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Effects of COVID-19 pandemic on pediatric endocrinology practice; childhood obesity, pubertal progression and diabetes

Yıl 2022, Cilt: 15 Sayı: 2, 399 - 406, 01.04.2022
https://doi.org/10.31362/patd.1006123

Öz

In the COVID-19 pandemic, millions of people have had to stay in isolation for months. Children did not go to school for a long time, they spent much more time at home and were sedentary. They also spent much more time on screen-related activities (personal computer (PC), mobile phone, music player, tablet, game console, and television (TV). These situations have had various effects on children and adolescents. Undoubtedly, long-term restrictions and lifestyle changes have had effects on individuals with childhood obesity, pubertal progression, and type 1 diabetes (T1D). In this review, articles investigating the effect of COVID-19 quarantine/pandemic on adolescence, childhood obesity and diabetes were compiled and the effect of the COVID pandemic on these frequently encountered situations in pediatric endocrine practice was tried to be revealed.

Kaynakça

  • 1. Dvorsky MR, Breaux R, Becker SP. Finding ordinary magic in extraordinary times: child and adolescent resilience during the COVID-19 pandemic. Eur Child Adolesc Psychiatry. 2020;1:1–3.
  • 2. Barchetta I, Cimini FA, Bertoccini L, Ceccarelli V, Spaccarotella M, Baroni MG, Cavallo MG. Effects of work status changes and perceived stress onglycaemiccontrol in individuals with type 1 diabetes during COVID-19 lockdown in Italy. Diabetes Res Clin Pract. 2020;170:108513.
  • 3. Latronico AC, Brito VN, Carel JC. Causes, diagnosis, and treatment of central precocious puberty. Lancet Diabetes Endocrinol. 2016;4(3):265-274.
  • 4. Stagi S, De Masi S, Bencini E, Losi S, Paci S, Parpagnoli M, Ricci F, Ciofi D, Azzari C. Increased incidence of precocious and accelerated puberty in females during and after the Italian lockdown for the coronavirus 2019 (COVID-19) pandemic. Ital J Pediatr. 2020;46(1):165.
  • 5. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity (Silver Spring). 2020;28(8):1382–5.
  • 6. Verzani M, Bizzarri C, Chioma L, Bottaro G, Pedicelli S, Cappa M. Impact of COVID-19 pandemic lockdown on early onset of puberty: experience of an Italian tertiary center. Ital J Pediatr. 2021;47(1):52.
  • 7. Karpati AM, Rubin CH, Kieszak SM, Marcus M, Troiano RP. Stature and pubertal stage assessment in American boys: the 1988-1994 third National Health and nutrition examination survey. J Adolesc Health. 2002;30(3):205–12.
  • 8. Burt Solorzano CM, McCartney CR. Obesity and the pubertal transition in girls and boys. Reproduction 2010;140:399-410.
  • 9. Salti R, Tarquini R, Stagi S, Perfetto F, Cornélissen G, Laffi G, et al. Agedependent association of exposure to television screen with children's urinary melatonin excretion? Neuro Endocrinol Lett. 2006;27(1–2):73–80.
  • 10. Sangün Ö, Dündar B, Çömlekçi S, Büyükgebiz A. The effects of electromagnetic field on the endocrine system in children and adolescents. Pediatr Endocrinol Rev. 2015;13(2):531–45.
  • 11. Waldhauser F, Weiszenbacher G, Tatzer E, Gisinger B, Waldhauser M, Schemper M, Frisch H. Alterations in nocturnal serum melatonin levels in humans with growth and aging. J Clin Endocrinol Metab. 1988;66(3):648–52.
  • 12. Hadinia SH, Carneiro PRO, Fitzsimmons CJ, Bédécarrats GY, Zuidhof MJ. Post-photostimulation energy intake accelerated pubertal development in broiler breeder pullets. Poult Sci. 2020;99(4):2215–29.
  • 13. Karatzias T, Shevlin M, Murphy J, McBride O, Ben-Ezra M, Bentall RP, et al. Posttraumatic Stress Symptoms and Associated Comorbidity During the COVID-19 Pandemic in Ireland: A Population-Based Study. J Trauma Stress. 2020(4):365-370.
  • 14. Stagi S, Papacciuoli V, Boiro D, Maggioli C, Ndambao NN, Losi S, et al. Auxological and endocrinological features in internationally adopted children. Ital J Pediatr. 2020;46(1):82.
  • 15. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol 2019;15:288-298.
  • 16. Kumar S, Kaufman T. Childhood Obesity. Panminerva Med. 2018 Dec;60(4):200-212.
  • 17. Yang S, Guo B, Ao L, Yang C, Zhang L, Zhou J, Jia P. Obesity and activity patterns before and during COVID-19 lockdown among youths in China. Clin Obes. 2020;10(6):e12416.
  • 18. Rundle AG, Park Y, Herbstman JB, Kinsey EW, Wang Y. COVID-19-Related School Closings and Risk of Weight Gain Among Children. Obesity (Silver Spring). 2020;28(6):1008-1009.
