 to 1.8), −2.86 (IQR, −8.7 to 1.9), at 4-6, 7-9, and 10-12 of months follow-up, respectively (all P < .05). Older age (≥12 years), greater severity of obesity, and Hispanic race/ethnicity were associated with better improvement in %BMIp95. A 5-percentage point decrease in %BMIp95 was associated with improvement in cardiometabolic risk factors. Overall, treatment in pediatric weight management programs is associated with a modest median decrease in BMI as measured by change in %BMIp95. Further studies are needed to confirm these findings, as well as to identify additional strategies to enhance the effectiveness of these multicomponent interventions for youth with severe obesity. ClinicalTrials.gov: NCT02121132.

ACS Style

Seema Kumar; Eileen C. King; Amy L. Christison; Aaron S. Kelly; Adolfo J. Ariza; Claudia Borzutzky; Suzanne Cuda; Shelley Kirk; I. Abraham-Pratt; L. Ali; S. Armstrong; H. Binns; J. Brubaker; A. Cristison; C. Fox; C. Gordon; S. Hendrix; D. Hes; L. Jenkins; M. Joseph; M. Heyrman; L. Liu; A. McClure; M. Hofley; S. Negrete; M. Novick; V. O'Hara; J. Rodrue; M. Santos; J. Stoll; W. Stratbucker; B. Sweeney; J. Tester; S. Walka; H. Deheer; S. Wallace; S. Walsh; C. Wittcopp; A. Weedn; J. Yee; B. Grace. Health Outcomes of Youth in Clinical Pediatric Weight Management Programs in POWER. The Journal of Pediatrics 2019, 208, 57 -65.e4.

AMA Style

Seema Kumar, Eileen C. King, Amy L. Christison, Aaron S. Kelly, Adolfo J. Ariza, Claudia Borzutzky, Suzanne Cuda, Shelley Kirk, I. Abraham-Pratt, L. Ali, S. Armstrong, H. Binns, J. Brubaker, A. Cristison, C. Fox, C. Gordon, S. Hendrix, D. Hes, L. Jenkins, M. Joseph, M. Heyrman, L. Liu, A. McClure, M. Hofley, S. Negrete, M. Novick, V. O'Hara, J. Rodrue, M. Santos, J. Stoll, W. Stratbucker, B. Sweeney, J. Tester, S. Walka, H. Deheer, S. Wallace, S. Walsh, C. Wittcopp, A. Weedn, J. Yee, B. Grace. Health Outcomes of Youth in Clinical Pediatric Weight Management Programs in POWER. The Journal of Pediatrics. 2019; 208 ():57-65.e4.

Chicago/Turabian Style

Seema Kumar; Eileen C. King; Amy L. Christison; Aaron S. Kelly; Adolfo J. Ariza; Claudia Borzutzky; Suzanne Cuda; Shelley Kirk; I. Abraham-Pratt; L. Ali; S. Armstrong; H. Binns; J. Brubaker; A. Cristison; C. Fox; C. Gordon; S. Hendrix; D. Hes; L. Jenkins; M. Joseph; M. Heyrman; L. Liu; A. McClure; M. Hofley; S. Negrete; M. Novick; V. O'Hara; J. Rodrue; M. Santos; J. Stoll; W. Stratbucker; B. Sweeney; J. Tester; S. Walka; H. Deheer; S. Wallace; S. Walsh; C. Wittcopp; A. Weedn; J. Yee; B. Grace. 2019. "Health Outcomes of Youth in Clinical Pediatric Weight Management Programs in POWER." The Journal of Pediatrics 208, no. : 57-65.e4.

Review
Published: 01 December 2018 in Panminerva Medica
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Childhood obesity has assumed epidemic proportions and it is currently one of the most prevalent public health problems. The pathophysiology of excess weight gain is complex with interactions between genetic factors, environment and biological factors. In this review, we highlight the epidemiology of childhood obesity and discuss clinical evaluation of a child with obesity. A staged approach to treatment is detailed. We discuss the role of lifestyle modifications, pharmacotherapy and bariatric surgery as treatment strategies.

ACS Style

Seema Kumar; Tara Kaufman. Childhood obesity. Panminerva Medica 2018, 60, 200 -212.

