ORCID Profile
0000-0001-7625-6713
Current Organisations
Royal College of Paediatrics and Child Health
,
Sheffield Children's NHS Foundation Trust
,
Sheffield Hallam University
,
National Institute for Health Research
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Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier BV
Date: 05-2021
Publisher: Elsevier BV
Date: 07-2022
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.JOCD.2014.01.004
Abstract: The ISCD 2007 Pediatric Official Positions define osteoporosis in children on the basis of fracture history and low bone density, adjusted as appropriate for age, gender, and body size. The task force on fracture prediction and osteoporosis definition has reviewed these positions and suggests modifications with respect to vertebral fracture and the definition of a significant fracture history and draws attention to the need to consider degree of trauma as a factor that may modify fracture risk prediction.
Publisher: The Endocrine Society
Date: 02-2015
DOI: 10.1210/JC.2014-3199
Abstract: Bone mass is low and fracture risk is higher in obese children. Hormonal changes in relation to skeletal microstructure and biomechanics have not been studied in obese children. The objective of the study was to ascertain the relationships of obesity-related changes in hormones with skeletal microstructure and biomechanics. High resolution peripheral quantitative computed tomography (HR-pQCT) was used to compare three-dimensional cortical and trabecular microstructure and biomechanics at load-bearing and nonload bearing sites in obese and lean children. The relationship between leptin, adiponectin, testosterone, estrogen, osteocalcin and sclerostin and skeletal microstructure was also determined. The study was conducted at a tertiary pediatric endocrine unit in the United Kingdom. Obese and lean children were matched by gender and pubertal stage. Radial cortical porosity (mean difference −0.01 [95% CI: −0.02, −0.004], P = .003) and cortical pore diameter (mean difference −0.005 mm [95% CI: −0.009, −0.001], P = .011) were lower in obese children. Tibial trabecular thickness was lower (mean difference −0.009 mm [95% CI: −0.014, −0.004], P = .003), and trabecular number was higher (mean difference 0.23 mm−1 [95% CI: 0.08, 0.38], P = .004) in obese children. At the radius, fat mass percentage negatively correlated with cortical porosity (r = −0.57, P & .001) and pore diameter (r = −0.38, P = .02) and negatively correlated with trabecular thickness (r = −0.62, P & .001) and trabecular von Mises stress (r = −0.39, P = .019) at the tibia. No difference was observed in the other biomechanical parameters of the radius and tibia. Leptin was higher in obese children (805.3 ± 440.6 pg/ml vs 98.1 ± 75.4 pg/ml, P & .001) and was inversely related to radial cortical porosity (r = 0.60, 95% CI: [−0.80, −0.30], P & .001), radial cortical pore diameter (r = 0.51, 95% CI [−0.75, −0.16], P = .002), tibial trabecular thickness (r = 0.55, 95% CI: [−0.78, −0.21], P = .001) and tibial trabecular von Mises stress (r = −0.39, 95% CI: −0.65, 0.04, P = .02). Childhood obesity alters radial and tibial microstructure. Leptin may direct these changes. Despite this, the biomechanical properties of the radius and tibia do not adapt sufficiently in obese children to withstand the increased loading potential from a fall. This may explain the higher incidence of fracture in obese children.
Publisher: Elsevier BV
Date: 02-2022
Publisher: Elsevier BV
Date: 2022
Publisher: The Endocrine Society
Date: 30-01-2020
Abstract: Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene are responsible for a subset of familial isolated pituitary adenoma (FIPA) cases and sporadic pituitary neuroendocrine tumors (PitNETs). To compare prospectively diagnosed AIP mutation-positive (AIPmut) PitNET patients with clinically presenting patients and to compare the clinical characteristics of AIPmut and AIPneg PitNET patients. 12-year prospective, observational study. We studied probands and family members of FIPA kindreds and sporadic patients with disease onset ≤18 years or macroadenomas with onset ≤30 years (n = 1477). This was a collaborative study conducted at referral centers for pituitary diseases. AIP testing and clinical screening for pituitary disease. Comparison of characteristics of prospectively diagnosed (n = 22) vs clinically presenting AIPmut PitNET patients (n = 145), and AIPmut (n = 167) vs AIPneg PitNET patients (n = 1310). Prospectively diagnosed AIPmut PitNET patients had smaller lesions with less suprasellar extension or cavernous sinus invasion and required fewer treatments with fewer operations and no radiotherapy compared with clinically presenting cases there were fewer cases with active disease and hypopituitarism at last follow-up. When comparing AIPmut and AIPneg cases, AIPmut patients were more often males, younger, more often had GH excess, pituitary apoplexy, suprasellar extension, and more patients required multimodal therapy, including radiotherapy. AIPmut patients (n = 136) with GH excess were taller than AIPneg counterparts (n = 650). Prospectively diagnosed AIPmut patients show better outcomes than clinically presenting cases, demonstrating the benefits of genetic and clinical screening. AIP-related pituitary disease has a wide spectrum ranging from aggressively growing lesions to stable or indolent disease course.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: No location found
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Paul Dimitri.