  • 19. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity (Silver Spring). 2020;28(8):1382-1385.
  • 20. Storz MA. The COVID-19 pandemic: an unprecedented tragedy in the battle against childhood obesity. Clin Exp Pediatr. 2020 Dec;63(12):477-482. doi: 10.3345/cep.2020.01081
  • 21. Ribeiro KD da S, Garcia LRS, Dametto JF dos S, Assunção DGF, Maciel BLL. COVID-19 and Nutrition: The Need for Initiatives to Promote Healthy Eating and Prevent Obesity in Childhood. Child Obes. 2020;16(4):235-237.
  • 22. Franckle R, Adler R, Davison K. Accelerated weight gain among children during summer versus school year and related racial/ethnic disparities: A systematic review. Prev Chronic Dis. 2014;12;11:E101.
  • 23. von Hippel, Paul T, Workman J. 2016. From kindergarten through second grade, US children's obesity prevalence grows only during summer vacations. Obesity 24(11):2296-2300.
  • 24. Workman J. How Much May COVID-19 School Closures Increase Childhood Obesity? Obesity (Silver Spring). 2020;28(10):1787.
  • 25. Brazendale K, Beets MW, Weaver RG, Pate RR, Turner-McGrievy GM, Kaczynski AT, et al. Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis. Int J Behav Nutr Phys Act 2017;14:100.
  • 26. An R. Projecting the impact of the coronavirus disease-2019 pandemic on childhood obesity in the United States: A microsimulation model. J Sport Health Sci. 2020;9(4):302-312.
  • 27. Cuschieri S. COVID-19 panic, solidarity and equity—the Malta exemplary experience. Z Gesundh Wiss. 2020;1-6.
  • 28. Nagata JM, Abdel Magid HS, Pettee Gabriel K. Screen Time for Children and Adolescents During the Coronavirus Disease 2019 Pandemic. Obesity (Silver Spring). 2020;28(9):1582-1583.
  • 29. Fang K, Mu M, Liu K, He Y. Screen time and childhood overweight/obesity: A systematic review and meta-analysis. Child Care Health Dev 2019;45:744-53.
  • 30. Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL,et al. Screen media exposure and obesity in children and adolescents. Pediatrics 2017;140(Suppl 2):S97-101.
  • 31. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020.
  • 32. Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol. 2020;8(9):782-792.
  • 33. Selvin E, Juraschek SP. Diabetes Epidemiology in the COVID-19 Pandemic. Diabetes Care, 2020; 43(8):1690–1694.
  • 34. Huang I, Lim MA, Pranata R. Diabtetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia e A systematic review, metaanalysis, and meta-regression. Diabetes Metab Syndr 2020;14:395-403
  • 35. Pitocco D, Tartaglione L, Viti L et al. Lack of Type 1 Diabetes involvement in SARS-CoV-2 population: Only a particular coincidence? Diabetes Res Clin Pract. 2020;164:108220
  • 36. Bronson SC. Letter to the Editor in response to the article “Lack of Type 1 Diabetes involvement in the SARS-CoV-2 population: Only a particular coincidence?”. Diabetes Res Clin Pract, 2020; 3:108306.
  • 37.Tatti P, Tonolo G, Zanfardino A, Iafusco D. Is it fair that patients with Type 1 Diabetes (autoimmune) may be spared by the infection of Covid-19? Medical Hypothesis 2020;14:109795.
  • 38. Rabbone I, Schiaffini R, Cherubini V et al. Has COVID-19 delayed the diagnosis and worsened the presentation of type 1 diabetes in children? Diabetes Care 2020;43:2870–2872.
  • 39. Chee YJ, Ng SJH, Yeoh E. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus. Diabetes Res Clin Pract 2020;164:108166.
  • 40. Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A. COVID-19 infection may cause ketosis and ketoacidosis. Diabetes Obes Metab. 2020;22(10):1935-1941. doi: 10.1111/dom.14057.
  • 41. Marchand L, Pecquet M, Luyton C. Type 1 Diabetes onset triggered by COVID‑19. Acta Diabetol. 2020; 11:1–2.
  • 42. Bonora BM, Boscari F, Avogaro A, Bruttomesso D, Fadini GP. Glycaemic Control Among People with Type 1 Diabetes During Lockdown for the SARS-CoV-2 Outbreak in Italy. Diabetes Ther. 2020;11(6):1-11.
  • 43. Di Dalmazi G, Maltoni G, Bongiorno C, Tucci L, Di Natale V, Moscatiello S, Laffi G, Pession A, Zucchini S, Pagotto U.Comparison of the effects of lockdown due to COVID-19 on glucose patterns among children, adolescents, and adults with type 1 diabetes: CGM study. BMJ Open Diabetes Res Care. 2020;8(2):e001664.
  • 44. Aragona M, Rodia C, Bertolotto A, Campi F, Coppelli A, Giannarelli R, Bianchi C, Dardano A, Del Prato S. Type 1 diabetes and COVID-19: The "lockdown effect". Diabetes Res Clin Pract. 2020;170:108468.
  • 45. Iughetti L, Trevisani V, Cattini U, Bruzzi P, Lucaccioni L, Madeo S, Predieri B. COVID-19 and Type 1 Diabetes: Concerns and Challenges. Acta Biomed. 2020 Sep 7;91(3):e2020033.

