Obesity and symptomatic cholelithiasis in childhood: epidemiologic and case-control evidence for a strong relation
OBJECTIVES/OBJECTIVE:The aims of this study were to correlate the temporal trends in obesity prevalence with hospitalization rates for symptomatic cholelithiasis and to estimate the strength of the association between obesity and symptomatic cholelithiasis in patients hospitalized at an urban children's hospital in New York serving a multiethnic population. METHODS:Using obesity prevalence data from the National Health and Nutrition Examination Survey and the rates of hospitalization for cholelithiasis derived from the Kids' Inpatient Database for 1997-2007, we estimated a correlation and a linear regression. We conducted a retrospective, case-control study in which each case ages 4 to 20 years with symptomatic cholelithiasis was individually matched to a control admitted with appendicitis based on age, sex, ethnicity, and race. RESULTS:The prevalence of obesity and the cholelithiasis hospitalization rate increased over time (R=0.87, P=0.0025). For every 1% increase in the obesity rate among children, the rate of hospitalization for gallstones increased by 0.65/100,000 children (RÂ²=0.75, P=0.0025, 95% confidence interval [CI] 0.32-0.99). The odds ratio for obesity in cases versus controls was 5.78 (n=518, P<0.0001, 95% CI 3.50-9.53). We found a significant dose-response effect, which showed that for every 1 z score increase in body mass index, the risk of cholelithiasis was increased by 79% (P<0.0001, 95% CI 1.5-2.13). CONCLUSIONS:The national trend in the prevalence of obesity from 1997 to 2009 was significantly correlated with increasing rates of hospitalization for pediatric cholelithiasis. Our case-control study suggests that obesity is a significant risk factor for hospital admission because of cholelithiasis.
Lack of association between response of OROS-methylphenidate and norepinephrine transporter (SLC6A2) polymorphism in Korean ADHD
This study investigated the relationship between the five common polymorphisms (rs2242446, rs5568, rs5569, rs998424, and rs1616905) in the norepinephrine transporter (NET) gene and the OROS-methylphenidate response in a medication-naÃ¯ve Korean attention-deficit hyperactivity disorder (ADHD) sample. One hundred thirty-seven patients with ADHD were recruited from the child and adolescent psychiatric outpatient units. The trial was an eight-week, open-label study of OROS-methylphenidate monotherapy, and treatment outcomes were measured using the Korean version of the ADHD Rating Scales-IV (K-ARS) for the parents, the Clinician Global Impression Severity Scale (CGI-S) and the Clinician Global Impression Improvement Scale (CGI-I). Associations between the five NET polymorphisms and the drug response were analyzed using genotype and allele frequencies at each locus. There was no significant difference in genotype and allele distribution for each NET polymorphism between responders and non-responders (P>0.05). There were no significant differences in change of the K-ARS score, change of CGI-S scores or CGI-I scores at 8 weeks among each genotype and allele of five NET polymorphisms (P>0.05). Although there were no significant positive results, our findings may have several implications and offer direction for future studies.