Entamoeba histolytica-associated diarrheal illness is negatively associated with the growth of preschool children: evidence from a prospective study

The enteric protozoa, Cryptosporidium, Giardia and Entamoeba histolytica, cause diarrhea in children. We investigated the association of enteric protozoan-associated diarrheal illness with the nutritional status and growth of preschool children in Dhaka, Bangladesh. The subjects were 221 children aged 2-5 years who were followed prospectively for diarrheal illness for 3 years. The weight and height of the children were measured at entry and at 4-month intervals. Cryptosporidium and E. histolytica were diagnosed with commercially available stool antigen detection kits. Giardia was diagnosed by conventional microscopy. Cryptosporidium- and Giardia-associated diarrheal illness was not associated with the growth of the children. Children with E. histolytica-associated diarrheal illness had lower weight for age Z-score changes (-0.103+/-0.120 vs. 0.176+/-0.052, P=0.038). Similarly, the change in height for age Z-score was lower in children with E. histolytica-associated diarrheal illness (-0.348+/-0.186 vs. 0.142+/-0.08, P=0.018). Children with E. histolytica-associated diarrheal illness were 2.93 times (95% CI 1.01-8.52, P=0.047) more likely to be malnourished and 4.69 times (95% CI 1.55-14.18, P=0.006) more prone to be stunted. Entamoeba histolytica-associated diarrheal illness was negatively associated with the growth of preschool children.     

学龄期1型糖尿病儿童生存质量差异的因素分析

目的 分析学龄期1型糖尿病(T1DM)儿童生存质量差异的因素,为制定改善TIDM患儿生存质量的治疗方案提供依据。方法 对2016年6月-2018年6月至西安市中心医院进行治疗的106例学龄期TIDM患儿进行问卷调查,问卷采用郑玲玲等编制的《重庆地区儿童青少年糖尿病患者生存质量调查量表》,观察调查问卷中患儿在影响领域、满意度领域得分,以及总体得分情况。观察不同的空腹血糖、糖化血红蛋白(HbA1c)等指标的患儿问卷得分差异,以及影响患儿生存质量的因素。结果 患儿生存质量量表分为影响领域和满意度领域两部分,106名学龄期T1DM患儿影响领域量表得分为(82.37±11.44)分,满意度领域(25.41±5.77)分,总体得分(110.54±18.89)分。空腹血糖≤6.1 mmol/L患儿的生存质量量表得分(105.16±14.88)明显低于空腹血糖>6.1 mmol/L的患儿(142.26±20.61)(t=10.064,P=0.001);HbA1c≤7.6%患儿的生存质量量表得分(103.67±19.26)明显低于HbA1c＞7.6%的患儿得分(144.58±22.27)(t=9.572,P<0.001)。不同性别、住址、家庭收入的患儿,其生存质量评分差异无统计学意义(P>0.05),但是糖尿病饮食遵守情况、胰岛素注射方式、注射次数、血糖监测次数以及病程会导致生存质量评分差异有统计学意义(P<0.001)。结论 1型糖尿病学龄期儿童的生存质量受多种因素影响,因此对此类儿童应制定严格的饮食方案,采用胰岛素泵进行注射,以维持患儿血糖和糖化血红蛋白在较长时间内的稳定。     

The effect of maternal T1DM on the fatty acid composition of erythrocyte phosphatidylcholine and phosphatidyethanolamine in infants during early life