COVID-19 pandemisinin çocukluk çağı obesitesi, pubertal progresyon ve tip-1 diyabet üzerine etkisi

Yıl 2022, Cilt: 15 Sayı: 2, 399 - 406, 01.04.2022
https://doi.org/10.31362/patd.1006123

Öz

COVID-19 pandemisi, sağlık hizmetleri üzerinde benzeri görülmemiş bir baskı yarattı ve karantina, milyonlarca insanı aylarca evlerinde izole kalmaya zorladı. Pandemi döneminde çocuklar okula gidemediler, evde çok daha fazla zaman geçirdiler ve hareketsiz kaldılar. Ayrıca ekran ilişkili etkinliklerde (bilgisayar, cep telefonu, müzik çalar, tablet, oyun konsolu ve televizyon) çok daha fazla zaman harcadılar. Kuşkusuz bu durumların çocuklar ve ergenler üzerinde çeşitli etkileri olmuştur. Uzun süreli kısıtlamalar ve büyük yaşam tarzı değişiklikleri, hassas bireyleri ve tip 1 diyabet (T1D) gibi kronik hastalıkları olanları etkileyebilir. Bu derlemede, COVID-19 karantinası/pandemisinin ergenlik, çocukluk çağı obezitesi ve diyabeti üzerine etkisini araştıran makaleler derlenerek pediyatrik endokrin pratiğinde sık karşılaşılan bu durumlara COVID pandemisinin etkisi ortaya koyulmaya çalışılmıştır.

