- Correspondence and Reply
- Endocrinology
- Authors’ reply to a commentary on “Testosterone therapy in boys with constitutional delay of growth and puberty: a PubMed-based systematic review and exploratory meta-analysis”
- Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Ahmed, Khaled A. Siddiq, Mohammed Qusad, Mohamed AlKhalaf
- Clin Exp Pediatr. 2026;69(10):823-824. Published online September 28, 2026
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- Correspondence
- Endocrinology
- A commentary on “Testosterone therapy in boys with constitutional delay of growth and puberty: a PubMed-based systematic review and exploratory meta-analysis”
- Muqaddas Boltaboeva, Abdulhamid Haydarov, Lola Rakhmanova
- Clin Exp Pediatr. 2026;69(10):820-822. Published online September 17, 2026
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Current evidence suggests that testosterone therapy is effective in boys with constitutional delay of growth and puberty; however, important knowledge gaps persist regarding genetic predisposition, nutritional and clinical factors, baseline endocrine assessments, and long-term outcomes. Addressing these factors may improve patient selection, optimize treatment strategies, and facilitate more individualized clinical decision-making.
- Original Article
- Endocrinology
- Gut microbiota profiles in Korean children with growth hormone deficiency: a case-control study
- So Yoon Choi, Seom Gim Kong, Gyu Min Yeon, Yoo Rha Hong, Minyoung Jung, Jung Hyun Lee
- Clin Exp Pediatr. 2026;69(10):797-805. Published online August 19, 2026
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Question: Is gut microbiota composition altered in children with growth hormone deficiency (GHD)?
Finding: Children with GHD exhibited altered gut microbiota composition and predicted microbial functional pathways despite similar overall microbial diversity.
Meaning: These preliminary findings suggest a potential association between gut microbiota and pediatric GHD and warrant validation in larger prospective studies.
- Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018–2024)
- Pattara Wiromrat, Preamrudee Poomthavorn, Ratikorn Chaisiwamongkol, Chaiyawat Suppasilp, Ouyporn Panamonta, Ratchaneewan Sinitkul
- Clin Exp Pediatr. 2026;69(9):733-742. Published online August 19, 2026
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Question: Did the incidence of central precocious puberty (CPP) and premature thelarche (PT) among Thai children change during 2018–2024?
Finding: CPP incidence in girls more than doubled during the COVID-19 pandemic and remained elevated thereafter, primarily at age 8 to <9 years. PT incidence increased progressively, particularly in girls aged 7 to <8 years.
Meaning: In peripubertal age groups, CPP and PT incidence increases may reflect pandemic-related factors, obesity, awareness, or earlier pubertal onset.
- Editorial
- Endocrinology
- A commentary on “Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018–2024)”
- Won Kyoung Cho
- Clin Exp Pediatr. 2026;69(9):704-705. Published online August 27, 2026
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Nationwide Thai data showed that central precocious puberty (CPP) incidence rose sharply during the COVID-19 pandemic and plateaued, whereas premature thelarche (PT) continued to increase postpandemic, particularly among girls aged 7-8 years. Because progression from PT to CPP cannot always be predicted at presentation, longitudinal follow up is preferable to reassurance after a single visit. Childhood obesity may further complicate diagnosis by blunting gonadotropin responses, warranting cautious interpretation of stimulation testing.
- Review Article
- Endocrinology
- Effect of lifestyle interventions on pediatric obesity: a lifestyle medicine systematic review
- Jung Eun Choi, Hee Jeoung Lim, Kyung Hee Kim, Hae Soon Kim
- Clin Exp Pediatr. 2026;69(9):686-693. Published online August 27, 2026
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Lifestyle interventions effectively improve the anthropometric and cardiometabolic outcomes of children and adolescents with overweight or obesity. Multicomponent approaches integrating diet, physical activity, and behavioral strategies demonstrate the most consistent and comprehensive benefits. These findings strongly support the application of lifestyle medicine principles in pediatric obesity management. Long-term integrated interventions addressing multiple health behaviors are needed to ensure sustainable improvements.
