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Biomedical subjects

G E Krassas

Publications and source records attributed to G E Krassas.

At least 19 recordsLinked to original sources
PubMed2006

Viral conjunctivitis interfering with the clinical activity score and management of thyroid ophthalmopathy.

INTRODUCTION: The management of Graves' ophthalmopathy is shared between endocrinologists and ophthalmologists. Assessment and treatment of the active inflammatory stage is based on the clinical activity and disease severity scores, often without detailed eye examination by the treating endocrinologist. MATERIALS AND METHODS: We report a case of acute viral keratoconjunctivitis occurring during immunosuppressive treatment for Graves' ophthalmopathy which masked the signs, symptoms and response to treatment of the orbitopathy, posing a differential diagnostic challenge. RESULTS: The apparent worsening of the ophthalmopathy and the increased clinical activity score led the treating endocrinologist to alter the management decisions. Ophthalmic examination confirmed the diagnosis of viral keratoconjunctivitis and immunosuppressive treatment was continued with significant final improvement of Graves' ophthalmopathy. DISCUSSION: Ocular surface conditions, unrecognised by the treating physician, may complicate the assessment of thyroid ophthalmopathy when detailed eye examination is not performed. The diagnostic challenge of Graves' ophthalmopathy requires a combined approach by an endocrinologist and an ophthalmologist working as a team.

Acute Disease↗
PubMed2006

Recent developments in the medical treatment of thyroid eye disease.

No real new treatment has been developed in the last decade for thyroid eye disease (TED). Glucocorticoids (GC), orbital radiotherapy (OR) or a combination of both, are most frequently used in the treatment of TED for the iv immunosuppressive effects. However, we now have novel information regarding the when and how corticosteroids should be used. In general, the iv route of GC administration is preferable to the oral use. iv GC should be used at much lower doses than previously (4.5 to 6 g cumulative dose), possibly with a small dose of oral prednisone (or equivalent) in the interpulse period and for a few weeks after completion of iv treatment. Careful assessment of patients before treatment for identification of possible risk factors of liver toxicity is mandatory. Finally, monitoring of patients, particularly for liver function, is warranted during and after treatment. Although OR's effectiveness was disputed by a study few years ago, more recent studies have reconfirmed its beneficial role in TED and shown that it still has a positive role to play in patients with active TED. Finally, although Somatostatin-analogs (SM-as) gave the impression some years ago that might represent an effective weapon for TED management and initial, mostly uncontrolled and non-randomized trials with small number of patients supported this notion, newer randomized, double-blind studies with larger number of patients have not confirmed the first optimistic results. The question after that is if SM-as should be considered as a rubber bullet in the treatment of TED and we have to forget about them. The answer should be "no yet," especially in the light that the role of SM-as may be revitalized by the use of analogs with higher affinity for all somatostatin receptors subtypes. Such analogs are now available and under investigation in different diseases with very promising results.

Glucocorticoids↗
PubMed2006

A questionnaire survey on the management of Graves' orbitopathy in Europe.

OBJECTIVE: To determine management patterns among clinicians who treat patients with Graves' orbitopathy (GO) in Europe. DESIGN AND METHODS: Questionnaire survey including a case scenario of members of professional organisations representing endocrinologists, ophthalmologists and nuclear medicine physicians. RESULTS: A multidisciplinary approach to manage GO was valued by 96.3% of responders, although 31.5% did not participate or refer to a multidisciplinary team and 21.5% of patients with GO treated by responders were not managed in a multidisciplinary setting. Access to surgery for sight-threatening GO was available only within weeks or months according to 59.5% of responders. Reluctance to refer urgently to an ophthalmologist was noted by 32.7% of responders despite the presence of suspected optic neuropathy. The use of steroids was not influenced by the age of the patient, but fewer responders chose to use steroids in a diabetic patient (72.1 vs 90.5%, P<0.001). Development of cushingoid features resulted in a reduction in steroid use (90.5 vs 36.5%, P<0.001) and increase in the use of orbital irradiation (from 23.8% to 40.4%, P<0.05) and surgical decompression (from 20.9 to 52.9%, P<0.001). More ophthalmologists chose surgical decompression for patients with threatened vision due to optic neuropathy, who were intolerant to steroids than other specialists (70.3 vs 41.8%, P<0.01). CONCLUSION: Deficiencies in the management of patients with GO in Europe were identified by this survey. Further training of clinicians, easier access of patients to specialist multidisciplinary centres and the publication of practice guidelines may help improve the management of this condition in Europe.