Kaynakça

  • 1. Dvorsky MR, Breaux R, Becker SP. Finding ordinary magic in extraordinary times: child and adolescent resilience during the COVID-19 pandemic. Eur Child Adolesc Psychiatry. 2020;1:1–3.
  • 2. Barchetta I, Cimini FA, Bertoccini L, Ceccarelli V, Spaccarotella M, Baroni MG, Cavallo MG. Effects of work status changes and perceived stress onglycaemiccontrol in individuals with type 1 diabetes during COVID-19 lockdown in Italy. Diabetes Res Clin Pract. 2020;170:108513.
  • 3. Latronico AC, Brito VN, Carel JC. Causes, diagnosis, and treatment of central precocious puberty. Lancet Diabetes Endocrinol. 2016;4(3):265-274.
  • 4. Stagi S, De Masi S, Bencini E, Losi S, Paci S, Parpagnoli M, Ricci F, Ciofi D, Azzari C. Increased incidence of precocious and accelerated puberty in females during and after the Italian lockdown for the coronavirus 2019 (COVID-19) pandemic. Ital J Pediatr. 2020;46(1):165.
  • 5. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity (Silver Spring). 2020;28(8):1382–5.
  • 6. Verzani M, Bizzarri C, Chioma L, Bottaro G, Pedicelli S, Cappa M. Impact of COVID-19 pandemic lockdown on early onset of puberty: experience of an Italian tertiary center. Ital J Pediatr. 2021;47(1):52.
  • 7. Karpati AM, Rubin CH, Kieszak SM, Marcus M, Troiano RP. Stature and pubertal stage assessment in American boys: the 1988-1994 third National Health and nutrition examination survey. J Adolesc Health. 2002;30(3):205–12.
  • 8. Burt Solorzano CM, McCartney CR. Obesity and the pubertal transition in girls and boys. Reproduction 2010;140:399-410.
  • 9. Salti R, Tarquini R, Stagi S, Perfetto F, Cornélissen G, Laffi G, et al. Agedependent association of exposure to television screen with children's urinary melatonin excretion? Neuro Endocrinol Lett. 2006;27(1–2):73–80.
  • 10. Sangün Ö, Dündar B, Çömlekçi S, Büyükgebiz A. The effects of electromagnetic field on the endocrine system in children and adolescents. Pediatr Endocrinol Rev. 2015;13(2):531–45.
  • 11. Waldhauser F, Weiszenbacher G, Tatzer E, Gisinger B, Waldhauser M, Schemper M, Frisch H. Alterations in nocturnal serum melatonin levels in humans with growth and aging. J Clin Endocrinol Metab. 1988;66(3):648–52.
  • 12. Hadinia SH, Carneiro PRO, Fitzsimmons CJ, Bédécarrats GY, Zuidhof MJ. Post-photostimulation energy intake accelerated pubertal development in broiler breeder pullets. Poult Sci. 2020;99(4):2215–29.
  • 13. Karatzias T, Shevlin M, Murphy J, McBride O, Ben-Ezra M, Bentall RP, et al. Posttraumatic Stress Symptoms and Associated Comorbidity During the COVID-19 Pandemic in Ireland: A Population-Based Study. J Trauma Stress. 2020(4):365-370.
  • 14. Stagi S, Papacciuoli V, Boiro D, Maggioli C, Ndambao NN, Losi S, et al. Auxological and endocrinological features in internationally adopted children. Ital J Pediatr. 2020;46(1):82.
  • 15. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol 2019;15:288-298.
  • 16. Kumar S, Kaufman T. Childhood Obesity. Panminerva Med. 2018 Dec;60(4):200-212.
  • 17. Yang S, Guo B, Ao L, Yang C, Zhang L, Zhou J, Jia P. Obesity and activity patterns before and during COVID-19 lockdown among youths in China. Clin Obes. 2020;10(6):e12416.
  • 18. Rundle AG, Park Y, Herbstman JB, Kinsey EW, Wang Y. COVID-19-Related School Closings and Risk of Weight Gain Among Children. Obesity (Silver Spring). 2020;28(6):1008-1009.
  • 19. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity (Silver Spring). 2020;28(8):1382-1385.
  • 20. Storz MA. The COVID-19 pandemic: an unprecedented tragedy in the battle against childhood obesity. Clin Exp Pediatr. 2020 Dec;63(12):477-482. doi: 10.3345/cep.2020.01081
  • 21. Ribeiro KD da S, Garcia LRS, Dametto JF dos S, Assunção DGF, Maciel BLL. COVID-19 and Nutrition: The Need for Initiatives to Promote Healthy Eating and Prevent Obesity in Childhood. Child Obes. 2020;16(4):235-237.
  • 22. Franckle R, Adler R, Davison K. Accelerated weight gain among children during summer versus school year and related racial/ethnic disparities: A systematic review. Prev Chronic Dis. 2014;12;11:E101.