- Linking pediatric obesity to youth-onset type 2 diabetes: integrated longitudinal and cross-sectional evidence from population-based studies worldwide
- Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Mohamed, Ahmed Elawwa
- Clin Exp Pediatr. 2026;69(8):622-635. Published online July 20, 2026
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Pediatric obesity and youth-onset type 2 diabetes have increased simultaneously across 6 continents over the last 25 years. Approximately 75% of affected youths are obese at diagnosis, beta-cell declines occur rapidly, and microvascular complications occur early. Glucagon-like peptide-1 receptor agonists and bariatric surgery achieve meaningful weight loss and glycemic improvement; however, the primary prevention of childhood obesity remains the most powerful strategy for arresting this epidemic.
- Testosterone therapy in boys with constitutional delay of growth and puberty: a PubMed-based systematic review and exploratory meta-analysis
- Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Ahmed, Khaled A. Siddiq, Mohammed Qusad, Mohamed AlKhalaf
- Clin Exp Pediatr. 2026;69(7):531-541. Published online June 18, 2026
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In boys with constitutional delay of growth and puberty, a short course of low-dose testosterone consistently accelerates linear growth and advances pubertal maturation. Long-term follow-up studies do not show a clinically meaningful effect of conservative regimens on near-adult height. As the pooled quantitative evidence represents only 46 boys in 2 controlled studies, treatment should remain individualized, while larger randomized trials using standardized patient-reported outcomes are needed.
- Original Article
- Endocrinology
- Intramuscular and subcutaneous gonadotropin-releasing hormone agonist tests for central precocious puberty in girls: a randomized controlled trial
- Worapimon Lerdrassameethad, Suttipong Wacharasindhu, Vichit Supornsilchai, Khomsak Srilanchakon
- Clin Exp Pediatr. 2026;69(6):518-523. Published online April 15, 2026
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Question: Did the intramuscular (IM) and subcutaneous (SC) administration of gonadotropin-releasing hormone (GnRH) agonists have comparable timing and diagnostic utility for evaluating central precocious puberty in girls?
Finding: Both the IM and SC GnRH stimulation tests demonstrated comparable times to peak luteinizing hormone levels.
Meaning: Clinicians may consider the IM route as a time-efficient alternative, as it offers similar diagnostic utility for central precocious puberty without compromising the detection of hypothalamic-pituitary-gonadal axis activation.
- Anthropometric trajectories of Korean children and adolescents with severe obesity
- Jeongho Han, Hakyung Lee, Dong Jun Ha, Jieun Lee, Yong Hee Hong, Hwa Young Kim, Jaehyun Kim
- Clin Exp Pediatr. 2026;69(6):508-517. Published online April 10, 2026
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Question: How do body mass index (BMI) and metabolic markers change over time in severely obese Korean children and adolescents receiving only lifestyle modifications?
Finding: Among 124 participants, BMI z scores decreased modestly over 2.6 years, primarily in younger prepubertal boys. However, most remained severely obese, with minimal improvement in body composition or metabolic markers.
Meaning: Lifestyle interventions alone have limited efficacy for severe pediatric obesity. Early and more intensive treatments are required.
- Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort
- Hala M. Sakhr, Mohammed H. Hassan, Esraa Abbass Abdallah, Amira Mahmoud Ewis, Mohamed Hesham Mohamed, Shymaa Gaber Rizk
- Clin Exp Pediatr. 2026;69(6):486-496. Published online March 26, 2026
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Question: Which factors influence pediatric thyroid disorder susceptibility and severity?
Finding: Anemia, selenium deficiency, excess copper, and the thyroid peroxidase (TPO) Arg386His polymorphism, especially with the histidine/histidine genotype, are strongly associated with pediatric thyroid disease and high thyroid-stimulating hormone levels.
Meaning: Pediatric thyroid disorders are multifactorial. The TPO Arg386His variant may help identify children at higher risk of severe thyroid dysfunction, enabling earlier diagnosis, improved risk stratification, and more personalized clinical management.
- Review Article
- Endocrinology
- Pubertal induction in prepubertal males with hypogonadotropic hypogonadism: testosterone or gonadotropins?