Decompression, Surgical↗
PubMed2005

Childhood Graves' ophthalmopathy: results of a European questionnaire study.

OBJECTIVE: Evaluation of the frequency of Graves' ophthalmopathy (GO) and its management in children and adolescents up to 18 years old with Graves' hyperthyroidism. STUDY DESIGN: This was a questionnaire study (QS) among members of the European Thyroid Association and the European Society for Paediatric Endocrinology. Approximately 300 QS were sent to members with electronic addresses and 110 QS were returned from 25 countries: 52 respondents said they had no experience with Graves' disease in this age group, but 67 respondents (23 paediatric and 44 adult endocrinologists) completed the QS. RESULTS: Out of 1963 patients with juvenile Graves' hyperthyroidism seen by respondents in the last 10 years, 641 (33%) had GO; about one-third of GO cases were < or =10 years old, and two-thirds were 11-18 years old. The prevalences of GO among juvenile Graves' hyperthyroidism were 36.6, 27.3 and 25.9% in countries in which the smoking prevalence among teenagers was > or =25, 20-25 and <20% respectively (P < 0.0001 by chi(2) test). When confronted with the standard case of a 13-year-old girl with Graves' hyperthyroidism and moderately severe active GO, the diagnostic approach included on average 4.9 biochemical tests (TSH, free thyroxine (FT(4)) and TSH.R-Ab, 100-88% of respondents) and 2.4 specific investigations (thyroid ultrasound by 69%, orthopsy/visual fields/visual acuity by 64% and orbital magnetic resonance imaging or computed tomography by 63%). Antithyroid drugs were the treatment of choice for 94% of respondents; 70% recommended a wait-and-see policy and 28% corticosteroids for the co-existing GO. In variants of the standard case, a younger age did not affect therapeutic approach very much. Recurrent hyperthyroidism would still be treated with antithyroid drugs by 66%, and with (131)I by 25%. Worsening of GO or active GO when euthyroid would convince about two-thirds of respondents to initiate treatment of GO, preferably with steroids. CONCLUSION: GO occurs in 33% of patients with juvenile Graves' hyperthyroidism; its prevalence is higher in countries with a higher prevalence of smoking among teenagers. The diagnostic approach to the standard case of a 13-year-old with Graves' hyperthyroidism and moderately severe active GO involves on average five biochemical tests; thyroid as well as orbital imaging is done in 84% of cases. Antithyroid drugs remain the treatment of choice for 94% of respondents, and even so in case of recurrences (66%). For GO, 70% recommend a wait-and-see policy; intervention, preferably with steroids, is advocated by two-thirds of respondents in cases of worsening or still-active eye disease despite euthyroidism.

Adolescent↗
PubMed2004

Somatostatin analogs: a new tool for the management of Graves' ophthalmopathy.