BACKGROUND: The risk for type 1 diabetes (T1DM) in children of mothers with T1DM is different to that in children of fathers with T1DM. Fatty acid (FA) intake, in particular EPA and DHA, has been associated with T1DM risk and has been suggested to be inadequate in infants of diabetic mothers. We asked, therefore, whether EPA and DHA FA nutritional status in offspring of mothers with T1DM could contribute to their reduced T1DM risk. METHODS: BABYDIET follows children with increased genetic and familial risk for T1DM from birth to age 3 years. FA nutritional state was assessed by determining the erythrocyte membrane phosphatidylethanolamine (PE) and phosphatidylcholine (PC) composition in children of T1DM mothers and children of T1DM fathers or with T1DM siblings participating in the BABYDIET study. Samples for determination of erythrocyte membrane FA composition were collected at ages 3 and 12 months in 48 and 49 infants, respectively. FA measurements were adjusted for breastfeeding duration, FA supplementation, and gluten exposure. RESULTS: 3-months-old children of T1DM mothers and T1DM fathers/sibs had similar levels of PC DHA and EPA (DHA 1.53+/-0.23 vs. 1.65+/-0.11 wt.%; EPA 0.15+/-0.02 vs. 0.21+/-0.03 wt.%) and PE DHA and EPA (DHA 7.54+/-0.37 vs. 7.92+/-0.38 wt.%; EPA 0.53+/-0.06 vs. 0.61+/-0.04 wt.%). No differences were also observed after stratification for breastfeeding. At age 12 months, a minor reduction of PE DHA was observed in children of T1DM mothers. Expected higher levels for DHA and EPA in fully breastfed children and in children of mothers taking fish oil supplementation were observed at 3 months in all children. Other differences included increased levels of the major saturated FA 16:0 in 3-months-old infants from T1DM mothers (PC 35.45+/-0.35 vs. 33.89+/-0.26 wt.%, mean +/- SEM, P(corr)=0.005; PE 16.13+/-0.39 vs. 14.93+/-0.24 wt.%, P(corr)=0.05). CONCLUSION: Although FA status was not identical in children from T1DM mothers and from T1DM fathers, maternal T1DM was not associated with changes in offspring's EPA and DHA incorporation into erythrocyte membrane.     

School-administered weekly iron supplementation – Effect on the growth and hemoglobin status of non-anemic Bolivian school-age children A randomized placebo-controlled trial

Summary Background Recent data suggest that daily iron supplementation of iron-replete children could impair their growth. If verified for weekly iron supplementation these results would markedly complicate targeting and implementing school-based weekly iron supplementation programs. Aim of the study To ascertain the effect of weekly iron supplementation on the growth and hemoglobin status of non-anemic school-age children. Subjects and methods 73 Bolivian non-anemic school-age children randomly assigned to the treatment group (n=37; receiving supplements containing FeSO₄ during 18 weeks) or the control group (n=36; receiving a placebo during the same period). Hemoglobin concentration and anthropometric measures were determined for each child at the beginning (T0) and the end (T18) of the study. Results The treatment group did not show any significant variation in hemoglobin concentration between T0 and T18 (−1.6±10.4 g/L; P=0.40) whereas the control group showed a significant decrease in hemoglobin concentration (−4.6±10.9 g/L; P=0.03). Anthropometric changes were not significantly different between the treatment and the control groups for weight, (1.63±1,11 kg vs 1.88±0.79 kg; P=0.30), height (2.35±0.94 cm vs 2.11±1.03 cm; P=0.34) or mid-upper arm circumference (0.29±0.57 cm vs 0.22±0.54 cm; P=0.64). Conclusion In our study, weekly iron supplementation of non-anemic school-age children had no negative effect on their growth while having a positive effect in preventing significant decreases in hemoglobin concentration. These results suggest that in regions where iron deficiency anemia (IDA) is prevalent, a simple and cost-effective way to control IDA in school-age children is to give weekly iron supplements to all children at school. Received: 5 June 2000, Accepted: 25 September 2000     