AMA Style

Seema Kumar, Tara Kaufman. Childhood obesity. Panminerva Medica. 2018; 60 (4):200-212.

Chicago/Turabian Style

Seema Kumar; Tara Kaufman. 2018. "Childhood obesity." Panminerva Medica 60, no. 4: 200-212.

Journal article
Published: 13 September 2018 in Preventive Medicine
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Adverse family experiences (AFEs) are associated with childhood obesity. We evaluated whether certain positive contextual factors reduce the risk of obesity and overweight among children exposed to AFEs in a nationally representative sample. Using data derived from the National Survey of Children's Health 2011–12 (N = 43,864), we calculated the distribution of positive contextual factors (very good/excellent maternal mental health, neighborhood and school safety, and child resilience) and AFEs across weight status. The AFEs composite score was modeled as a categorical measure (0 or ≥1 AFEs). Positive contextual factors, AFEs and their interactions were evaluated in weighted, adjusted, multinomial logistic regression models predicting the odds of overweight and obesity. Children exposed to lack of very good/excellent maternal mental health and at least one AFE were at risk for overweight (OR = 1.43; 95% CI: 1.16, 1.76) and obesity (OR = 1.53; 95% CI: 1.22, 1.93). Unsafe school or neighborhood environment and exposure to 1 or more AFEs was. associated with overweight (OR = 1.32; 95% CI: 1.08, 1.61) and obesity (OR = 1.66; 95% CI: 1.34, 2.05). Lack of child resilience and exposure to 1 or more AFEs was associated with an increased risk of obesity (OR = 1.45; 95% CI: 1.17, 1.90) and overweight (OR = 1.29; 95% CI: 1.06, 1.57). These odds of obesity and overweight all decreased when positive contextual factors were present. Among children exposed to AFEs, overweight and obesity risk is reduced with positive contextual factors. Optimizing the early childhood environment can impact obesity risk.

ACS Style

Brian A. Lynch; Lila J. Finney Rutten; Patrick M. Wilson; Seema Kumar; Sean Phelan; Robert M. Jacobson; Chun Fan; Amenah Agunwamba. The impact of positive contextual factors on the association between adverse family experiences and obesity in a National Survey of Children. Preventive Medicine 2018, 116, 81 -86.

AMA Style

Brian A. Lynch, Lila J. Finney Rutten, Patrick M. Wilson, Seema Kumar, Sean Phelan, Robert M. Jacobson, Chun Fan, Amenah Agunwamba. The impact of positive contextual factors on the association between adverse family experiences and obesity in a National Survey of Children. Preventive Medicine. 2018; 116 ():81-86.

Chicago/Turabian Style

Brian A. Lynch; Lila J. Finney Rutten; Patrick M. Wilson; Seema Kumar; Sean Phelan; Robert M. Jacobson; Chun Fan; Amenah Agunwamba. 2018. "The impact of positive contextual factors on the association between adverse family experiences and obesity in a National Survey of Children." Preventive Medicine 116, no. : 81-86.

Journal article
Published: 19 July 2018 in Surgery for Obesity and Related Diseases
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Spexin is a novel peptide predominantly produced in human white adipose tissue and has recently been implicated as a potential signal in the regulation of body weight, energy homeostasis and satiety. The effect of bariatric surgery on spexin is unknown. To study the effect of roux-en-Y gastric bypass (RYGB) surgery on endogenous spexin concentration and various risk factors of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in youth with severe obesity. University Hospital, United States Spexin, body mass index (BMI), insulin, glucose, total (T)- and high molecular weight (HMW)-adiponectin, leptin and high sensitivity C- reactive protein were measured longitudinally (baseline, 6-m and 12-m) following RYGB surgery in girls with severe obesity (n= 12; Age=16.7 ± 1.5 years; BMI= 51.6 ± 2.9 kg/m2). Serum spexin concentration increased (p= 0.01) at 6-mo following surgery and stabilized afterwards. Spexin level correlated negatively with HOMA-IR (Spearman correlation r= -0.796, P < 0.001) and positively with HMW-adiponectin (Spearman correlation r= 0.691, P= 0.011). The change in spexin concentration, from baseline to 6 months following surgery, was inversely correlated with the corresponding change in BMI (Spearman correlation r= -0.573, P= 0.051). Further, the 6-month changes in spexin and HOMA-IR, were inversely correlated [slope (SE)= -0.0084 (0.0019), P = 0.001)], even after adjusting for the change in BMI . The enhancement of circulating spexin concentration in response to RYGB and correlations with beneficial postoperative changes in various adipokines in youth are novel findings that require further validation.