- Paolo Cavarzere, Riccardo Battiston, Valentina Lupieri, Valentina Mancioppi, Claudio Maffeis
- Clin Exp Pediatr. 2026;69(1):1-10. Published online December 18, 2025
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The pubertal induction process in males still poses a challenge for pediatric endocrinologists. The existing literature is limited, and it is not yet possible to make definitive recommendations. We described the various treatment for this condition and tried to analyze the unresolved questions to address the question posed in the title of our manuscript.
- Original Article
- Endocrinology
- Long-term epidemiological insights into rickets: a nationwide population-based retrospective study
- Chun-Hao Chu, Ying-Chuan Chen, Pei-Yao Liu, Chun-Chieh Hu, Yu-Lung Lin, Feng-Chih Kuo, Chieh-Hua Lu, Tzu-Ju Hsu, Yu-Tung Hung, Fuu-Jen Tsai, Chien-Ming Lin
- Clin Exp Pediatr. 2025;68(11):879-891. Published online August 20, 2025
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Question: What are the nationwide trends and mortality risk factors of nutritional versus hereditary rickets among children in Asia?
Finding: In 2012–2018, the incidence of rickets steadily increased, whereas mortality rates declined. Mortality is associated with a low household income, anemia, chronic kidney disease, secondary hyperparathyroidism, and a prolonged hospital stay.
Meaning: Early diagnosis and targeted interventions addressing social and medical vulnerabilities are critical to reducing ricket-related mortality.
- Editorial
- Endocrinology
- Rickets prevalence and treatment outcome: real-world data from Taiwan
- Young Suk Shim
- Clin Exp Pediatr. 2025;68(11):868-870. Published online October 23, 2025
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Rickets should be recognized as a significant public health concern during infancy and childhood. Recent studies from Taiwan have demonstrated a steady increase in the prevalence of nutritional rickets, and a similar trend is likely to emerge in Korea. Therefore, comprehensive clinical evaluation and appropriate biochemical assessment are essential to prevent long-term skeletal and systemic complications. Prompt diagnosis and timely initiation of appropriate treatment are crucial.
- Review Article
- Endocrinology
- Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications
- Hwa Young Kim, Jaehyun Kim
- Clin Exp Pediatr. 2025;68(11):842-851. Published online October 2, 2025
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Continuous glucose monitoring (CGM) has transformed pediatric type 1 diabetes care by facilitating tighter glycemic control, reducing hypoglycemia, and improving quality of life.
Recent advances in CGM technology and the expansion of insurance coverage in Korea have led to its broader adoption.
Emerging metrics such as time in tight range offer refined tools for individualized glycemic assessment, highlighting CGM’s evolving role in personalized pediatric diabetes management.
- Impact of hematopoietic stem cell transplantation on growth outcomes in mucopolysaccharidosis: a systematic review
- Farzaneh Abbasi, Asal Khalili Dehkordi, Reihaneh Mohsenipour
- Clin Exp Pediatr. 2025;68(6):417-427. Published online March 11, 2025
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Hematopoietic stem cell transplantation (HSCT) enhances the growth outcomes of pediatric patients with mucopolysaccharidosis, with early intervention leading to improved height, weight, and body mass index. However, achieving a standard adult height remains uncommon among these patients, even in cases of early HSCT. Growth hormone therapy provides short-term benefits but does not address long-term height deficits. Pubertal development is generally normal; however, precocious puberty and pubertal arrest may occur.
- Original Article
- Endocrinology
- Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency
- Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul
- Clin Exp Pediatr. 2025;68(3):238-246. Published online November 13, 2024
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Question: What is the prevalence of an impaired trabecular bone score (TBS), a measure of bone microarchitecture, in adolescents with 21-hydroxylase deficiency (21OHD)? Do prednisolone and hydrocortisone affect TBS differently in this patient population?
Finding: Impaired TBS was observed in 18% of participants. Prednisolone use negatively impacted TBS change.
Meaning: Impaired TBS is prevalent among adolescents with 21OHD. Prednisolone impairs trabecular bone microarchitecture development.