口服亚硒酸钠和维生素E对高海拔地区心血管病患者甲状腺激素的影响

目的探讨使用亚硒酸钠和维生素E对高海拔地区心血管病患者甲状腺激素的影响.方法将心血管病患者随机分为3组A组42例患者口服亚硒酸钠,同时加服维生素E;B组28例患者口服亚硒酸钠;对照组20例,未服用亚硒酸钠及维生素E.观察对象分别于治疗前和治疗6个月后抽血检测血清硒(Se)、血浆谷胱甘肽过氧化物酶(GSH-Px)活力、丙二醛(MDA)含量及甲状腺激素(T3、T4)等指标,以观察远期疗效.结果治疗后A组和B组血清Se含量[(0.71±0.22)、(0.68±0.18)μmol/L]明显高于治疗前[(0.31±0.17)、(0.33±0.14)μmol/L],差异有显著性(P＜0.01);A组和B组血浆GSH-Px活力分别为(87.12±13.61)、(84.79±12.13)U/L,较治疗前[分别为(58.43±18.93)、(57.12±17.36)U/L]明显增加.A组和B组MDA含量[(4.86±1.18)、(4.18±1.23)nmol/ml]较治疗前[(8.66±0.96)、(8.71±0.87)nmol/ml]明显降低,差异均有显著性(P＜0.01);A组和B组患者T3和T4较对照组明显降低,趋于正常.血清Se与血浆GSH-Px呈正相关(r=0.781,P＜0.01),与MDA、T3、T4浓度呈负相关(r=-0.385;r=-0.687;r=-0.412,均P＜0.05).甲状腺激素恢复正常者A组31例(73.81%)、B组20例(71.42%);部分恢复者A组4例(9.52%)、B组2例(7.43%),其恢复率明显高于对照组,差异有显著性(P＜0.05),远期疗效较好.结论补充适量硒和维生素E可纠正高原环境下因低Se而引起的甲状腺激素代谢异常.     

Serum levels assessment of vitamin A, E, C, B2 and carotenoids in malnourished and non-malnourished hospitalized elderly patients

AIMS & METHODS: Serum levels of vitamins A, E, C, B2 and carotenoids were determined in protein-energy malnourished (PEM, with body mass index, BMI<18.5 kg/m2) and non-PEM (BMI+/-18.5 kg/m2) hospitalized elderly (age > or = 65 years) patients, in the University Hospital of Faculty of Medicine of Ribeir?o Preto, S?o Paulo University. RESULTS: PEM (n=21) and non-PEM (n=106) patients were paired for age (73.6+/-7.3 vs. 71.6+/-5.6 years) and male percentage (65.1 vs. 52.4%). As expected, PEM elderly showed lower (P<0.05) body weight (median 43.1; range: 29.9-51.4 vs. 58.1; range: 45.7-143.5 kg), triceps skinfold (5.2+/-3.1 vs. 10.1+/-4.9 mm), and mid-arm muscle circumference (20.3+/-2.5 vs. 23.1+/-3.4 cm). Serum albumin (4.0+/-0.9 vs. 4.1+/-0.7 g/dl) and total lymphocytes count (1918.3+/-919 vs. 1842.7+/-862 mm(3)) were similar, respectively, among PEM and non-PEM patients. The percentage of biochemical riboflavin deficiency (58.8 vs. 56.2), low serum levels of vitamin A (28.6 vs. 29.6) and vitamin E (18.7 vs. 25) were similar, respectively, between PEM and non-PEM groups. The prevalence of low serum levels of water soluble vitamins was higher (P<0.01) in malnourished elderly than in the non-PEM group (ascorbic acid, 80.9 vs. 56.7%, and carotenoids, 14.3 vs. 3%, respectively).CONCLUSIONS: These results suggest that hospitalized malnourished elderly show high percentage of low water soluble vitamin serum levels, a phenomenon possibly linked to decreased food intake, especially fruits and vegetables.     

