Plasma alpha-tocopherol (vitamin E) levels and tocopherol-lipid ratio among children with protein-energy malnutrition (PEM)

The fat-soluble vitamin E (alpha-tocopherol) status of 47 malnourished children was assessed and compared with that of a control group of ten age-matched normal children. Plasma levels of alpha-tocopherol, total lipid and the ratio of alpha-tocopherol to total lipid were determined. The plasma vitamin E level was low, with a value of less than 11.61 mumol/l (500 micrograms/dl) in 40 (85%) of the malnourished children while the remaining seven (15%) children had values that ranged between 11.61 and 17.20 mumol/l (500-741 micrograms/dl). On the other hand, the tocopherol/total lipid ratio was less than 0.8 mg/g of total lipid in only seven of the malnourished children. The remaining 40 (85%) subjects had values that ranged between 0.8 and 1.96 mg/g of total lipid, whereas in the control group, both the plasma tocopherol levels and the tocopherol/lipid ratio were greater than 11.61 mumol/l (500 micrograms/dl) and 0.8 mg/g of plasma total lipid respectively.     

Vitamin E status in hypercholesterolemic children

The prime role of oxidized low-density lipoprotein in the pathogenesis of atherosclerosis is almost universally accepted. Fat soluble antioxidant vitamin E associated with lipoproteins, appears to have antiatheroma properties. In the presented studies concentration of vitamin E and the relationship between tocopherol and lipids were studied in blood of hypercholesterolemic children. Level of vitamin E was determined by high-performance liquid chromatography (HPLC) method. Compared with normocholesterolemic children, hypercholesterolemic patients had a significantly lower red blood cell vitamin E content (2.55 +/- 0.19 micromol/l vs 3.15+/- 0.33 micromol/l; p<0.005) in spite of their higher plasma vitamin E concentration (27.9 +/- 8.3 micromol/l vs 21.01 +/- 3.6 micromol/l; pl;0.001). In the group of patient tocopherol-to-total cholesterol and tocopherol-to-lipids ratio was statistically lower compared to those in the control group. In hypecholesterolemic children vitamin E positively correlated with total cholesterol (r=0.43; p<0.02), LDL-C (low-density lipoprotein cholesterol) (r=0.42; p<0.02) and lipids (triglycerides + total cholesterol) (r=0.45; p<0.02). This study demonstrates that total plasma vitamin E concentration is not a suitable predictor of cell vitamin E status. Our results suggested that the tocopherol of erythrocytes and vitamin E to lipids ratio in plasma, could be more meaningful indicators to evaluate the vitamin E status in hypercholesterolemic children.     

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目的探讨单纯性肥胖儿童载脂蛋白(apolipoprotein,Apo)E基因多态性的分布及其对血脂、脂蛋白、载脂蛋白的影响,及其与冠状动脉、心电图改变的关系。并对其早期预测和疾病预防提供理论依据。方法选择2002年12月至2004年12月潍坊医学院附属医院儿科的6～14岁单纯性肥胖儿童89例和健康儿童76例。抽取外周静脉血,测定血清中甘油三酯(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDLC),低密度脂蛋白胆固醇(LDLC),载脂蛋白A1(ApoA1),载脂蛋白B100(ApoB100)浓度。应用改良的聚合酶链式反应限制性片段长度多态性(PCRRFLP)分析及聚丙烯酰胺凝胶电泳测定儿童ApoE基因型。结果共检出4种ApoE基因型,E3/3、E4/3、E2/3、E4/2,以ε3为最常见。与健康儿童比较,肥胖儿童ε4等位基因频率增高,差异有显著性(P<0.05)。结论单纯性肥胖儿童有ApoE基因多态性的变化,且明显影响小儿血浆脂类代谢,肥胖儿童ApoE4与冠心病有密切相关性。     

