Betül Ersoy

Microalbuminuria indices may miss early diabetic kidney disease (DKD) and can regress. Urinary podocyte and tubular injury biomarkers may detect subclinical kidney injury before albuminuria. We evaluated urinary podocyte- and tubule-derived biomarkers in adolescents/young adults with type 1 diabetes mellitus (T1DM) and compared 12-year prognostic performance with albuminuria. A total of 130 participants with T1DM were screened; 109 were eligible and included in the baseline analysis, and 30 age-matched healthy controls were enrolled. Baseline urinary podocalyxin (u-PCX), nephrin (u-nephrin), and liver-type fatty acid-binding protein (u-LFABP) were measured by ELISA and indexed to creatinine; albuminuria was assessed by 24-h albumin excretion rate (u-AER) and spot albumin-to-creatinine ratio (u-ACR). Fifty-one participants were reassessed after 12 years; measurements were obtained at baseline and at the 12-year follow-up visit. Incident DKD (micro-/macroalbuminuria) was the primary outcome. Discrimination was assessed by ROC curves and Youden thresholds. At baseline, 90% had normoalbuminuria. Participants with normoalbuminuria had higher u-PCX/Cr, u-nephrin/Cr, and u-LFABP/Cr vs. controls (all p ≤ 0.001). Over 12 years, 7/51 developed DKD. Baseline u-PCX/Cr discriminated incident DKD (AUC 0.96; 95% CI 0.91-1.00): <78 ng/mgCr (NPV 100%) and ≥193 ng/mgCr had specificity 95.5%; DKD incidence across <78, 78-193 and ≥193 ng/mgCr strata was 0%, 20% and 75%, respectively (p-trend < 0.001). Baseline spot u-ACR also performed well (AUC 0.87; 95% CI 0.74-1.00). Baseline u-PCX/Cr and u-LFABP/Cr were elevated in those who developed micro-/macroalbuminuria at 12 years. Spot u-ACR remains a practical prognostic tool, while u-PCX/Cr provides complementary, actionable long-term risk cut-points requiring external validation.

Objective: Investigating the validity and reliability of the Turkish versions of the obesity-specific health-related quality of life perception scales for children and parents , Sizing Me Up/Sizing Them Up (SMU/STU), was the aim of this study. Materials and Methods: Sizing me up/sizing them up were translated into Turkish following a standardized translation procedure. Test-retest reliability, internal consistency, discriminant and convergent validity, as well as confirmatory factor analysis (CFA) were all assessed. Results: Sizing me up /sizing them up had a total scale Cronbach’s alpha of 0.873, 0.872. In the test-retest evaluations, significant correlation was found in the SMU (except the Teasing/ Marginalization subscale), while no correlation was found in the Physical Functioning, Teasing/ Marginalization, School and Mealtime Difficulties subscales in the STU. The Pediatric Quality of Life Generic Core Scales (PedsQL) total mean score and the SMU/STU total mean scores exhibited a significant correlation (r= 0.671, P < .0001/r = 0.663, P < .001). Regarding the SMU total scale score and other subscale scores, excluding the Social Avoidance subscale, and the STU total scale score and other subscale scores, excluding Mealtime and School Functioning, a significant difference was found between the OB and non-OB samples. In CFA, the com- parative fit index (CFI) and root mean square error of approximation (RMSEA) values were not compatible with the expected values. Conclusion: The results demonstrated that both scales are suitable for use in the Turkish context and showed the validity and reliability of the Turkish versions of the SMU/STU; however, some inconsistencies were found in the items related to social avoidance in the SMU scale and positive social attributes, mealtime challenges, and school functioning in the STU, so it is recommended that these items should be interpreted separately and carefully when evaluating scale scores by researchers or clinicians Cite this article as: Kızılay DÖ, Tepe D, Ersoy B, Sapmaz ŞY. Reliability and validity of the Turkish version of a self-reported sizing me up and a parent-proxy sizing them up: Obesity specific health-related quality of life measures. Turk Arch Pediatr. 2025;60(3):334-340.