  • 23. von Hippel, Paul T, Workman J. 2016. From kindergarten through second grade, US children's obesity prevalence grows only during summer vacations. Obesity 24(11):2296-2300.
  • 24. Workman J. How Much May COVID-19 School Closures Increase Childhood Obesity? Obesity (Silver Spring). 2020;28(10):1787.
  • 25. Brazendale K, Beets MW, Weaver RG, Pate RR, Turner-McGrievy GM, Kaczynski AT, et al. Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis. Int J Behav Nutr Phys Act 2017;14:100.
  • 26. An R. Projecting the impact of the coronavirus disease-2019 pandemic on childhood obesity in the United States: A microsimulation model. J Sport Health Sci. 2020;9(4):302-312.
  • 27. Cuschieri S. COVID-19 panic, solidarity and equity—the Malta exemplary experience. Z Gesundh Wiss. 2020;1-6.
  • 28. Nagata JM, Abdel Magid HS, Pettee Gabriel K. Screen Time for Children and Adolescents During the Coronavirus Disease 2019 Pandemic. Obesity (Silver Spring). 2020;28(9):1582-1583.
  • 29. Fang K, Mu M, Liu K, He Y. Screen time and childhood overweight/obesity: A systematic review and meta-analysis. Child Care Health Dev 2019;45:744-53.
  • 30. Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL,et al. Screen media exposure and obesity in children and adolescents. Pediatrics 2017;140(Suppl 2):S97-101.
  • 31. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020.
  • 32. Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol. 2020;8(9):782-792.
  • 33. Selvin E, Juraschek SP. Diabetes Epidemiology in the COVID-19 Pandemic. Diabetes Care, 2020; 43(8):1690–1694.
  • 34. Huang I, Lim MA, Pranata R. Diabtetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia e A systematic review, metaanalysis, and meta-regression. Diabetes Metab Syndr 2020;14:395-403
  • 35. Pitocco D, Tartaglione L, Viti L et al. Lack of Type 1 Diabetes involvement in SARS-CoV-2 population: Only a particular coincidence? Diabetes Res Clin Pract. 2020;164:108220
  • 36. Bronson SC. Letter to the Editor in response to the article “Lack of Type 1 Diabetes involvement in the SARS-CoV-2 population: Only a particular coincidence?”. Diabetes Res Clin Pract, 2020; 3:108306.
  • 37.Tatti P, Tonolo G, Zanfardino A, Iafusco D. Is it fair that patients with Type 1 Diabetes (autoimmune) may be spared by the infection of Covid-19? Medical Hypothesis 2020;14:109795.
  • 38. Rabbone I, Schiaffini R, Cherubini V et al. Has COVID-19 delayed the diagnosis and worsened the presentation of type 1 diabetes in children? Diabetes Care 2020;43:2870–2872.
  • 39. Chee YJ, Ng SJH, Yeoh E. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus. Diabetes Res Clin Pract 2020;164:108166.
  • 40. Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A. COVID-19 infection may cause ketosis and ketoacidosis. Diabetes Obes Metab. 2020;22(10):1935-1941. doi: 10.1111/dom.14057.
  • 41. Marchand L, Pecquet M, Luyton C. Type 1 Diabetes onset triggered by COVID‑19. Acta Diabetol. 2020; 11:1–2.
  • 42. Bonora BM, Boscari F, Avogaro A, Bruttomesso D, Fadini GP. Glycaemic Control Among People with Type 1 Diabetes During Lockdown for the SARS-CoV-2 Outbreak in Italy. Diabetes Ther. 2020;11(6):1-11.
  • 43. Di Dalmazi G, Maltoni G, Bongiorno C, Tucci L, Di Natale V, Moscatiello S, Laffi G, Pession A, Zucchini S, Pagotto U.Comparison of the effects of lockdown due to COVID-19 on glucose patterns among children, adolescents, and adults with type 1 diabetes: CGM study. BMJ Open Diabetes Res Care. 2020;8(2):e001664.
  • 44. Aragona M, Rodia C, Bertolotto A, Campi F, Coppelli A, Giannarelli R, Bianchi C, Dardano A, Del Prato S. Type 1 diabetes and COVID-19: The "lockdown effect". Diabetes Res Clin Pract. 2020;170:108468.
  • 45. Iughetti L, Trevisani V, Cattini U, Bruzzi P, Lucaccioni L, Madeo S, Predieri B. COVID-19 and Type 1 Diabetes: Concerns and Challenges. Acta Biomed. 2020 Sep 7;91(3):e2020033.
Toplam 45 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Sağlığı ve Hastalıkları
Bölüm Derleme
Yazarlar

