Association of Average Telomere Length with Body-Mass Index and Vitamin D Status in Juvenile Population with Type 1 Diabetes

Background

Type 1 diabetes (T1D) is an autoimmune chronic disease where hyperglycemia, increased risk of oxidative stress, advanced glycation end-products and other genetic and environmental factors lead to T1D complications. Shorter telomeres are associated with hyperglycemic levels and lower serum vitamin D levels.

Methods

Average telomere length (ATL) in whole blood DNA samples was assessed with qPCR method in 53 Slovenian T1D children/adolescents (median age 8.7 years, 1:1.3 male/female ratio). Body mass index standard deviation score (BMI-SDS), glycated haemoglobin and serum level of vitamin D metabolite (25-(OH)-D3) and the age at the onset of T1D were collected from the available medical documentation.

Results

Results indicate shorter ATL in subjects with higher BMI-SDS when compared to those with longer ATL (0.455 ± 0.438, −0.63 ± 0.295; p=0.049). Subjects with higher BMI-SDS had lower serum vitamin D levels when compared to those with lower BMI-SDS (40.66 ± 3.07 vs. 52.86 ± 4.85 nmol/L; p=0.045). Vitamin D serum levels did not significantly differ between subjects with longer/shorter ATL.

Conclusion

T1D children/adolescents with shorter ATL tend to have higher BMI-SDS. Lower serum vitamin D levels were associated with higher BMI-SDS, while associations between vitamin D serum levels, age at the onset of T1D, glycated haemoglobin and ATL were not observed. Additional studies with more participants are required to clarify the role of the telomere dynamics in T1D aetiology and development of complications.     

幼年特发性关节炎治疗现状与展望北大核心CSCD

幼年特发性关节炎(JIA)是一组具有遗传异质性、病因不明、以慢性关节滑膜炎症为主要特征的儿童时期常见的结缔组织病,目前尚无法治愈,主要治疗目标是达到临床缓解。治疗JIA的药物目前主要包括非甾体类抗炎药、糖皮质激素、改变病情抗风湿药及生物制剂。现总结近年对JIA治疗的认识及相关临床研究的进展,并对未来药物的研发方向及治疗理念作一展望。     

Osteoporosis in children and young adults

Osteoporosis is a major public health problem with serious long-term complications. In children, the definition of osteoporosis is not only based on densitometric criteria but also takes into account vertebral and long bone fragility fractures. Several factors, such as long-term high-dose steroids, chronic inflammation, malnutrition, immobility, lack of sex steroids, and medication can reduce bone density and increase the risk for fragility fractures when left untreated. Also, genetic conditions can predispose to primary bone fragility disorders, with osteogenesis imperfecta being the most common. Furthermore, since the growing skeleton is at an increased rate of bone remodeling, the ability to heal long bone fractures and reshape vertebral fractures differentiates children from adults. The scope of this chapter is to review the risk factors of osteoporosis and fragility fractures and describe the commonest causes of primary and secondary osteoporosis and their management in children and young adults.     

复方银花解毒颗粒对干酵母诱导幼鼠发热模型的退热作用研究

目的：研究复方银花解毒颗粒对干酵母所致幼龄大鼠发热模型的解热作用,为复方银花解毒颗粒的儿童给药剂量提供参考。方法：将SPF级3-5周龄幼年雄性SD大鼠分为正常对照组、模型组、布洛芬组、复方银花解毒颗粒低中高三个剂量组（给药剂量分别为2.5、5、10 g·kg-1）。各组灌胃给药,连续7天,末次给药1 h后皮下注射干酵母混悬液制备发热模型,造模后于不同时间点分别测定肛温。检测血清中IL-1β、IL-6、TNF-α含量以及下丘脑内cAMP水平。Western blot检测下丘脑炎症信号相关COX2的含量,并检测NF-κB的核转录情况,检测相关IκBα磷酸化水平变化。结果：造模后2~4 h,布洛芬、复方银花解毒颗粒高剂量组（10 g·kg-1）均能抑制发热大鼠体温升高,在3 h时体温降低效果显著;造模3h后,与模型组比较,复方银花解毒颗粒低剂量组（2.5 g·kg-1）能显著降低IL-6、IL-1β水平;复方银花解毒颗粒中剂量组（5 g·kg-1）、高剂量组（10 g·kg-1）能显著降低IL-6、TNF-α含量。复方银花解毒颗粒高剂量组（10 g·kg-1）下丘脑内NF-κB、IκBα、COX2蛋白表达量与模型组相比也显著下降。结论：复方银花解毒颗粒能有效降低发热模型幼鼠的体温,降低体内炎症因子水平,其退热机制可能与cAMP信号转导通路和NFκB信号通路有关。     

Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968–1976: Evidence of an increasing incidence

Summary A computer file of all Scottish hospital admissions in the period 1968–1976 was searched to identify the 2,505 children (aged < 19 years) with a diagnosis of diabetes. The average annual incidence of the disease (based on first hospital admission) was estimated to be 13.8 per 100,000 children aged < 19 years (boys 14.4 per 100,000; girls 13.2 per 100,000). The highest incidence, 20.0 per 100,000 was in the age group 10–14 years and the lowest 7.1 per 100,000 in those aged < 5 years. It is estimated that during the study period there was an 80% increase in the annual incidence of juvenile diabetes, from about 10 per 100,000 in 1968 to about 18 per 100,000 in 1976. First admission rates showed seasonal variations for those aged 5 years or more, with peaks in October/November and January/February. Marked variation was found in the incidence rates in the different counties of Scotland. The central lowlands which includes the cities of Edinburgh and Glasgow was an area of low incidence. There appeared to be an inverse correlation between the incidence rate in each county and population density. In Glasgow, there was an inverse association between the incidence rate in each city ward and the average number of persons per room. There was no evidence of space-clustering of the disease in different years within the parishes (rural districts) of each county and there was no convincing evidence that the variation in the incidence of diabetes between parishes in the same county was more than might have been expected to arise by chance. The observations are compatible with the disease having a viral aetiology but it is difficult to explain the striking rise in incidence over the study period on this basis.     

全身型幼年特发性关节炎患儿自身抗体和炎性细胞因子研究

目的探讨自身抗体和炎性细胞因子在全身型幼年特发性关节炎(So-JIA)中的变化。方法分别采用间接免疫荧光法和酶联免疫吸附法检测活动期、缓解期So-JIA患儿血清抗角蛋白抗体(AKA)、抗环瓜氨酸肽抗体(抗CCP抗体)、白细胞介素-17(IL-17)和白细胞介素-6(IL-6)的表达水平。以健康儿童作为健康对照组进行比较。结果活动期组血清AKA、抗CCP抗体阳性率分别为29.4%、47.1%,缓解期组分别为17.2%、27.6%,活动期组均高于缓解期组(P0.05)。So-JIA组AKA的灵敏度和特异度分别为21.1%和97.2%,抗CCP抗体的灵敏度和特异度分别为41.3%和91.9%,抗CCP抗体的灵敏度高于AKA。活动期组抗CCP抗体、IL-17、IL-6水平均高于健康对照组和缓解期组(P0.05);缓解期组抗CCP抗体、IL-17、IL-6水平高于健康对照组,但比较差异无统计学意义(P0.05)。结论自身抗体AKA和抗CCP抗体对So-JIA具有较高的特异度,但灵敏度欠佳,二者联合检测对提高So-JIA诊断特异度,尤其对提高活动期So-JIA诊断阳性率有一定的临床价值。     

Prognosis of diabetics with diabetes onset before the age of thirtyone

Summary A follow-up on three hundred and seven patients diagnosed before 1933 and before the patient was thirty-one years old was conducted as of 1.1.1973, i.e. after at least forty years of diabetes. All patients were seen at the Steno Memorial hospital and were referred from all parts of Denmark. A small proportion of the patients (5.9%) could not be traced. Of the remaining two hundred and eightynine patients 40% were alive. Three-hundred and six patients were insulin dependent, 87% being treated with insulin twice daily. More than 50% survived their diabetes for more than thirty-five years. The mortality rate was 2–6 times that in an age- and sexmatched non-diabetic population. In 31% of the deceased patients the cause of death was uraemia; in 25% myocardial infarction. The excess mortality among patients exhibiting persistent proteinuria before forty years of diabetes was 3–4 times higher than in patients who did not have proteinuria after forty years.16% of the whole study population became blind, and another 14% had severely impaired vision; 21% exhibited objective signs of myocardial infarction, 10% of stroke, and 12% had gangrene or had undergone amputation of the foot or lower leg; 38% had proteinuria and 22% uraemia. Death with or from hypoglycaemia was more common than death in ketoacidotic coma. Clinical manifestations of late diabetic complications were considerably less common in patients who were still alive after more than forty years of diabetes than in patients who died before their fortieth year of diabetes.