Somatostatin (SM), a peptide inhibiting the release of GH, is present and plays an inhibitory role in the regulation of several organ systems in men and other species. Various SM analogs (SM-As) have been developed and used in clinical practice because the short half-life of SM makes it unsuitable for routine treatment. Recently it has been shown that SM-As might be of therapeutic value in the treatment of active thyroid ophthalmopathy. So far, 61 patients have been treated with octreotide and the results have been published in the literature. It was found that in 41 patients the drug had a beneficial effect. Ten patients were given lanreotide and 8 of those had a positive response, while 23 patients were treated with long-acting release octreotide and 16 improved. The exact mechanism of action of SM-As has not yet been fully clarified. One possible mechanism could be a direct inhibition of insulin-like growth factor (IGF)-I mediated effects. A second mechanism could be an inhibition of the release of lymphokines and inflammatory mediators from T-lympocytes. Finally, SM-As may act directly on target cells through specific cell surface receptors. With the introduction from Novartis of SOM-230, a compound which binds with high affinity to SM-receptors (SM-Rs) subtypes 1, 2, 3 and 5, with lower affinity to SM-Rs 4, and which has a very favorable T1/2 of nearly 24 h, a much better therapeutic outcome is expected. Thus, SM-As may provide a well-tolerated therapeutic alternative to corticosteroids. However, prospective placebo-controlled studies with large numbers of patients are needed before their role in the treatment of Graves' opthalmopathy is definitely established.

Graves Disease↗
PubMed2004

The cost of immunosuppressive therapies currently used in patients with thyroid eye disease.

Thyroid eye disease (TED) is an inflammatory condition of the orbit occurring in patients with autoimmune disease. In patients with mild TED, the most important therapeutic measure is reassurance. In severe cases, immunosuppressive therapy is the mainstay of treatment and around 10 immunosuppressive regimens have been suggested and used in such patients so far. The efficacy of these regimens varies according to the number of studies that have addressed these issues. "Response" to the treatment is also variably defined. However, to the best of our knowledge, no study has reported on the cost of immunosuppressive therapy in such patients. The aim of this study was mainly to provide information concerning the cost of different immunosuppressive regimens that patients with active thyroid ophthalmopathy undergo in different European countries. We have shown that the cheapest treatment is oral glucocorticoids (GC) and the most expensive is iv immunoglobulins. Cyclosporine is the second cheapest treatment. Radiotherapy plus oral GC have a cost between 850-3200 Euro; while SS analogues (SS-a) are expensive with a cost between 5000-10000 Euro. However, it is worth noting that the patients studied so far in this group were only few and most of them selected on a basis of a positive octreoscan, the cost of which has to be considered when choosing this type of treatment. Germany is by far the most expensive country as regards the costs of the main remedies, whereas Greece is the cheapest. Denmark is the most expensive country concerning radiotherapy, while Germany is the cheapest.

Drug Costs↗
PubMed2004

Treatment of juvenile Graves' disease and its ophthalmic complication: the 'European way'.

Three treatment modalities are available for Graves' disease: antithyroid drugs, surgery and radioactive iodine (RAI). None has been shown to be ideal or superior to the others. There are wide differences between individual physicians and between the physicians in different countries on the optional treatment for childhood hyperthyroidism. While antithyroid drugs remain the initial treatment of choice in almost all the medical centers in Europe, with surgery being used mainly to deal with antithyroid failures, radioiodine is preferred by only a small percentage of physicians for this group of patients. In the USA, on the contrary, radioiodine treatment of thyrotoxicosis in children has strong advocates, who emphasize the safety, simplicity and economic advantages of iodine-131 ablation, which should be considered more commonly in children. Until now, the available data have shown no significant increase in thyroid neoplasia, gonadal injury or congenital abnormalities in the offspring of older children and adults receiving RAI for thyrotoxicosis. Given the considerable increase in the risk of thyroid cancer in young children exposed to external radiation, it has been hypothesized that there may be a small increase in the risk of thyroid cancer in young children treated with RAI. Until long-term data on safety are available, specifically for young children, differences between the physicians in different countries will remain.

Antithyroid Agents↗
PubMed2003

Thyroid disease and male reproductive function.

Despite the high prevalence of thyroid diseases in the general population, male reproductive function in patients with thyroid disease has been the subject of only a few studies. Hyperthyroidism appears to cause sperm abnormalities (mainly reduction in motility), which reverse after restoration of euthyroidism. Radioiodine therapy for hyperthyroidism or thyroid cancer may cause transient reductions in sperm count and motility, but there appears to be little risk of permanent effects provided that the cumulative dose is less than 14 MBq. The effects of hypothyroidism on male reproduction appear to be more subtle than those of hyperthyroidism and reversible. Severe, prolonged hypothyroidism in childhood may be associated with permanent abnormalities in gonadal function.