Elif Sagsak 0000-0001-7121-1575

Zehra Aycan 0000-0003-4584-2976

Yayımlanma Tarihi 1 Nisan 2022
Gönderilme Tarihi 7 Ekim 2021
Kabul Tarihi 15 Aralık 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 15 Sayı: 2

Kaynak Göster

APA Sagsak, E., & Aycan, Z. (2022). Effects of COVID-19 pandemic on pediatric endocrinology practice; childhood obesity, pubertal progression and diabetes. Pamukkale Medical Journal, 15(2), 399-406. https://doi.org/10.31362/patd.1006123
AMA Sagsak E, Aycan Z. Effects of COVID-19 pandemic on pediatric endocrinology practice; childhood obesity, pubertal progression and diabetes. Pam Tıp Derg. Nisan 2022;15(2):399-406. doi:10.31362/patd.1006123
Chicago Sagsak, Elif, ve Zehra Aycan. “Effects of COVID-19 Pandemic on Pediatric Endocrinology Practice; Childhood Obesity, Pubertal Progression and Diabetes”. Pamukkale Medical Journal 15, sy. 2 (Nisan 2022): 399-406. https://doi.org/10.31362/patd.1006123.
EndNote Sagsak E, Aycan Z (01 Nisan 2022) Effects of COVID-19 pandemic on pediatric endocrinology practice; childhood obesity, pubertal progression and diabetes. Pamukkale Medical Journal 15 2 399–406.
IEEE E. Sagsak ve Z. Aycan, “Effects of COVID-19 pandemic on pediatric endocrinology practice; childhood obesity, pubertal progression and diabetes”, Pam Tıp Derg, c. 15, sy. 2, ss. 399–406, 2022, doi: 10.31362/patd.1006123.
ISNAD Sagsak, Elif - Aycan, Zehra. “Effects of COVID-19 Pandemic on Pediatric Endocrinology Practice; Childhood Obesity, Pubertal Progression and Diabetes”. Pamukkale Medical Journal 15/2 (Nisan 2022), 399-406. https://doi.org/10.31362/patd.1006123.
JAMA Sagsak E, Aycan Z. Effects of COVID-19 pandemic on pediatric endocrinology practice; childhood obesity, pubertal progression and diabetes. Pam Tıp Derg. 2022;15:399–406.
MLA Sagsak, Elif ve Zehra Aycan. “Effects of COVID-19 Pandemic on Pediatric Endocrinology Practice; Childhood Obesity, Pubertal Progression and Diabetes”. Pamukkale Medical Journal, c. 15, sy. 2, 2022, ss. 399-06, doi:10.31362/patd.1006123.
Vancouver Sagsak E, Aycan Z. Effects of COVID-19 pandemic on pediatric endocrinology practice; childhood obesity, pubertal progression and diabetes. Pam Tıp Derg. 2022;15(2):399-406.
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