Respiratory and cardiovascular functions among smoking and nonsmoking girls from two regions with different air pollution degree

AIM: The aim of the present study was to analyze the respiratory and cardiovascular functions among smoking and nonsmoking girls attending two schools situated in regions with different levels of air pollution. The characteristic of air pollution is based on the data gathered by stations 1 and 2 belonging to the Uniform National System for Monitoring the Air Pollution in Bulgaria. The participants (n=108, 16.07+/-0.80 years) were separated in two groups: smokers (S1 - from school 1, S2 - from school 2) and nonsmokers (NS1 - from school 1, NS2 - from school 2). All of them performed pulmonary function testing and .cardiopulmonary exercise testing on a treadmill using our modification of the Balke protocol (Marinov et al., 2000). Reference values for European children, previously validated for the Bulgarian population, were used. RESULTS: There are no significant differences in mean levels of VC, IC, FEV1, MEF50 and MEF25 (as a percentage from the predicted value as well). The average level of the Tiffneau index is noticeably higher among nonsmokers from the two regions and is the lowest among smokers from the more polluted area, but a significant difference exists between S2 (88.7+/-5.9) and NS2 (92.6+/-4.7), p=0.047; T(L,CO)%pred: S1 (85.4+/-7.2) vs. S2 (86.7+/-8.2), p=0.048 and NS1 (88.3+/-8.2) vs. NS2 (92.8+/-14.5), p=0.037; V(E)%pred: S1 (127.5+/-9.6) vs. S2 (123.7+/-6.1), p=0.035; higher levels of total lung capacity (TLC%pred), S1 (107.3+/-9.2) vs. NS2 (104.3+/-9.1), p=0.009 and alveolar ventilation (VA), S1 (5.0+/-0.6) vs. NS2 (4.6+/-0.5), p=0.008. CONCLUSIONS: 1. The negative effects of the combined influence of tobacco smoking and air pollution on some respiratory and cardiovascular functions of adolescent girls are more pronounced than each influence alone. 2. The cardiopulmonary exercise test gives adequate information about the combined effect of air pollution and smoking and using it for preventive purposes is an advisable method.     

Characteristics of tidal expiratory flow pattern in healthy people and patient with chronic obstructive pulmonary disease

According to data reported in literature tidal breathing parameters and especially tidal expiratory flow pattern parameters can be useful in distinguishing airflow obstruction. The purpose of the present study was to investigate the parameters of the tidal breathing in healthy people and patients with chronic obstructive pulmonary disease. The study sample included 158 patients with COPD in clinically stable condition and different degree of functional disturbances (FEV1% pred. = 42% +/- 15%; ATS dyspnea scale = 2.5 +/- 0.9; mean +/- SD). The control group of healthy subjects consisted of 43 men and 37 women. The obtained results show that TPTEF/TE (the time necessary to reach the peak expiratory flow in tidal breathing over the total expiratory time) and VPTEF/VE (the volume necessary to reach the peak expiratory flow in tidal breathing over the total expiratory volume) are an independent aspect of tidal breathing. In healthy people these parameters show weak negative correlation with age and high variability. In COPD they are statistically significantly lower than those of healthy people but, since they are highly variable, they cannot be used for an individual assessment. The increase of the mean inspiratory flow (TV/Tin) and the shortening of VPTEF/VE, TPTEF/TE and Tin/Ttot, are indicative of the lung mechanics changes which have a bearing on dyspnea, too. According to factor analysis the parameters of tidal breathing are four separate dimensions: 1. Breathing frequency and respiratory times; 2. Relationship between the respiratory times; 3. Minute ventilation, mean expiratory flow, mean inspiratory flow and tidal volume; 4. Parameters of the expiratory flow VPTEF/VE and TPTEF/TE. The parameters of forced expiration and those of tidal breathing are separate dimensions of the functional profile of patients with COPD.     