单纯性肥胖儿童外周血单核细胞载脂蛋白E基因的表达

目的　探讨单纯性肥胖儿童外周血单核细胞载脂蛋白E基因表达及其与血脂、脂蛋白、载脂蛋白的相关关系。方法　采用竞争性逆转录 聚合酶链式反应方法分析 3 2例单纯性肥胖儿童和 3 2例正常健康儿童外周血单核细胞的载脂蛋白E基因表达。结果　载脂蛋白E基因能在儿童外周血单核细胞表达 ,与健康儿童比较 ,单纯性肥胖儿童外周血单核细胞载脂蛋白E基因表达水平显著下调 (P <0 0 1) ,重度肥胖儿童尤其明显 ,载脂蛋白E基因表达水平与肥胖度呈负相关 (P <0 0 5)。肥胖儿童存在明显的血脂代谢紊乱 ,载脂蛋白E基因表达水平与低密度脂蛋白 胆固醇呈负相关 ,与血载脂蛋白E浓度呈正相关 (P <0 0 5) ,与血总胆固醇、甘油三酯、高密度脂蛋白 胆固醇、脂蛋白 (a)、载脂蛋白AⅠ水平无明显相关 (P >0 0 5)。结论　单纯性肥胖儿童外周血单核细胞载脂蛋白E基因表达水平明显下调 ,并与肥胖程度及血脂代谢异常相关联 ,提示载脂蛋白E基因表达变化可能与肥胖的发生发展及肥胖的心血管病变相关联     

单纯性肥胖儿童血脂类、内皮素、糖耐量变化的意义

目的研究不同程度单纯性肥胖儿童血总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、内皮素(ET)及糖耐量变化。方法选择单纯性肥胖儿童436例,其中轻度单纯肥胖242例、中度单纯肥胖138例、重度单纯肥胖56例。对照组儿童80例。检测各组儿童血TC、TG、LDL、ET、糖耐量。结果单纯肥胖患儿血TC、TG、LDL、ET明显高于对照组,各项之间均有显著性差异,且增高程度与体质量呈正相关;重度单纯肥胖患儿中4例糖耐量异常,对照组无异常。结论单纯性肥胖儿童血脂类和ET表达水平均有增高,个别重度肥胖患儿有糖耐量下降情况,应对单纯性肥胖儿童进行早期干预。     

Leptin in African-American children

Leptin, the protein product of the obesity gene, produced by adipose tissue, regulates body weight and energy expenditure through CNS feedback mechanisms. In obesity, leptin levels are elevated suggestive of leptin resistance. Because of increased prevalence of obesity in African-Americans, the aim of this study was to assess leptin and its relationship to adiposity in African-American children. We measured plasma leptin levels in 42 African-American children (23 M, 19 F), age 11.8 +/- 0.3 yr, and compared them with 30 American-White children matched for age, body composition and puberty. Body composition was assessed by bioelectrical impedance and plasma leptin by RIA. Data are presented as means +/- SEM and statistical significance is implied by p < 0.05. There was no racial difference in plasma leptin levels (Blacks: 9.8 +/- 1.6, Whites 9.8 +/- 1.9 ng/ml). Leptin correlated with %BF in Black (r = 0.75, p = 0.005) and White (r = 0.79, p = 0.005) children. There were no gender or puberty related differences in leptin levels in African-American children. We concluded that leptin levels are comparable between African-American and American White children of similar body composition. The major determinant of serum leptin levels in these children is degree of adiposity with no gender or puberty related differences. Longitudinal studies are needed to assess leptin's role during puberty in both genders.     