Objectives: The trend in declining age at menarche (AAM) largely continues while body size increases globally. The aim was to investigate trends in AAM, menstrual characteristics, and post‐menarcheal anthropometric parameters in adolescents living in an urban area in Türkiye between 1999 and 2018.Methods: Female adolescent high school students in the Manisa region were asked about menarche and socioeconomic status (SES). There were 1017 girls in the first study (1999–2001) and 1304 (2016–2018) in the second study. Height and weight were measured. Body mass index (BMI) was calculated. Adolescent girls were grouped into three socioeconomic status (SES) groups based on parental education and occupation, and all parameters were evaluated using SES.Results: The mean ± standard deviation for AAM in the first period was 12.82 ± 1.07 years and 12.83 ± 0.9 years in the second. AAM did not differ between the two periods nor between SES groups in either period. Post‐menarcheal height, weight, and BMI increased in the second period compared to the first study and across all SES groups (p < 0.05). The whole group AAM was similar in both periods, only 3 months earlier in the second period than in the first period. However, the AAM in girls with a post‐menarcheal BMI indicating being overweight or obese was significantly earlier than that of those with a normal post‐menarcheal BMI in both periods (p < 0.05).Conclusions: Despite changing sociodemographic characteristics and an increasing trend in height, weight, and BMI in all socioeconomic groups, no change was observed in mean AAM in an urban region of Western Türkiye over 18 years. While the inverse relationship between BMI and postmenarcheal BMI continued in both periods, the decline in AAM became more pronounced over the years in the presence of high postmenarcheal BMI.

Congenital adrenal hyperplasia (CAH) is a group of diseases characterized by genetic defects in the enzymes involved in adrenal steroidogenesis. The most common type is 21hydroxylase (OH) deficiency. In this disease, earlier diagnosis is possible because there is a ambigius genitalia girls. However, diagnosis may be delayed in boys. In addition, salt-wasting types can be fatal, especially in boys, as they are difficult to recognize. 17-hydroxyprogesterone (17OHP) is an important identifier for newborns at risk for 21OH deficiency. Therefore, earlier diagnosis of the disease may be possible by measuring 17OHP in newborn babies on the first week of life. Threshold 17(OH)P values for the disease are calculated based on birth weight and gestational age. In this section, neonatal screening methods for CAH, the reasons for false negative or positive screening results, the status of countries in the world that perform this screening, and the cost-effectiveness of screening are explained.

Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is common in the community. The most important clinical manifestation of G6PD deficiency is acute hemolytic anemia due to oxidative stressors. Diabetes Mellitus (DM) can precipitate hemolysis in patients with G6PD deficiency. Here, we described a 15-year-old male with newly diagnosed type 1 DM (T1DM) and unknown G6PD deficiency who suffered from hemolytic anemia during normalization of blood glucose. On admission, the patient did not have ketoacidosis. After the patient's blood sugars were regulated with insulin therapy, he presented five days later with hemolytic anemia. The cause of hemolytic anemia was G6PD deficiency. The patient had no previous episodes of hemolysis and had no relevant family history. Hypoglycemia did not occur during blood glucose regulation. The return of blood sugar to normal after a long period of hyperglycemia was thought to be the possible cause of hemolysis. In conclusion, G6PD deficiency should be considered when there is an episode of hemolysis in newly diagnosed children and adolescents with T1DM, especially in the absence of ketoacidosis and hypoglycemia.

