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Obesity has
reached epidemic proportions worldwide; the term “globesity” defines the
current situation. If the prevalence of obesity remains unabated this will be
the first generation of children who die before their parents! The disease is
now attracting the attention of pediatric endocrinologists. At the LWPES/APS
there were multiple presentations on the subject and a symposium on adiposity.
Obesity is now recognized to be at the crossroads of insulin resistance, a
condition implicated in the “deadly quartet” of western civilization: diabetes
mellitus, hyperlipidemia, hypertension and cardiovascular disease, as well as
other common pediatric endocrine conditions, ie, PCOS, acanthosis nigricans,
glucose intolerance, etc. The obesity epidemic has its roots in a lifestyle
which facilitates consumption of excess calories over and above energy
expenditures.
Adipocytes function as an endocrine organ and play an important role in
the pathogenesis of obesity and its complications. However the potential role
of infectious agents triggering or being associated with obesity and/or its
co-morbidities is rarely discussed, nor are the potential endocrine alterations
that may be induced by infective processes. In this issue of GGH such an
omission is addressed by Drs. Dhurandhar, Atkinson and Ahmed. Their review
should shed light and attract attention to this poorly understood area and
facilitate an understanding of obesity in its entirety. Filling the void of
this often neglected aspect may also stimulate research by pediatric
endocrinologists wishing to clarify the endocrine interactions with adipocytes
and infective agents.
The editors have reviewed a variety of papers addressing subjects of
great interest. Noteworthy in the growth field are the papers on the long-term
mortality of recipients of pituitary derived growth hormone, the novel
dysfunctional growth hormone variant, the growth hormone and IGF-I effects on
longitudinal growth, and cancer risk. Also note the papers disproving the risk
of type 1 diabetes mellitus with childhood vaccinations as well as those
addressing new discoveries of leptin action and a novel treatment of
osteogenesis imperfecta. I also want to highlight the 2 papers on intersex,
intersexuality and sexual identity which denote the current state of treatment
controversies.
I am also pleased to bring to your attention enhancements in the print
and web-based journal with the addition of color figures and a more efficient
search capability. Please keep us posted with your comments and suggestions so
we may continue improving the journal.
Respectfully,
Fima Lifshitz, MD
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Current GGH - Vol. 24 No. 1
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