重庆市0~12岁儿童维生素D营养状况

  目的  了解重庆市0~12岁儿童维生素D营养状况,分析其维生素D缺乏(vitamin D deficiency, VDD)可能的影响因素。  方法  随机抽取2019年1月至2021年12月于重庆市妇幼保健院进行规律儿童保健的0~6岁儿童1 877名和重庆市3所小学6~12岁学龄儿童707名,采集静脉血采用化学发光法检测血清25-(OH)-D水平,自行设计问卷并分析维生素D缺乏可能的影响因素。  结果  儿童血清25-(OH)-D平均质量体积浓度为(39.9±9.1) ng/mL,VDD检出率为14.59%。不同年龄段、就诊时间、就诊季节、体型、户外活动时间和维生素D补充情况儿童VDD检出率(0~3,4~6,7~12岁分别为14.73%,22.19%,10.47%;疫情前、疫情后分别为11.18%,17.08%;就诊季节春、夏、秋、冬分别为12.97%,10.65%,14.86%,21.33%;体型消瘦或正常、超重或肥胖分别为12.34%,26.13%;户外活动时间充足、不足分别为11.84%,16.27%;补充维生素D、未补充维生素D分别为11.71%,15.62%),差异均有统计学意义(χ2值分别为26.17,17.59,30.98,53.74,9.60,6.17,P值均＜0.05)。体型消瘦或正常、户外活动时间充足和规律补充维生素D与儿童VDD均呈负相关[OR值(OR值95%CI)分别为0.68(0.55~0.84),0.57(0.25~0.77),0.62(0.44~0.85),P值均＜0.05]。  结论  重庆市学龄前及学龄儿童VDD检出率高,控制超重/肥胖、增加户外活动时间和口服维生素D制剂等群体防控策略可能改善维生素D缺乏情况。     

Enteropathogen carriage by healthy individuals living in an area with poor sanitation

Faecal carriage of bacterial enteropathogens (enteropathogenic Escherichia coli (EPEC), shigellae and salmonellae) was studied in 265 individuals: 65 infants 3-6 months of age (50 bottle-fed and 15 breast-fed), 100 school-age children 8-10 years of age and 100 adults 21-50 years of age. All were apparently healthy, did not have gastrointestinal symptoms, had not received antibiotics in the preceding fortnight and were not malnourished. Enteropathogens were isolated from the faeces of 24 individuals (9.1%). Cultures were positive for enteropathogens in 20% of the infants (both breast- and bottle-fed), 8% of school-age children and 3% of the adults. EPEC was the most frequent isolate. Twelve different serotypes were detected. The highest recoveries were E. coli 026:K60 and 044 . K74. Shigella was detected only in school-age children (2%) and salmonella only in adults (1%). Campylobacter jejuni and Yersinia enterocolitica were studied only in the school-age children: there was one isolate of each of them. Most enteropathogens isolated were susceptible to the majority of the antibiotics tested. Only four E. coli strains, isolated from bottle-fed infants, could be considered multi-resistant. Two of the strains wer E. coli 044:K74 and 020a020c:K61. The remainder were E. coli 0111:K58 and wee capable of transferring some of their antibiotic resistance traits to a recipient strain.     

Enteropathogen carriage by healthy individuals living in an area with poor sanitation.

Faecal carriage of bacterial enteropathogens (enteropathogenic Escherichia coli (EPEC), shigellae and salmonellae) was studied in 265 individuals: 65 infants 3-6 months of age (50 bottle-fed and 15 breast-fed), 100 school-age children 8-10 years of age and 100 adults 21-50 years of age. All were apparently healthy, did not have gastrointestinal symptoms, had not received antibiotics in the preceding fortnight and were not malnourished. Enteropathogens were isolated from the faeces of 24 individuals (9.1%). Cultures were positive for enteropathogens in 20% of the infants (both breast- and bottle-fed), 8% of school-age children and 3% of the adults. EPEC was the most frequent isolate. Twelve different serotypes were detected. The highest recoveries were E. coli 026:K60 and 044 . K74. Shigella was detected only in school-age children (2%) and salmonella only in adults (1%). Campylobacter jejuni and Yersinia enterocolitica were studied only in the school-age children: there was one isolate of each of them. Most enteropathogens isolated were susceptible to the majority of the antibiotics tested. Only four E. coli strains, isolated from bottle-fed infants, could be considered multi-resistant. Two of the strains wer E. coli 044:K74 and 020a020c:K61. The remainder were E. coli 0111:K58 and wee capable of transferring some of their antibiotic resistance traits to a recipient strain.     