Objective: The main hormones and adipokines that regulate growth, energy metabolism and adipogenesis in the intrauterine period are insulin, leptin, ghrelin, and adiponectin. Changes in these hormones and adipokines may affect weight gain, obesity and metabolic syndrome in advanced ages. In this study, it was aimed to investigate the relationship between insulin, leptin, ghrelin, adiponectin levels in the cord blood of term newborns and growth in the first two years of age. Methods: Term newborns in our hospital between May 2019 and October 2019 were included in the study. Insulin, glucose, ghrelin, leptin and adiponectin levels were studied in the umbilical cord blood of 80 newborns. The growth of 44 of the 80 newborns included in the study was monitored until the age of two years. Results: The relationship between insulin, ghrelin, leptin and adiponectin levels in the cord blood of 44 newborns included in the study with growth up to two years of age was investigated. A positive correlation was found between the insulin level in the cord blood and birth weight, birth head circumference, and the weights at the 12th and 24th months of life. A negative correlation was found between the level of ghrelin in the cord blood and the weights at the 6th and 24th months of life. A positive correlation was found between the level of adiponectin in the cord blood and the weight in the 6th month of life. There was no significant correlation between cord leptin level and anthropometric measurements in the first two years of age. Conclusion: While the levels of insulin and adiponectin in the cord blood were positively correlated with the weight in the first two years of life, they were negatively correlated with the ghrelin level in the cord blood. The level of leptin in cord blood did not correlate significantly with the weight in the first two years of life.

Purpose To determine the variation in anti-Mullerian hormone (AMH) and androstenedione (A4) concentrations in adolescent girls, with or without menstrual cycle disorder in relation to phenotypic features of. PCOS. Methods Adolescent girls (n = 129), age range 14–19 years, were recruited in the cohort study. All participants were in the 4th or 5th year after menarche. Sixty-eight had menstrual irregularities, usually oligomenorrhea (OM), and 61 had regular menstruation (RM). AMH and A4 concentrations were measured. Hirsutism was recorded. Polycystic ovarian morphology (PCOM) was evaluated by transabdominal pelvic ultrasonography. Polycystic ovary syndrome (PCOS) features were defined according to Rotterdam consensus criteria. Results AMH and A4 were significantly higher in adolescent girls with OM than in girls with RM (p < 0.05). A4 and body mass index (BMI) of adolescents with OM was significantly higher in those with hirsutism than those without hirsutism (p = 0.01 and 0.008, respectively). There was a positive correlation between A4 and BMI (r: 0.327, p < 0.01). Logistic regression showed that the frequency of OM in the presence of PCOM was 10.8 times (95% CI 2.04–12.09) compared to those without PCOM. The highest AMH concentrations were found in girls with OM, hirsutism, and PCOM (p < 0.05). Conclusions AMH and A4 are elevated in adolescents with oligomenorrhoea. High A4 is more prominent in the presence of hirsutism and is associated with increased BMI. PCOM, increases the likelihood of oligomenorrhea by about 10 times. AMH increase as the combination of clinical features of PCOS increases in adolescents with menstrual irregularity.

Purpose To determine the variation in Anti-Mullerian Hormone (AMH) and Androstenedione (A4) concentrations in adolescent girls, with or without menstrual cycle disorder in relation to phenotypic features of PCOS. Methods Adolescent girls (n=129), age range 14-19 years, were recruited in the cohort study. All participants were in the 4th or 5th year after menarche. Sixty-eight had menstrual irregularities, usually oligomenorrhea (OM), and 61 had regular menstruation (RM). AMH and A4 concentrations were measured. Hirsutism was recorded. Polycystic ovarian morphology (PCOM) was evaluated by transabdominal pelvic ultrasonography. Polycystic ovary syndrome (PCOS) features were defined according to Rotterdam consensus criteria. Results AMH and A4 were significantly higher in adolescent girls with OM than in girls with RM (p<0.05). A4 and body mass index (BMI) of adolescents with OM was significantly higher in those with hirsutism than those without hirsutism (p=0.01 and 0.008, respectively). There was a positive correlation between A4 and BMI (r: 0.327, p<0.01). Logistic regression showed that the frequency of OM in the presence of PCOM was 10.8 times (95% CI 2.04-12.09) compared to those without PCOM. The highest AMH concentrations were found in girls with OM, hirsutism, and PCOM (p<0.05). Conclusions AMH and A4 are elevated in adolescents with oligomenorrhoea. High A4 is more prominent in the presence of hirsutism and is associated with increased BMI. PCOM, increases the likelihood of oligomenorrhea by about 10 times. AMH increase as the combination of clinical features of PCOS increases in adolescents with menstrual irregularity.