Characterization of vitamin E status in cholestatic children by conventional laboratory standards and a new functional assay

In the present study, the clinical application of a new functional test for vitamin E deficiency was evaluated. Erythrocytes from cholestatic children at risk for vitamin E deficiency and appropriate controls were incubated in vitro with hydrogen peroxide and the malondialdehyde generated and released into the supernatant quantitated. The results of these incubations were compared with fasting plasma vitamin E levels, the ratio of plasma vitamin E to plasma lipid levels, and, in some instances, hydrogen peroxide hemolysis tests. Malondialdehyde formation was less than 6% in controls and vitamin E-sufficient cholestatic children. However, cholestatic vitamin E-deficient children had a mean malondialdehyde formation of 41%. The results also suggest that for children less than 4 months of age, a ratio of plasma vitamin E to total plasma lipids less than 0.6 mg/g may be sufficient to provide protection from in vitro peroxidation. The authors suggest that this functional assay of vitamin E status be included in the evaluation of individuals with the potential for vitamin E deficiency.     

Obesity and lipid profiles in children and adolescents

Childhood obesity is associated with unfavorable lipid profile, suggesting that obese children should be screened for hypercholesterolemia. However, the prevalence of hypercholesterolemia in childhood obesity, and the effect of the degree of obesity on lipid profile, are unknown. Eighty-nine obese children and adolescents (BMI >85%, mean age 10.4 +/- 2.5 years) and 53 non-obese control children matched for age, gender and pubertal stage participated in the study. Early morning blood samples for serum lipids were collected in all children after a 12-h fast. Mean serum cholesterol and triglycerides (TG) levels were significantly higher (p <0.05) among the obese children (cholesterol: 175.2 +/- 31.4 vs 143.3 +/- 24.3 mg/dl; TG: 122.8 +/- 69.7 vs 94.3 +/- 37.8 mg/dl in obese and control children, respectively). Among the obese children, 52% had elevated serum cholesterol levels (>170 mg/dl) compared to 16% in the controls. The degree of obesity (BMI 85-95% vs BMI >95%) had no effect on serum lipids. Unfavorable lipid levels were relatively common among obese children, suggesting that obesity should be considered a risk factor for hypercholesterolemia, and that screening obese children for hypercholesterolemia should be considered.     

Serum adiponectin, C-reactive protein and TNF-alpha levels in obese Korean children

AIM: To determine whether there are differences of serum adiponectin, CRP and TNF-a levels between obese and non-obese children and to investigate the relationship between childhood obesity and inflammation. METHODS: A total of 103 (73 obese, 30 non-obese) children were evaluated for height, weight, blood pressure and body mass index (BMI). We measured serum adiponectin, hs-CRP, and TNF-alpha levels and analyzed their correlation with BMI, serum glucose, lipid profile and insulin resistance. RESULTS: Serum adiponectin levels were significantly decreased in the obese children compared to non-obese children, and had a negative correlation with BMI, fasting glucose and HOMA-IR. Serum hs-CRP and TNF-alpha levels were increased in obese children compared to non-obese children, and had a positive correlation with BMI. CONCLUSIONS: Serum adiponectin level was decreased and serum CRP and TNF-alpha levels were increased in obese children. Our findings suggest that childhood obesity is associated with inflammatory processes.     

Selenium and vitamin E in mucoviscidosis

Selenium and vitamin E are two important components which protect membrane lipids from oxidative damage. Recently an abnormal fatty acid turnover in the membrane phospholipids was found in cystic fibrosis (CF). We studied vitamin E and selenium status in 26 CF children compared to a control group. we measured selenium concentration in plasma and erythrocytes using flameless atomic absorption. The measure of erythrocyte glutathione peroxidase activity allowed a functional assessment of selenium. Total plasma tocopherol concentrations (HPLC) were referred to total lipids. The vitamin E and selenium levels in not yet treated children (n = 6) were very low, with an important decrease in glutathione peroxydase activity. The antioxidative agents deficiency was mild in children with pancreatic enzyme replacement and vitamin E supplementation (n = 20). In the 2 groups, this deficiency was combined and may play a role in CF membrane abnormalities.     