Humans↗
PubMed2003

Free and total insulin-like growth factor (IGF)-I, -II, and IGF binding protein-1, -2, and -3 serum levels in patients with active thyroid eye disease.

To determine whether serum levels of total (T) and free (F) IGF-I and -II and IGF binding protein (IGFBP),-1, -2, and -3 are normal in euthyroid patients with Graves' disease and active thyroid ophthalmopathy, we investigated the above-mentioned parameters in 21 patients (11 male, 10 female) aged 50.8 +/- 11.8 yr (range 35-70) and 19 healthy individuals matched for age, gender, and body mass index. All patients had active thyroid eye disease (TED) with clinical activity scores > or = 4 and positive orbital octreoscan in both eyes. Serum T and F IGF-I and IGF-II were determined using noncompetitive time-resolved monoclonal immunofluorometric assays, IGFBP-1 was determined by an in-house RIA, IGFBP-2 by a novel in-house time-resolved immunofluorometric assay, whereas IGFBP-3 by an immunoradiometric assay. All data are expressed as mean +/- SD. Our results show that T and F IGF-I, -II, and IGFBP-1, -2, and -3 levels in patients were similar to controls and did not show any significant difference. Specifically, mean T IGF-I for patients group was 131 (61), F IGF-I was 0.47 (0.16), T IGF-II was 1056 (300), F IGF-II was 1.45 (0.54), IGFBP-1 was 33 (14), IGFBP-2 was 848 (377), and finally IGFBP-3 was 3953 (1422). For controls, mean T IGF-I was 146 (51), F IGF-I was 0.85 (0.43), T IGF-II was 939 (197), F IGF-II was 1.53 (0.53), IGFBP-1 was 44 (24), IGFBP-2 was 764 (316) and finally IGFBP-3 was 3721 (1017). Furthermore, no statistically differences emerged in the ratio between molar weights of T IGF-I/IGFBP-3 and T IGF-II/IGFBP-3, as well as to the F/T IGF-I and F/T IGF-II. Finally, no relationship was found between the levels of the above-mentioned parameters and clinical activity scores, octreoscan scores, and thyroid hormones. Our data demonstrate for the first time that serum levels of IGFs (including free fractions) and IGFBPs are not increased in euthyroid Graves' patients with active TED. The increased IGF levels in retrobulbar tissues previously described, appear to be independent of serum IGFs concentration and probably represent autocrine and/or paracrine activity.

Adult↗
PubMed2002

A prospective controlled study of the impact of hyperthyroidism on reproductive function in males.