ACS Style

Seema Kumar; Jobayer Hossain; Thomas Inge; P Babu Balagopal. Roux-en-Y gastric bypass surgery in youth with severe obesity: 1-year longitudinal changes in spexin. Surgery for Obesity and Related Diseases 2018, 14, 1537 -1543.

AMA Style

Seema Kumar, Jobayer Hossain, Thomas Inge, P Babu Balagopal. Roux-en-Y gastric bypass surgery in youth with severe obesity: 1-year longitudinal changes in spexin. Surgery for Obesity and Related Diseases. 2018; 14 (10):1537-1543.

Chicago/Turabian Style

Seema Kumar; Jobayer Hossain; Thomas Inge; P Babu Balagopal. 2018. "Roux-en-Y gastric bypass surgery in youth with severe obesity: 1-year longitudinal changes in spexin." Surgery for Obesity and Related Diseases 14, no. 10: 1537-1543.

Journal article
Published: 06 July 2018 in Children
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Mindfulness has gained attention in the treatment of obesity. However, there is a paucity of data on family-based training in mindful eating in children. The objective of this pilot randomized clinical trial was to evaluate the feasibility and acceptability of a family-based mindful eating intervention (MEI) in adolescents with obesity, and to compare the efficacy of the MEI versus standard dietary counseling (SDC) for decreasing weight and improving cardiometabolic risk markers. Twenty-two adolescents (age 14.5–17.9 years) and parent pairs were randomized to the MEI or SDC. The MEI was administered in four 90-min sessions over 10 weeks and SDC was provided at baseline, 12 weeks, and 24 weeks. Despite the requirement of more frequent visits with the MEI, adolescents and parents attended 100% of the sessions and there were no dropouts in that group. High density lipoprotein (HDL) cholesterol increased in the SDC group, but not in the MEI group. Adolescents receiving the MEI demonstrated an increase in awareness at 24 weeks (p = 0.01) and a decrease in distraction during eating at 12 weeks (p = 0.04), when compared with the SDC group. The family-based MEI showed feasibility and acceptability in adolescents with obesity. Future studies with more intense therapy and larger sample sizes are warranted to examine the role of mindful eating in treating pediatric obesity.

ACS Style

Seema Kumar; Ivana T. Croghan; Bridget K. Biggs; Katrina Croghan; Rose Prissel; Debbie Fuehrer; Bonnie Donelan-Dunlap; Amit Sood. Family-Based Mindful Eating Intervention in Adolescents with Obesity: A Pilot Randomized Clinical Trial. Children 2018, 5, 93 .

AMA Style

Seema Kumar, Ivana T. Croghan, Bridget K. Biggs, Katrina Croghan, Rose Prissel, Debbie Fuehrer, Bonnie Donelan-Dunlap, Amit Sood. Family-Based Mindful Eating Intervention in Adolescents with Obesity: A Pilot Randomized Clinical Trial. Children. 2018; 5 (7):93.

Chicago/Turabian Style

Seema Kumar; Ivana T. Croghan; Bridget K. Biggs; Katrina Croghan; Rose Prissel; Debbie Fuehrer; Bonnie Donelan-Dunlap; Amit Sood. 2018. "Family-Based Mindful Eating Intervention in Adolescents with Obesity: A Pilot Randomized Clinical Trial." Children 5, no. 7: 93.