Seroprevalence of Helicobacter pylori in children with type 1 diabetes mellitus in Sardinia

A few studies have reported an increased prevalence of Helicobacterpylori (HP) infection in diabetic subjects, which may be one of the causes of gastrointestinal symptoms and chronic atrophic gastritis frequently seen in diabetes of long duration. We determined the prevalence of HP infection in children and adolescents with Type 1 diabetes mellitus (T1DM) in the area of Sassari (northern Sardinia, Italy), which is characterized by an ethnically homogenous population at high risk of T1DM. HP IgG and IgA titres were measured in 138 patients with T1DM and 138 age-matched healthy controls. The percentage of infected subjects did not differ between T1DM patients (29.7%) and controls (32.6%). Globally, infected subjects were more than 1 yr older (13.0 +/- 2.7 yr) than non-infected ones (11.8 +/- 2.9 yr), independently of the presence of T1DM; in most HP-positive subjects infection was asymptomatic, and only 2 subjects in each group reported clinically relevant symptoms. HP-positive and HP-negative diabetic patients had the same duration of the disease (5.6 +/- 3.5 vs 5.5 +/- 3.6 yr) and received very similar doses of insulin (0.94 +/- 0.27 vs 0.96 +/- 0.4 IU/kg/d), whereas mean HbA1c was significantly lower in HP-positive patients (7.8 +/- 1.6% vs 8.6 +/- 1.7%,p=0.02). We conclude that the prevalence of HP infection is not higher in Sardinian children with T1DM as compared to controls of similar age, and the overall clinical impact of HP infection in terms of gastrointestinal symptoms and diabetic control seems to be low.     

Albumin synthesis is diminished in men consuming a predominantly vegetarian diet

Albumin synthesis was calculated in healthy male volunteers consuming diets differing in the relative contribution of protein from animal or vegetable sources. In one study (Study 1, n = 4) two isoenergetic and isonitrogenous diets were consumed for a period of 10 d each. One diet (diet A) was animal protein rich (74%), the other one (diet V) contained 67% of vegetable protein. Albumin synthesis rate was measured from L-[(2)H(5)]phenylalanine incorporation (43 mg/kg) at the end of each dietary period. Both albumin fractional synthesis rate (FSR) (5.7 +/- 0.6 vs. 6.7 +/- 0. 8%/d, P = 0.04) and absolute synthesis rate (ASR) (123 +/- 6 vs. 143 +/- 8 mg. kg(-1). d(-1), P = 0.05) were reduced after diet V. In a second study (Study 2, n = 8) a third dietary treatment was added (Diet VS). This was similar to diet V but supplemented with soy protein (18g/d). The results of study 2 confirmed that albumin synthesis was reduced after diet V (FSR: 5.9 +/- 0.3 vs. 6.7 +/- 0. 5%/d, P = 0.015; ASR: 126 +/- 7 vs. 146 +/- 9 mg. kg(-1). d(-1), P = 0.007), but it also showed that the drop could be prevented by adding supplemental protein to the predominantly vegetarian diet (Diet VS) (FSR: 6.4 +/- 0.3%/d, P = 0.08; ASR: 140 +/- 7 mg. kg(-1). d(-1), P = 0.03). Albumin synthesis appears to be modulated by changes in the proportion of animal vs. vegetable protein occurring in the diet. The mechanism might be related to differences in digestibility and consequently in net amino acid availability between diets.     