Twenty-year dynamics in adiposity and blood lipids of Greek children: regional differences in Crete persist

AIM: To examine whether secular trends in adiposity and blood lipid profile of Greek children manifested equally among individuals from urban and rural provinces. METHODS: Cretan boys (aged 12.1+/-2.3 y) from urban and rural areas of Crete were recruited in 1982 (n=277 and 251, respectively) and 2002 (n=440 and 180, respectively). Height, weight, and body mass index (BMI), as well as plasma lipid concentrations were measured and compared across cohorts (1982 vs 2002) and regions (urban vs rural) by two-way analysis of covariance (adjusted for age) with interaction. RESULTS: Temporal changes in height (positive), weight (positive), and BMI (positive) manifested equally in children from urban and rural provinces, as no interaction was detected. Similar results were obtained for triacylglycerol (positive), low-density lipoprotein cholesterol (LDL-C, positive) and high-density lipoprotein cholesterol (negative) concentrations. A significant interaction was observed only for total cholesterol (TC), which increased from 1982 among rural (by 6.2%, p < 0.05) but not among urban boys. In all other instances, regional differences in 1982 persisted in 2002. More specifically, children from urban provinces were taller, heavier, and had higher BMI values than those from rural areas, while they also had higher LDL-C concentrations, whether nowadays or 20 y ago. Regional differences in TC in 1982 were not apparent in 2002. CONCLUSION: These findings suggest that changes in anthropometric characteristics and plasma lipids during the past 20 y have occurred largely in parallel among urban and rural Cretan children, and they emphasize the importance of developing a common national strategy for the prevention and treatment of childhood obesity in Greece.     

促酰化蛋白水平与儿童肥胖的关系

目的：儿童肥胖不仅是体内脂肪过度积蓄,它常延伸至成人,导致心血管疾病、糖尿病发病增高。促酰化蛋白(ASP)与脂肪代谢密切相关,据此该文测定儿童ASP及血脂水平,并分析与肥胖的相关性。 方法：将该院门诊就诊的单纯性肥胖儿童分为肥胖组(n=30);正常体检儿童分为对照组(n=30),分别测定ASP及血脂水平。ASP检测采用ELISA方法检测血浆ASP水平,试剂盒由加拿大麦吉尔大学医学中心皇家维多利亚医院心血管研究室提供,血脂检测采用免疫比浊法在全自动生化分析仪上检测。 结果：肥胖组血浆ASP、胆固醇、甘油三酯、载脂蛋白B依次为 73.87 ± 24.04 g/L , 5.71 ±0.61 mmol/L, 1.77±0.30 mmol/L,0.98±0.20 mmol/L;对照组为 39.47±13.68 g/L,4.29±0.49 mmol/L,1.02±0.25 mmol/L,0.85±0.11 mmol/L。两组比较其差异有显著性意义(P<0.01或P<0.05);ASP与体重指数(BMI)、血浆甘油三酯、胆固醇呈正相关(相关系数分别为r=0.43,0.48,0.68,分别P<0.05,P<0.05,P<0.01);肥胖组中有肥胖家族史患儿血浆ASP水平比无家族史患儿增高更明显 103.4±10.57 g/L vs71.15±24.9 g/L,差异有显著性(P<0.01)。 结论：血浆ASP水平可作为脂质代谢检测的一种新指标,对判断儿童肥胖发展趋势和肥胖儿童未来发生心血管疾病危险度作出初步估价。     

单纯性重度肥胖儿童的血液流变学变化

目的　探讨重度肥胖对血液粘度产生的影响。方法　检测27例单纯性重度肥胖儿童和20例健康儿童的血液粘度的变化,并进行相关分析。结果　肥胖组儿童的低、中、高切变率下的全血粘度、血浆粘度、全血还原粘度、红细胞聚集指数（ARBC）红细胞变形指数（TK） 均明显高于对照组;血浆粘度与胆固醇、纤维蛋白原的增高呈显著正相关;高切变率下的全血粘度与血浆粘度、胆固醇及纤维蛋白原呈显著正相关;低切变率下的全血粘度与血浆粘度、纤维蛋白原呈显著正相关。结论　重度肥胖能够引起血液高凝状态,成为心、脑血管疾病发生的高危因素。     