Journal article
Published: 22 June 2018 in Diabetes
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Background: Body weight homeostasis and the progression of obesity to comorbidities such as nonalcoholic steatohepatitis (NASH), type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) involve the gut-brain axis, a complex and highly coordinated system of peripheral appetite hormones and centrally mediated neuronal regulation. Data on the role of a gut-adipose axis in children with obesity-related comorbidities are sparse. We determined novel signals in the gut-adipose axis such as pro-uroguanylin (PUG) produced in the gut and spexin, predominantly produced in white adipose tissue along with traditional appetite/satiety hormones in insulin-resistant children with (NASH) and simple obesity. Method: A total of 29 children (age: 8-17 years) in three groups, normal weight (NW; n=11; BMI95th%) and biopsy-proven NASH (n=9; NAS-score>2) were studied. Spexin, PUG, leptin, total (T)- and high molecular weight (HMW)-adiponectin and insulin were measured. Results: Spexin, PUG and both T and HMW adiponectins were lower in children with NASH compared to both children with simple obesity and their NW counterparts, while leptin and insulin were higher (p<0.05). Spexin/leptin ratio and concentration of PUG were significantly lower (p<0.05) in children with NASH vs. simple obesity, whereas leptin and insulin were higher (p<0.05). Conclusions: Lower concentrations of novel signals such as PUG and spexin in the current study suggest that perturbations in the gut-brain axis occur at an early age in the clinical course of obesity and NASH. The potential role of these novel gut-adipose axis signals, by themselves or in unison with other factors, in diagnosing and/or monitoring the development and/or progression of obesity-related comorbidities such as NASH, T2DM and CVD as well as the potential development of more directed therapies appears to be promising and warrants further studies. Disclosure M.D. Di Guglielmo: None. S. Mansoor: None. V. Uppal: None. K.N. Furuya: None. S. Kumar: None. P. Balagopal: None.

ACS Style

Matthew D. DI Guglielmo; Sana Mansoor; Vikas Uppal; Katryn N. Furuya; Seema Kumar; P. Babu Balagopal. Alterations in Novel Signals in the Gut–Adipose Axis–A Pilot Study in Insulin-Resistant Children with Obesity and Biopsy-Proven Nonalcoholic Steatohepatitis. Diabetes 2018, 67, 1362 .

AMA Style

Matthew D. DI Guglielmo, Sana Mansoor, Vikas Uppal, Katryn N. Furuya, Seema Kumar, P. Babu Balagopal. Alterations in Novel Signals in the Gut–Adipose Axis–A Pilot Study in Insulin-Resistant Children with Obesity and Biopsy-Proven Nonalcoholic Steatohepatitis. Diabetes. 2018; 67 (Supplement):1362.

Chicago/Turabian Style

Matthew D. DI Guglielmo; Sana Mansoor; Vikas Uppal; Katryn N. Furuya; Seema Kumar; P. Babu Balagopal. 2018. "Alterations in Novel Signals in the Gut–Adipose Axis–A Pilot Study in Insulin-Resistant Children with Obesity and Biopsy-Proven Nonalcoholic Steatohepatitis." Diabetes 67, no. Supplement: 1362.

Original article
Published: 30 May 2018 in Clinical Endocrinology
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Background There is lack of consensus on the cardiometabolic consequences of mild subclinical hypothyroidism (SCH) among children. The objective of the current study was to compare lipid profiles in children with mild SCH with those of euthyroid children. Study Design Retrospective medical record review. Patients Children (ages 2‐18 years) who had undergone simultaneous measurement of TSH, free thyroxine (T4) and lipids. Lipids in children with mild SCH (TSH 5‐<10 mIU/L and normal free T4, n=228) were compared with those in euthyroid children (n=1215). Results TSH level was positively associated with total cholesterol and non‐high density lipoprotein (non‐HDL) cholesterol [ß 0.05(0.03 – 0.08), P<0.0001 and ß 0.05(0.03 ‐0.08), P< 0.0001 respectively]. Total cholesterol was significantly higher in children and adolescents with mild SCH compared with euthyroid children (4.43 ±1.14 mmol/L vs 4.2±0.85 mmol/L, P = 0.0005). Similarly, non‐HDL cholesterol level was also higher in children with mild SCH relative to euthyroid children (3.08 ± 1.14 mmol/L vs 2.91 ± 0.8 mmol/L, P=0.001). The adjusted odds ratio of having elevated total cholesterol and elevated non‐HDL cholesterol was greater in children with mild SCH compared with euthyroid children (OR 1.88, 95% CI; 1.28‐2.73; P=0.001 and 1.72, 95% CI 1.2‐2.5; P=0.003, respectively). Presence of thyroid autoimmunity was not associated with higher rates of dyslipidemia. Conclusions Mild SCH in children and adolescents was associated with higher rates of elevated total cholesterol and elevated non‐HDL cholesterol. Randomized placebo controlled studies are warranted to determine if treatment of mild SCH in children leads to improvement in lipid profile. This article is protected by copyright. All rights reserved.

