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Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) are differentiated by the presence of cardiometabolic risk factors (CMRFs) and insulin resistance (IR). This study aimed to evaluate the prevalence and clinical characteristics of MHO in Korean children and adolescents and to investigate the anthropometric, laboratory, and lifestyle predictors of MHO. This study included data from 530 obese subjects, aged 10–19 years, obtained from the Fourth Korea National Health and Nutrition Examination Survey. Subjects were classified into MHO and MUO groups according to the presence of CMRF (MHOCMRF/MUOCMRF) and degree of IR (MHOIR/MUOIR). Demographic, anthropometric, cardiometabolic, and lifestyle factors were compared between the groups. Logistic regression analysis and receiver operating characteristic curve analysis were performed to identify factors that predicted MHO. The prevalence of MHOCMRF and MHOIR in obese Korean youth was 36.8% (n = 197) and 68.8% (n = 356), respectively. CMRF profiles were significantly less favorable in MUO children. Longer and more vigorous physical activity and less protein intake were associated with MHOCMRF phenotype. The best predictors of MHOCMRF and MHOIR were waist circumference (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.77–0.88; P < 0.001) and body mass index (BMI) standard deviation score (OR, 0.24; 95% CI, 0.15–0.39; P < 0.001), respectively. The prevalence of MHO differed depending on how it was defined. To adequately manage obesity in youth, the approach to individuals with MHO and MUO should be personalized due to variation in clinical characteristics. Longitudinal studies are needed to evaluate long-term consequences of MHO., Graphical Abstract

Background and Purpose cAMP as a second messenger stimulates expression of microphthalmia-associated transcription factor (MITF) or the tyrosinase gene in UVB-induced skin pigmentation. Diphenylmethylene hydrazinecarbothioamide (QNT 3-80) inhibits α-melanocyte-stimulating hormone (α-MSH)-induced melanin production in B16 murine melanoma cells but its molecular basis remains to be defined. Here, we investigated the mechanism underlying the amelioration of skin hyperpigmentation by QNT 3-80. Experimental Approach We used melanocyte cultures with raised levels of cAMP and UVB-irradiated dorsal skin of guinea pigs for pigmentation assays. Immunoprecipitation, kemptide phosphorylation, fluorescence analysis and docking simulation were applied to elucidate a molecular mechanism of QNT 3-80. Key Results QNT 3-80 inhibited melanin production in melanocyte cultures with elevated levels of cAMP, including those from human foreskin. This compound also ameliorated hyperpigmentation in vivo in UVB-irradiated dorsal skin of guinea pigs. As a mechanism, QNT 3-80 directly antagonized cAMP binding to the regulatory subunit of PKA, nullified the dissociation and activation of inactive PKA holoenzyme in melanocytes and fitted into the cAMP-binding site on the crystal structure of human PKA under the most energetically favourable simulation. QNT 3-80 consequently inhibited cAMP- or UVB-induced phosphorylation (activation) of cAMP-responsive element-binding protein in vitro and in vivo, thus down-regulating expression of genes for MITF or tyrosinase in the melanogenic process. Conclusions and Implications Our data suggested that QNT 3-80 could contribute significantly to the treatment of skin disorders with hyperpigmented patches with the cAMP-binding site of PKA as its molecular target.

Ultraviolet (UV) radiation under sunlight stimulates skin pigmentation through immediately affecting the oxidative modification of existing melanin pigments and the spatial redistribution of pigmented melanosomes followed by the up-regulation of melanogenic genes in delayed kinetics. However, abnormal accumulation and synthesis of melanin biopolymers are responsible for skin disorders with more pigmented patches. Chemical-based regulation of the hyperpigmented disorders has been a long-standing goal for cosmetic and pharmaceutical applications. A large number of the chemicals with antimelanogenic activity have met with limited or no success in the treatment of skin patients, since they may not overcome the challenge of penetrating the skin barrier. Guinea pig skin displays similar kinetic parameters to human skin in the transdermal absorption of numerous chemicals, thus can serve as the surrogate for human skin. Here, we provide a concise review of our current understanding of the chemical-based therapy against skin hyperpigmentation in UV-irradiated guinea pig models, suggest molecular mechanisms of the action and emphasize the translation from preclinical outcomes to skin patients.

Mice lacking the IL-1R–associated kinase 4 (IRAK4) are completely resistant to LPS-induced endotoxic disorder or the TLR9 agonist CpG DNA plus d-galactosamine–induced acute liver injury (ALI), whereas wild-type strains succumb. However, translational drugs against sepsis or ALI remain elusive. Lonicerae flos extract is undergoing the clinical trial phase I in LPS-injected healthy human volunteers for sepsis treatment. In the current study, chlorogenic acid (CGA), a major anti-inflammatory constituent of lonicerae flos extract, rescued endotoxic mortality of LPS-intoxicated C57BL/6 mice, as well as ameliorated ALI of LPS/d-galactosamine–challenged C57BL/6 mice. As a mechanism, CGA inhibited various TLR agonist–, IL-1α–, or high-mobility group box-1–stimulated autophosphorylation (activation) of IRAK4 in peritoneal macrophages from C57BL/6 or C3H/HeJ mice via directly affecting the kinase activity of IRAK4, a proximal signal transducer in the MyD88-mediated innate immunity that enhances transcriptional activity of NF-κB or AP-1. CGA consequently attenuated protein or mRNA levels of NF-κB/AP-1 target genes encoding TNF-α, IL-1α, IL-6, and high-mobility group box-1 in vivo under endotoxemia or ALI. Finally, this study suggests IRAK4 as a molecular target of CGA in the treatment of innate immunity–related shock and organ dysfunction following insult of various TLR pathogens from bacteria and viruses.

Central precocious puberty (CPP) is caused by premature activation of the hypothalamic-gonadal axis, and must be treated adequately. In particular, CPP that occurs at a relatively young age or in boys is likely to be caused by an organic lesion. Hypothalamic hamartoma (HH) is the most common organic cause of CPP. The present case report describes an 11-month-old female infant who presented with vaginal bleeding and rapidly progressive secondary sex characteristics from the age of 6 months. She was diagnosed with CPP following the detection of HH via magnetic resonance imaging. The infant girl was successfully treated with gonadotropin-releasing hormone agonist. After 6 months, her breast had regressed and clinical and radiological follow-up demonstrated stable findings with no evidence of tumor growth or secondary sexual characteristics until the fourth year after the initiation of treatment. This patient is the one of the youngest infants presenting with CPP and HH in Korea; treatment was successful over a relatively long follow-up period.