Effect of a common mutation (D442G) of the cholesteryl ester transfer protein gene on lipids and lipoproteins in children

Cholesteryl ester transfer protein (CETP) is thought to regulate plasma HDL. Patients with CETP deficiency caused by mutation of the CETP gene [D442G; a missense mutation (Asp442-->Gly)] have been reported to show high plasma HDL levels. However, there are no data available on children with D442G. To determine the effects of plasma CETP and CETP gene mutation (D442G) on lipids and lipoproteins in children, we screened children by PCR and restriction fragment length polymorphism analysis of the CETP gene. Plasma lipids, apolipoproteins, and CETP mass levels were also determined. In the current study, 22 children with D442G were found (21 heterozygotes and a homozygote). A homozygous child showed high plasma HDL level and very low plasma CETP mass. In heterozygous children, plasma concentrations of HDL cholesterol, apo A-I and apo A-II were not increased, whereas plasma CETP mass was significantly decreased. Plasma CETP mass in heterozygous children was correlated with plasma concentrations of total cholesterol, LDL cholesterol, and apo B. Plasma CETP mass in children without D442G was not correlated with the plasma concentration of any lipid or apolipoprotein. All of these data suggest that the D442G mutation, by itself, might not affect HDL metabolism in children. The CETP mass required for efficient HDL-cholesteryl ester clearance in children may be less than that in older subjects.     

Serum Lipid and Lipoproteins Concentrations in Obese Children as Atherogenic Risk Factors

Nine hundred and ninety-eight obese children aged 6 to 15 years participated in the present study. Fasting serum lipid and lipoprotein cholesterol values were measured and the relationship between obesity and abnormalities of serum lipids and lipoproteins was assessed. The results were as follows: 1. Obese children were more likely than non-obese children to have elevated serum total cholesterol (TC), triglyceride (TG) and LDL-C(low density lipoprotein cholesterol) levels and reduced HDL-C (high density lipoprotein cholestrol) levels. 2. The more the relative body weight index increased, the worse the abnormalities of serum lipids and lipoproteins became. This tendency was marked in junior high-school boys. 3. Hypercholesterolemia in obese children was mostly accounted for by LDL-C only and elevated HDL-C could not be detected.     

Tocopherol efficacy and safety for preventing retinopathy of prematurity: a randomized, controlled, double-masked trial

To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plasma levels of 3 to 3.5 mg/dL). In the 196 infants completing ophthalmic follow-up, tocopherol did not prevent retinopathy of prematurity of any stage (28% placebo treated v 26% tocopherol treated) or moderately severe retinopathy of prematurity (8% placebo treated v 11% tocopherol treated). Cicatricial sequelae were not significantly different (1/97 placebo treated v 3/99 tocopherol treated), with one placebo-treated infant and one tocopherol-treated infant having retinal detachments. Among all 232 infants examined, those treated with tocopherol had more retinal hemorrhage than placebo-treated infants (8/121 placebo treated v 16/111 tocopherol treated), and retinal hemorrhage correlated positively (P less than .01) with plasma levels of tocopherol after the first 2 weeks of age. Prospective monitoring of morbidity including late-onset sepsis, necrotizing enterocolitis, etc revealed no differences between groups except that grades 3 and 4 intraventricular hemorrhage occurred more frequently in infants weighing less than 1 kg at birth who had received tocopherol (14/42, 33%) v those who had received placebo (4/43, 9%) (P less than .02). Our data do not support the use of tocopherol for prophylaxis against retinopathy of prematurity in premature infants and suggest that IV tocopherol treatment starting on day 1 may increase the incidence of hemorrhagic complications of prematurity, particularly in infants with birth weights of less than 1 kg.     