The aim of this prospective controlled study was to ascertain the effect of hyperthyroidism on sperm quality and composition. We studied 23 thyrotoxic male patients, aged 43.8 +/- 2.4 yr (mean +/- SEM), and 15 healthy male controls of approximately the same age (42.2 +/- 2.2 yr). Two semen analyses at intervals of 2-3 wk were obtained before and about 5 months after euthyroidism was achieved either by methimazole alone (14 patients) or (131)I plus methimazole (9 patients). Total fructose, zinc (Zn), and magnesium (Mg) were also measured in seminal plasma in 16 patients, because 7 had semen volume less than 2 ml. In the control group semen analysis was performed only once. Mean (+/-SEM) semen volume was within normal range both in patients (3.3 +/- 0.2 ml) and controls (3.5 +/- 0.4 ml; P = NS). Mean sperm density was lower in patients, although the difference compared with controls did not reach statistical significance (35.7 +/- 5.3 vs. 51.5 +/- 6.1 x 10(6)/ml; P = 0.062). The same was found with sperm morphology (68 +/- 7% vs. 78 +/- 8%; P = NS). Finally, mean motility was lower in thyrotoxic males than in controls (28 +/- 8% vs. 57 +/- 7%; P < 0.01). After treatment, sperm density and motility improved [35.7 +/- 5.3 vs. 43.3 +/- 6.5 x 10(6)/ml (P = NS) and 28 +/- 8% vs. 45 +/- 7% (P < 0.05), respectively], but sperm morphology did not change (68 +/- 7% vs. 70 +/- 6%; P = NS). Mean values for fructose, Zn, and Mg did not differ between controls and patients either before or after achievement of euthyroidism [9.2 +/- 0.7, 3.0 +/- 0.5, and 4.2 +/- 0.7 nmol/liter vs. 8.6 +/- 0.9, 3.0 +/- 0.5, and 4.7 +/- 0.8 nmol/liter (patients before) and 9.1 +/- 0.7, 3.1 +/- 0.6, and 4.5 +/- 0.9 nmol/liter (patients after treatment) for fructose, Zn, and Mg, respectively]. Moreover, according to the treatment given, no statistically significant differences were found before or after treatment. Finally, seminal plasma fructose, Zn, and Mg levels did not correlate with sperm parameters or with pretreatment thyroid hormone levels. In conclusion, the results of our study indicate that male patients with hyperthyroidism have abnormalities in seminal parameters, mainly sperm motility. These abnormalities improve or normalize when the patients become euthyroid. Restoration of sperm parameters was independent of the treatment provided for the hyperthyroid syndrome. Moreover, seminal plasma elements, such as fructose, Zn, and Mg, did not correlate with sperm density, motility, or morphology.

Adult↗
PubMed2001

Age-related changes in bone density among healthy Greek males.

Osteoporosis in men is increasingly recognized as a problem in clinical medicine, but it has received much less attention than its counterpart in women. It is termed idiopathic if no known cause of bone disease can be identified clinically or in the laboratory. The true incidence of idiopathic osteoporosis (IO) in males is difficult to estimate because population characteristics and referral patterns differ so widely. The aim of this study was to investigate the incidence of IO in healthy Greek male volunteers by measuring bone mineral density (BMD) at four skeletal sites and examining the relations among age, BMI, and bone status. This type of information has not yet been published. We considered osteoporosis to be present when the BMD was less than or equal to -2.5 SD from the average value for healthy young men. Three hundred and sixty-three normal male volunteers were investigated. The mean age was 51.3+/-8.7 yr, and BMI was 27.5+/-3.7 kg/m2. In all subjects BMD at four skeletal sites - lumbar spine (LS), femoral neck (FN), Ward's triangle (WT), and finally trochanter (T) - was measured using dual-energy X-ray absorptiometry (DEXA). T-score, Z-score and g/cm2 values were estimated. Forty-four subjects (11%) had BMD< or =-2.5 SD (T-score). The mean age and BMI for the men with decreased BMD was 54.8+/-6.4 yr and 26.3+/-3.3 kg/m2, whereas mean age and BMI for those with normal BMD was 51.0+/-8.9 yr and 27.6+/-3.6 kg/m2, respectively. These differences were statistically significant (p<0.001 and p<0.05, respectively). A positive correlation was found between BMI and bone density (g/cm2) at three skeletal sites: LS (r=0.235, p<0.001), WT (r=0.126, p<0.001) and FN (r=0.260, p<0.001). A positive correlation was also found between BMI and T-score at all skeletal sites studied: LS (r=0.276, p<0.001), WT (r=0.133, p<0.05), FN (r=0.233, p<0.001), and T (r=0.305, p<0.001). Finally, a positive correlation was also found between BMI and Z-score: LS (r=0.256, p<0.001), WT (r=0.117, p<0.005), FN (r=0.240, p<0.001), and T (r=0.187, p<0.001). A negative correlation was found between age and bone density (g/cm2) at FN (r=-0.157, p<0.01) and WT (r=-0.183, p<0.001). The same was true between age and T-score at FN only (r=0.137, p<0.05). Furthermore, a similar correlation was found between age and Z-score at LS (r=0.174, p<0.001). When ANOVA one-way analysis was used, a significant difference was found between the different age groups and BMD (g/cm2) at FN, T, and WT (p<0.001 for all sites). For T-score, a significant difference between age groups was found only at FN (p<0.005). Finally, a significant difference in Z-score was found at FN (p<0.001) and LS (p<0.005). When multiple regression analysis was applied, it was found that BMD (g/cm2) at two sites, FN and WT, independently correlated with age and BMI (FN: p<0.001 for both, WT: p<0.01 and p<0.05, respectively). Finally, we found an accelerated trend toward decreased BMD (g/cm2), when the odds ratio was applied. In conclusion, this study demonstrated that 11% of otherwise healthy Greek men had BMD less than or equal to -2.5 SD. A strong association was found between BMD (g/cm2) and age at three skeletal sites when ANOVA one-way analysis was applied. Moreover, BMD was positively correlated with BMI and negatively correlated with age. Currently available data are sparse and much more research is needed to increase our understanding concerning the etiology of this condition as well as illuminating the relationship between bone density and fracture.