ACS Style

Amanda R. Dahl; Anoop Mohamed Iqbal; Aida N. Lteif; Siobhan T. Pittock; Peter J. Tebben; Seema Kumar. Mild subclinical hypothyroidism is associated with paediatric dyslipidaemia. Clinical Endocrinology 2018, 89, 330 -335.

AMA Style

Amanda R. Dahl, Anoop Mohamed Iqbal, Aida N. Lteif, Siobhan T. Pittock, Peter J. Tebben, Seema Kumar. Mild subclinical hypothyroidism is associated with paediatric dyslipidaemia. Clinical Endocrinology. 2018; 89 (3):330-335.

Chicago/Turabian Style

Amanda R. Dahl; Anoop Mohamed Iqbal; Aida N. Lteif; Siobhan T. Pittock; Peter J. Tebben; Seema Kumar. 2018. "Mild subclinical hypothyroidism is associated with paediatric dyslipidaemia." Clinical Endocrinology 89, no. 3: 330-335.

Journal article
Published: 01 May 2018 in Metabolic Syndrome and Related Disorders
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Background: The relationship among inadequate vitamin D status, obesity, and cardiometabolic risk and the potential impact of physical activity-based interventions on vitamin D status are poorly characterized in children. This study aimed to address these issues. Methods: We studied a total of 21 adolescents (15 obese and 6 normal weight; age: 14–18 years; Tanner stage>IV). Adolescents with obesity (n = 15) underwent a randomized controlled (8 in the intervention group and 7 in the control group) 3-month physical activity-based lifestyle intervention. 25-Hydroxy vitamin D [25(OH)D] by mass spectrometry, adiponectin, leptin, high-sensitivity C-reactive protein (CRP), insulin, and glucose were measured and body composition was assessed by dual-energy x-ray absorptiometry (DXA). Analysis of covariance and mixed-effects model were used to compare mean change in 25(OH)D between intervention and nonintervention groups. Bootstrap method was used to validate the estimates and principle component analysis reduced the variables in the data for adjustment. Results: 25(OH)D was lower (P < 0.001) in the obese versus lean adolescents. Homeostasis model assessment-insulin resistance, CRP, fat mass (FM), and body mass index z-score were negatively correlated with baseline 25(OH)D, while adiponectin showed a positive correlation. After adjustment for baseline biomarkers of cardiometabolic risk, the concentration of 25(OH)D increased in the obese intervention group (P = 0.06), but not in the nonintervention group. Fat-free mass increased and FM decreased (P < 0.05 for both) in the intervention group. The magnitudes of increase in 25(OH)D and decrease in FM directly correlated (P < 0.05). Conclusions: The increase in circulating 25(OH)D concentration by physical activity-based lifestyle-only intervention in adolescents with obesity, who did not receive vitamin D supplementation, suggests a putative independent role of physical activity-based interventions in the regulation of vitamin D status and potentially in the mitigation of risk factors of cardiovascular disease.

ACS Style

Jobayer Hossain; Alexa Levinson; Donald George; José Cañas; Seema Kumar; P Babu Balagopal. Vitamin D Status and Cardiovascular Risk in Obesity: Effect of Physical Activity in Nonvitamin D Supplemented Adolescents. Metabolic Syndrome and Related Disorders 2018, 16, 197 -203.

AMA Style

Jobayer Hossain, Alexa Levinson, Donald George, José Cañas, Seema Kumar, P Babu Balagopal. Vitamin D Status and Cardiovascular Risk in Obesity: Effect of Physical Activity in Nonvitamin D Supplemented Adolescents. Metabolic Syndrome and Related Disorders. 2018; 16 (4):197-203.