Maternal infant-feeding style and children's adiposity at 5 years of age

OBJECTIVES: To examine the relationship between maternal infant-feeding style and adiposity in childhood and to determine whether feeding style explains any of the association between maternal obesity and childhood adiposity. DESIGN: Prospective cohort study. SETTING: Cincinnati metropolitan area. PARTICIPANTS: A total of 313 preschool children; 80% were white and 20% were black. MAIN OUTCOME MEASURES: Seven factors describing maternal infant-feeding style derived from the Infant Feeding Questionnaire administered at age 3 years; maternal obesity, defined as a body mass index of 30 or higher before pregnancy; and adiposity at 5 years of age as assessed by dual-energy x-ray absorptiometry. RESULTS: The mean +/- SD fat mass was 4.55 +/- 1.64 kg. Seventeen percent of the mothers were obese before pregnancy. Children whose mothers had high concern about the infant overeating or becoming overweight (the highest tertile of the "overeating" factor) had 0.67 kg (95% confidence interval, 0.31-1.03 kg) higher fat mass than children whose mothers did not have high concern (the other 2 tertiles). None of the other 6 feeding factors were related to childhood adiposity. Children of obese mothers had 0.54 kg (95% confidence interval, 0.10-0.98 kg) higher fat mass than children of nonobese mothers. High concern about the infant overeating, which was more common in obese mothers, accounted for 15% of this 0.54-kg difference. CONCLUSION: High maternal concern about an infant overeating or becoming overweight was associated with higher adiposity at 5 years of age and explained some of the association between maternal obesity and child adiposity.     

Metabolic relations of serum lipids and lipoproteins in diabetic children

Serum lipids and lipoproteins of 29 insulin dependent diabetic children have been determined and related to the metabolic status of the patients. The findings were compared to results obtained in 30 healthy children. The diabetic children showing unsatisfactory metabolic parameters had significantly higher total lipid and total triglyceride levels than did the healthy children (p less than 0.01). All diabetic children, independently of their metabolic status, exhibited an increased low density lipoprotein cholesterol level (p less than 0.01). On the other hand, high density lipoprotein cholesterol levels found in diabetics did not differ from normal values and showed no relationship with their metabolic status. Prevention of vascular complications of diabetes must be started in childhood by attentive care directed to all details of the pathomechanism.     

瘦素/脂联素值与肥胖儿童体质量指数及糖脂代谢的关系

目的 探讨瘦素/脂联素(L/A)值与单纯性肥胖儿童体质量指数(BMI)、糖脂代谢及肥胖症发病的关系.方法 单纯性肥胖60例和57例健康儿童,采用放射免疫分析(RIA)法测定其血清瘦素水平;ELISA法测定其血清脂联素、空腹胰岛素(FINS)水平;免疫比浊法测定其血脂各成分.分析并比较血清瘦素、脂联素及L/A值与肥胖儿童BMI、糖脂代谢的相关性.结果 1.肥胖儿童血清瘦素、FINS和三酰甘油(TG)水平与健康对照组相比明显增加;脂联素水平降低,差异均有显著性(Pa＜0.05,0.01).2.单纯性肥胖儿童瘦素与BMI、FINS、TG水平均呈显著正相关(r=0.408,0.301,0.301 Pa＜0.05,＜0.01);脂联素水平与BMI、FINS、TG均呈显著负相关(r=-0.360,-0.413,-0.258 Pa＜0.01,＜0.05).3.L/A值与BMI、FINS、TG呈显著正相关(r=0.780,0.764,0.601 Pa＜0.001).结论 血清瘦素和脂联素与肥胖儿童的发病有关,可作为儿童肥胖的监控指标;L/A值较单独瘦素、脂联素更能反映肥胖症儿童的代谢状况,可为肥胖症儿童糖脂代谢提供更为有效的监测指标.