Adult↗
PubMed2001

Serum levels of tumor necrosis factor-alpha, soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, and soluble interleukin-1 receptor antagonist in patients with thyroid eye disease undergoing treatment with somatostatin analogues.

The aim of this prospective, randomized study was to investigate the serum levels of tumor necrosis factor-alpha (TNF-alpha), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble interleukin-1 receptor antagonist (sIL-1RA) in patients with thyroid eye disease (TED) before and 1 and 3 months after treatment with somatostatin analogues (SM-a). Thirty patients, all with signs and symptoms of TED, were studied. Twenty-two patients (13 females) had active eye disease with a clinical activity score (CAS) > or = 4 (patients with active disease [PA]) and 8 patients (5 females) had inactive TED with CAS < or = 3 (patients with inactive disease [PI]). All PA patients had a positive orbital octreoscan, whereas PI patients had a negative one. Fifteen patients from the PA group were selected randomly and received SM-a (PA-S subgroup), while the remaining 7 patients were used as control subgroup (PA-C), received neither therapy, nor placebo. From the 15 patients who received SM-a (PA-S), 6 received octreotide (OCT) and 9 lanreotide (LRT). TED was reevaluated using the CAS 1 and 3 months after the initiation of SM-a treatment. Ten healthy individuals (6 females) were used as controls (group C). We found an increase in the basal levels of TNF-alpha (14.2 +/- 7.1 pg/mL), sICAM-1 (809.1 +/- 167.0 ng/mL), and sIL-1RA (542.1 +/- 259.0 pg/mL) in PA patients as a total group compared with the PI (1.6 +/- 1.9, 676.8 +/- 73.4, 267.6 +/- 152.8, respectively) group and C (1.9 +/- 1.4, 598.0 +/- 126.2, 258.6 +/- 155.1, respectively). The basal levels of TNF-alpha (13.3 +/- 8.3 pg/mL) and sIL-1RA (533.7 +/- 308.9 pg/mL) in PA-S as well as in PA-C (16.0 +/- 2.9, 560.2 +/- 107.3, respectively) subgroups were also increased compared with PI patients and C (1.9 +/- 1.4 and 258.6 +/- 155.1, respectively). The same was true for sICAM-1 when baseline levels compared with C (817.1 +/- 187.3 and 791.9 +/- 123.5, respectively vs. 598.0 +/- 126.2 ng/mL). After SM-a, serum levels of sICAM-1 and sVCAM-1 were decreased significantly 1 (781.2 +/- 205.9, 1,193.5 +/- 511.8 ng/mL) and 3 months (786.8 +/- 199.6, 1,122.1 +/- 225.3 ng/mL) after the initiation of treatment. In conclusion, serum levels of TNF-a, sICAM-1, and sIL-1RA were elevated in patients with active TED compared to controls. Furthermore, sICAM-1 and sVICAM-1 levels declined during the treatment with SM-a in patients with active TED.

