Endocrine disease in Childhood And adolescence Department of Endocrinology Children's hospital Fudan University Email:shenshuixian@sina.com luofh@163.com
Endocrine Disease In Childhood And Adolescence Department of Endocrinology Children’s Hospital Fudan University Email: shenshuixian@sina.com luo_fh@163.com
Introduction Growth and growth disorders Adrenal disorders and sexual development abnormalities Thyroid disorders Disorders of calcium and phosphorus metabolism Diabetes mellitus and hypoglycemia Other disorders: obesity, autoimune endocrinopathies tumor, in born meta bolic disease, water homeostasis, hypertension, et al
Introduction • Growth and growth disorders • Adrenal disorders and sexual development abnormalities • Thyroid disorders • Disorders of calcium and phosphorus metabolism • Diabetes mellitus and hypoglycemia • Other disorders: obesity, autoimune endocrinopathies, tumor, inborn metabolic disease, water homeostasis, hypertension, et al
下丘脑 Hypothalamus 下丘脑通过垂体 门脉系统血流释放 垂体前叶 Anterior pituitary 垂体后叶 Posterior pituitary 垂体前叶细胞 血管加压素 分泌特异性激素 69 催产素 甲状腺 Thyroid 骨骼生长 Bone growth乳腺 肾上腺皮质 Breast卵巢 Adrenal 雌二醇孕酮睾酮 子宫内膜 前列腺
Hypothalamus Anterior pituitary Posterior pituitary Bone growth Breast Ovary Testes Adrenal Thyroid
Diabetes mellitus in childhood and adolescent
Diabetes Mellitus in Childhood and Adolescent
Maior obiective To master pediatric diabetes diagnosis, clinical presentation and therapy Minor objectives: To be familiar with the etiology and pathogenesis of pediatric diabetes To understand diabetes classification clinical findings, diagnosis and therapy To understand dia betic ketoacidosis diagnosis and treatment To understand diabetic complications and prevention
Major objective •To master pediatric diabetes diagnosis, clinical presentation and therapy Minor objectives: •To be familiar with the etiology and pathogenesis of pediatric diabetes •To understand diabetes classification, clinical findings, diagnosis and therapy •To understand diabetic ketoacidosis diagnosis and treatment •To understand diabetic complications and prevention
Definition Diabetes mellitus is a metabolic disorder of multiple etiology characterized by chronic hyperglycemia due to defective insulin secretion or insulin action or both
Definition Diabetes mellitus is a metabolic disorder of multiple etiology characterized by chronic hyperglycemia due to defective insulin secretion or insulin action or both
Epidemiology of diabetes 32.9 24% 84.5 17.5 132.3 23% 57% 14.1 50% 44% World 1.0 2000: 151 rnillion 1.3 2010:221 million 33 n 46%
Epidemiology of diabetes
Location( Age<15yo) TIDM incidence(1/100000 Finland 34 14.6 Australia 14.4 Indonesia 2.53 Singapore 2.4 South Korea 186 New Zealand 1/1000 Japan 23(88-92yr) Hang Kong 125 Tai wan 1.5(<20y) Beijing 0.94 Shanghai 083 luNy 0.12 Guilin 0.30 Huhehaote 0.91 Nanjing 0.69 Hainan 20
Location（Age<15yo） T1DM incidence (1/100000) Finland 34 U.S.A . 14.6 Australia 14.4 Indonesia 2.53 Singapore 2.4 South Korea 1.86 New Zealand 1/1000 Japan 2.53（88－92yr） Hang Kong 1.25 Tai Wan 1.5（< 20y ) Beijing 0.94 Shanghai 0.83 Zuiyi 0.12 Guilin 0.30 Huhehaote 0.91 Nanjing 0.69 Hainan 0.29
Classification of dia betes mellitus I. Type I diabetes(B-cell destruction, usuall leading to absolute insulin deficiency) A Immune mediated TIa B Idiopathic TIB II. Type 2 diabetes American Diabetes Association, 2004 To be continued
I. Type 1 diabetes (-cell destruction, usually leading to absolute insulin deficiency) A. Immune mediated T1A B. Idiopathic T1B II. Type 2 diabetes American Diabetes Association, 2004 Classification of diabetes mellitus To be continued
Classification of diabetes mellitus IlL. Other specific types A. Genetic defects of B-cell function 1. modY 3: Chromosome 12 HNF-1a 2. MODY 2: Chromosome 7, glucokinase 3. MODY 1: Chromosome 20 HNF-4a 4. MODY4: Chromosome 13. insulin promoter factor-1(IPF-1) 5. MODY5: Chromosome 17, HNF-I B 6. MoDY6: Chromosome 2. NeuroD 1 7. Mitochondrial dna 8. Others To be continued
Classification of diabetes mellitus III. Other specific types A. Genetic defects of -cell function 1. MODY 3 : Chromosome 12, HNF-1 2. MODY 2 : Chromosome 7, glucokinase 3. MODY 1 : Chromosome 20, HNF-4 4. MODY4 : Chromosome 13, insulin promoter factor-1 (IPF-1) 5. MODY5: Chromosome 17, HNF-1 6. MODY6 : Chromosome 2, NeuroD1 7. Mitochondrial DNA 8. Others To be continued