Chicago/Turabian Style

Jobayer Hossain; Alexa Levinson; Donald George; José Cañas; Seema Kumar; P Babu Balagopal. 2018. "Vitamin D Status and Cardiovascular Risk in Obesity: Effect of Physical Activity in Nonvitamin D Supplemented Adolescents." Metabolic Syndrome and Related Disorders 16, no. 4: 197-203.

Editorial
Published: 01 March 2018 in Metabolic Syndrome and Related Disorders
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Seema Kumar; P. Babu Balagopal. Vaspin and Omentin-1 in Obese Children with Metabolic Syndrome: Two New Kids on the Block? Metabolic Syndrome and Related Disorders 2018, 16, 73 -75.

AMA Style

Seema Kumar, P. Babu Balagopal. Vaspin and Omentin-1 in Obese Children with Metabolic Syndrome: Two New Kids on the Block? Metabolic Syndrome and Related Disorders. 2018; 16 (2):73-75.

Chicago/Turabian Style

Seema Kumar; P. Babu Balagopal. 2018. "Vaspin and Omentin-1 in Obese Children with Metabolic Syndrome: Two New Kids on the Block?" Metabolic Syndrome and Related Disorders 16, no. 2: 73-75.

Journal article
Published: 27 February 2018 in Journal of Clinical Research in Pediatric Endocrinology
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Klinefelter syndrome is the most frequent chromosomal aneuploidy in males occurring in about 1 in 660 males. Epidemiological studies have demonstrated increased risk of type 1 diabetes and type 2 diabetes in adults with Klinefelter syndrome. There is only one previous report of neonatal diabetes in a patient with Klinefelter syndrome. We report transient neonatal diabetes due to a pathogenic heterozygous variant in KCNJ11 in a male infant with Klinefelter syndrome. A 78-day old male infant was noted to have sustained hyperglycemia with serum glucose ranging between 148 mg/dL (8.2 mmol/L) and 381 mg/dL (21.2 mmol/L) three days after undergoing a complete repair of an atrioventricular defect. Hemoglobin A1c was 6.6%. The patient was born at term with a birth weight of 2.16 kg following a pregnancy complicated by gestational diabetes that was controlled with diet. The patient was initially started on a continuous intravenous insulin drip and subsequently placed on subcutaneous insulin (glargine, human isophane and regular insulin). Insulin was gradually decreased and eventually discontinued at seven months of age. Chromosomal microarray at 11 weeks of age showed XXY and a panel-based, molecular test for neonatal diabetes revealed a pathogenic heterozygous variant c.685G>A (p.Glu229Lys) in KCNJ11. The patient is now 34 months old and continues to have normal fasting and post-prandial glucose and HbA1C levels. The patient will need prospective follow up for assessment of his glycemic status. To our knowledge this is the second reported case of neonatal diabetes in an infant with Klinefelter syndrome and the first due to a mutation in the KCNJ11 in a patient with Klinefelter syndrome.

ACS Style

Amanda R. Dahl; Radhika Dhamija; Alaa Al Nofal; Siobhan T. Pittock; W. Frederick Schwenk; Seema Kumar. Transient Neonatal Diabetes due to a Mutation in KCNJ11 in a Child with Klinefelter Syndrome. Journal of Clinical Research in Pediatric Endocrinology 2018, 10, 79 -82.

AMA Style

Amanda R. Dahl, Radhika Dhamija, Alaa Al Nofal, Siobhan T. Pittock, W. Frederick Schwenk, Seema Kumar. Transient Neonatal Diabetes due to a Mutation in KCNJ11 in a Child with Klinefelter Syndrome. Journal of Clinical Research in Pediatric Endocrinology. 2018; 10 (1):79-82.

Chicago/Turabian Style

Amanda R. Dahl; Radhika Dhamija; Alaa Al Nofal; Siobhan T. Pittock; W. Frederick Schwenk; Seema Kumar. 2018. "Transient Neonatal Diabetes due to a Mutation in KCNJ11 in a Child with Klinefelter Syndrome." Journal of Clinical Research in Pediatric Endocrinology 10, no. 1: 79-82.