- Review Article
- Endocrinology
- Hidden link between endocrine-disrupting chemicals and pediatric obesity
- Min Won Shin, Shin-Hye Kim
- Clin Exp Pediatr. 2025;68(3):199-222. Published online November 28, 2024
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Studies indicate potential connections between exposure to endocrine-disrupting chemicals (EDCs) and childhood obesity. Variations in the impact of EDCs in epidemiological studies may result from differences in exposure concentrations and timing, measurement methods, and interactive effects of multiple EDCs. Longitudinal studies on exposure to multiple EDCs are crucial to elucidating their contribution to pediatric obesity and minimize the adverse health consequences of EDC exposure.
- Original Article
- Endocrinology
- Efficacy of leuprolide acetate versus triptorelin pamoate administered every 3 months for treatment of central precocious puberty
- Thanaporn Thaneetrakool, Suphab Aroonparkmongkol, Nattakarn Numsriskulrat, Vichit Supornsilchai, Suttipong Wacharasindhu, Khomsak Srilanchakon
- Clin Exp Pediatr. 2025;68(1):91-96. Published online November 6, 2024
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Question: What are the differences in efficacy between leuprolide acetate and triptorelin pamoate administered every 3 months for the treatment of central precocious puberty (CPP)?
Finding: There were no significant intergroup differences in luteinizing hormone suppression or predicted adult height at the end of treatment in girls with CPP.
Meaning: Leuprolide acetate and triptorelin pamoate have comparable efficacy for treating CPP.
- Review Article
- Endocrinology
- A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders
- Nur Faten Hafizah Rosli, Noor Shafina Mohd Nor, Rose Adzrianee Adnan, Siti Hamimah Sheikh Abdul Kadir
- Clin Exp Pediatr. 2025;68(1):30-52. Published online November 6, 2024
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· The prevalence of vitamin D deficiency is high among children and adolescents and mainly attributed to changes in environmental factors.
· Vitamin D hormone-like properties are associated with many endocrine-related disorders.
· The effect of vitamin D is modulated by the vitamin D receptor, polymorphisms of which are reportedly associated with an increased risk of disease development in children and adolescents.
- Lifelong medical challenges and immunogenetics of Turner syndrome
- Won Kyoung Cho
- Clin Exp Pediatr. 2024;67(11):560-568. Published online July 31, 2024
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· This summary emphasizes the importance of the early diagnosis of Turner syndrome (TS) and presents a multidisciplinary approach to its prevention and management, high-lighting the need for customized care.
· Advancements in immunogenetic research may improve our understanding of TS and improve its outcomes.
· TS encompasses a wide array of medical challenges, including cardiovascular, endocrine, autoimmune, and mental health issues, as well as a heightened cancer risk.
- Growth plate closure and therapeutic interventions
- Ja Hyang Cho, Hae Woon Jung, Kye Shik Shim
- Clin Exp Pediatr. 2024;67(11):553-559. Published online October 28, 2024
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Height gains result from longitudinal bone growth. Upon adequate growth, growth plate closure limits longitudinal bone growth. To date, gonadotropin-releasing hormone analogs, aromatase inhibitors, C-type natriuretic peptide analogs, and fibroblast growth factor receptor 3 inhibitors have been studied or used as therapeutic interventions to delay growth plate closure and increase human height. The development of more effective therapeutic modalities for short stature, precocious puberty, and skeletal dysplasia is anticipated.
- Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis
- Maya L. Nasser, Joseph Nasr, Reem B. Zalloum, Nathanael Q.E. Yap, Natalie E. Bourdakos, Shahid Miangul, Tara A. Betts, Hayato Nakanishi, Christian A. Than, Serge Jabbour
- Clin Exp Pediatr. 2024;67(10):486-497. Published online June 27, 2024
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· The safety and efficacy of the two-bag versus one-bag system for treating patients with diabetic ketoacidosis (DKA) < 21 years remains unestablished.
· Our meta-analysis demonstrated similar safety outcomes but sooner DKA resolution and shorter mean response time for intravenous fluid changes for the two-bag system.
· This preliminary evidence suggests that the two-bag system has some advantages in efficacy, but further studies are needed to evaluate their extent.