Adult↗
PubMed2001

Immunosuppressive therapy in patients with thyroid eye disease: an overview of current concepts.

Thyroid eye disease (TED) is a debilitating disease impairing the quality of life of affected patients. Treatment is often not satisfactory. This review summarizes the existing literature and discusses the most widely used forms of treatment for TED such as glucocorticoids (GCs), and other immunosuppressive agents. GCs are the most commonly used treatment in patients with TED. Other immunosuppressive agents such as cyclosporin A, azathioprin, cyclophosphamide and ciamexone have been used, but the results are modest at best and indicate an unfavorable benefit-risk relationship. Limited experience indicates that methotrexate may be effective even in patients with refractory TED. Somatostatin analogs, octreotide and lanreotide, may provide a valuable, although costly, therapeutic alternative to GCs. Orbital radiotherapy has been used in the management of TED for almost 60 years. However, its beneficial effects have been questioned recently by several studies, the details of which have not yet been published. Other studies have argued in favor of orbital radiotherapy; however, the benefits appear to be limited to improvement of extraocular muscle dysfunction.

Glucocorticoids↗
PubMed2001

Prevalence and trends in overweight and obesity among children and adolescents in Thessaloniki, Greece.

Obesity is the most prevalent nutrition-related problem in Western societies. Childhood obesity is rapidly emerging as a global epidemic that will have profound public health consequences, as overweight children become overweight adults. The aim of this study was to investigate the prevalence of overweight and obesity among children and adolescents in the city of Thessaloniki, and evaluate the trends in Greece by comparing our results to those of other cross-sectional studies. Data concerning the height and weight of 2,458 schoolchildren aged 6 to 17 years (1,226 6-10 years, 1,232 11-17 years) of 27 primary and secondary public schools were collected. BMI was calculated from the two measurements. In the analyses, the estimations of the prevalence of overweight and obesity are based on recently established international BMI percentile curves and cut-off points from 2-18 years. To investigate the secular trends in obesity in Greece, data of schoolchildren from four successive surveys were used. In the younger group (6-10 yr), the prevalence of overweight and obesity were 25.3% and 5.6%, while for adolescents (11-17 yr) they were 19.0% and 2.6%, respectively. The prevalence was 25.9% and 5.1% for all males, and 19.1% and 3.2% for all females, respectively. As far as trends are concerned, an increase of BMI was found among males when the results of our survey were compared with those of the previous three. However, the trends for girls are different. An increase was found when the results of our study were compared with 1942. A decrease of BMI at most ages was found when the results of our study were compared with those of the 1982 survey, while an increase was recorded only for younger girls below 13 years compared to the 1984-5 study. This study demonstrates that the prevalence of overweight and obesity among schoolchildren is 22.2% and 4.1%, respectively, and has been increasing in the last decades, especially among boys.

Adolescent↗
PubMed2001

Determinants of body mass index in Greek children and adolescents.

The aim of this study was to investigate the determinants of body mass index (BMI) among Greek children and adolescents, such as parental age and BMI, number of family members in the household, parents' educational status and occupation, physical activity and hours of television viewing and playing computer games by children per day. This cross-sectional study included 2,495 children aged 6-17 years from primary and high schools of Thessaloniki, capital of Northern Greece. Data were collected by questionnaires concerning age, height and weight of the parents, number of family members, and socioeconomic status as determined by occupation and educational status of the parents. Our results revealed that overweight in Greek children and adolescents is influenced positively by several determinant factors, such as parental age and obesity, hours of television viewing, and negatively by a high parental educational level. No significant association was found between children's BMI and physical activity. Intervention and prevention measures should be targeted at the reduction of sedentary activities, especially television viewing, and promotion of physical activity. These measures should be directed at families that are affected and/or concerned with obesity.

Adolescent↗