- Association between pre- and postnatal exposure to endocrine-disrupting chemicals and birth and neurodevelopmental outcomes: an extensive review
- Ozge Yesildemir, Mensure Nur Celik
- Clin Exp Pediatr. 2024;67(7):328-346. Published online November 16, 2023
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· Sensitivity to endocrine-disrupting chemical (EDC) exposure increases during critical developmental periods (in embryos, fetuses, and neonates).
· Pre- and postnatal exposure to EDCs is associated with fetal growth restriction, preterm birth, and low birth weight.
· Exposure to EDCs during fetal and early postnatal life can have lasting and lifelong neurodevelopmental outcomes, including autism spectrum, attention deficit hyperactivity, and other cognitive and behavioral disorders.
- Original Article
- Endocrinology
- Kisspeptin and DLK1 levels for monitoring treatment of girls with central precocious puberty
- Witchuwan Onsoi, Nattakarn Numsriskulrat, Suphab Aroonparkmongkol, Vichit Supornsilchai, Khomsak Srilanchakon
- Clin Exp Pediatr. 2024;67(6):296-302. Published online May 21, 2024
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Questions: Can the serum levels of kisspeptin and DLK1 be potential biomarkers for monitoring the treatments for central precocious puberty (CPP)?
Findings: There were no significant differences in the baseline serum kisspeptin and DLK1 levels in CPP girls compared to girls with premature thelarche (PT). After 6 months of GnRH analogue treatment in CPP girls, median serum kisspeptin levels decreased, while median serum DLK1 levels increased compared to baseline.
Meanings: Serum levels of kisspeptin and DLK1 may serve as novel biomarkers for monitoring the efficacy of treatments for CPP.
- Editorial
- Endocrinology
- Nonalcoholic fatty liver disease in children and adolescents
- Hae Sang Lee
- Clin Exp Pediatr. 2024;67(2):90-91. Published online January 24, 2024
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· With the increase in childhood obesity, nonalcoholic fatty liver disease (NAFLD) has become a concern in recent years.
· NAFLD is strongly associated with insulin resistance.
· Lifestyle modifications are the mainstay treatment for NAFLD.
- Review Article
- Endocrinology
- Applications of genomic research in pediatric endocrine diseases
- Ja Hye Kim, Jin-Ho Choi
- Clin Exp Pediatr. 2023;66(12):520-530. Published online June 14, 2023
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· Recent advances in molecular genetics have improved our understanding of pediatric endocrine disorders and are now used in mainstream medical practice.
· Genome-wide association studies can increase our understanding of the biological mechanisms of disease and inform new therapeutic options.
· The identification of founder mutations leads to the efficient localization of the genes underlying Mendelian disorders.
· Next-generation sequencing technologies benefit clinical practice and research of pediatric endocrinology.
- Nonalcoholic fatty liver disease and insulin resistance in children
- Kyungchul Song, Ho-Seong Kim, Hyun Wook Chae
- Clin Exp Pediatr. 2023;66(12):512-519. Published online January 9, 2023
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· The prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) increased from 8.2% in 2009 to 12.1% in 2018 in Korea.
· Laboratory tests, biomarkers, and imaging studies are used for the early detection of NAFLD.
· Insulin resistance is closely related to NAFLD.
- Letter to the Editor
- Endocrinology
- Accuracy of predicted adult height using the Greulich-Pyle method and artificial intelligence medical device
- Dongho Cho, Yun Sun Choi, Hayun Oh, Young min Ahn, Ji-Young Seo
- Clin Exp Pediatr. 2023;66(3):145-147. Published online January 25, 2023
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- Clinical Note
- Endocrinology
- Graves’ disease: an uncommon cause of late sequelae following DRESS (drug reaction with eosinophilia and systemic symptoms)
- Therdpong Tempark, Amatanun Tangthanapalakul, Tawatchai Deekajorndech, Susheera Chatproedprai, Vichit Supornsilchai, Siriwan Wananukul
- Clin Exp Pediatr. 2022;65(12):602-604. Published online June 22, 2022
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