The frequency of Trp64Arg polymorphism of the beta3-adrenergic receptor gene in healthy and obese Hungarian children and its association with cardiovascular risk factors

OBJECTIVE: To estimate the frequency of Arg64 allele of the beta(3)-adrenergic receptor (3-BAR) gene in healthy (H) and obese (O) Hungarian children, and to look for possible associations between this polymorphism and some clinical and metabolic characteristics of obese children. PATIENTS/METHODS: In all, 147 healthy (male: 68) and 295 obese (male: 168) children were examined. The average age of the children in the two groups was 12.4+/-1.7 vs 12.6+/-3.2, respectively. Exon 1 of 3-BAR was amplified by polymerase chain reaction and the fragments were digested with BstN1. In obese children, oral glucose tolerance test was carried out and blood pressure (BP) was checked. RESULTS: The frequency of Trp64Arg polymorphism in normal and obese Hungarian children was similar (H vs O: n=14/9.5% vs n=35/11.8%). Obese children carrying the Arg64 allele (n=35, male: 23) were compared to randomly chosen, obese children without the Arg64 allele (n=35, male: 20). A significant difference was found between the body weight (81.2+/-23.2 vs 75.6+/-17.7 kg; mean+/-s.d.; P<0.01), body fat (38.8+/-3.9 vs 36.5+/-2.3%; mean+/-s.d.; P<0.05), mean fasting insulin levels (31.4+/-16.7 vs 16.9+/-7.6 microIU/ml; P<0.001) and mean systolic BP values (125.2+/-10.1 vs 114.5+/-8.3 mmHg; P<0.001) of the two obese groups. CONCLUSIONS: The frequency of Trp64Arg polymorphism was similar in Hungary as compared to other European countries. Although the prevalence of this polymorphism was similar in H and O children, the presence of Arg64 allele seems to be associated with increased adiposity, elevated systolic BP and higher fasting insulin levels.     

北京市2004年2-18岁儿童青少年超重和肥胖流行现状

目的分析北京市2～18岁儿童青少年超重和肥胖检出率水平及分布特征.方法利用2004年北京市儿童代谢综合征调查总样本中21 198名2～18岁人群的体重指数数据,分别采用中国（WGOC标准）、美国疾病预防控制中心（CDC 2000标准）和国际肥胖工作组（IOTF标准）推荐的儿童青少年超重和肥胖体重指数分类标准计算超重和肥胖检出率.结果北京市2～18岁儿童青少年合并超重（包括肥胖）检出率、肥胖检出率分别是18.6%和8.1%（CDC 2000标准）,17.4%和5.1%（IOTF标准）;根据WGOC计算的7～18岁合并超重检出率和肥胖检出率是20.9%和8.9%.学龄儿童（6～18岁）的合并超重率高于学龄前儿童（19.8%：14.8%,CDC 2000标准）;学龄儿童中,男性高于女性（26.7%：16.5%,WGOC标准）,城市高于农村（27.0%：15.9%,WGOC标准）;学龄前儿童城乡间差异无统计学意义.结论北京市有1/5的儿童青少年超重或肥胖,居国内最高水平.儿童青少年肥胖已经成为北京市一个重要公共卫生问题,需要引起社会高度关注.     

Opioidergic modulation of ventilatory response to sustained hypoxia in obese Zucker rats.

OBJECTIVE: To determine whether altered central and/or peripheral opioidergic mechanisms contribute to the altered ventilatory response to sustained hypoxia in obese Zucker rats. RESEARCH METHODS AND PROCEDURES: Eight lean (176 +/- 8 [SEM] g) and eight obese (225 +/- 12 g) Zucker rats were studied at 6 weeks of age. Pulmonary ventilation ((E)), tidal volume (V(T)), and breathing frequency (f) at rest and in response to sustained (30 minutes) hypoxic (10% O(2)) challenges were measured on three separate occasions by the barometric method after the randomized, blinded administration of equal volumes of saline (control), naloxone methiodide (N(M); 5 mg/kg, peripheral opioid antagonist), or naloxone hydrochloride (N(HCl); 5 mg/kg, peripheral and central opioid antagonist). RESULTS: Administration of N(M) and N(HCl) in lean animals had no effect on (E) either at rest or during 30 minutes of sustained exposure to hypoxia. Similarly, N(M) failed to alter (E) in obese rats. In contrast, N(HCl) significantly (p < 0.05) increased (E) and V(T) both at rest and during 2 to 10 minutes of hypoxic exposure in obese rats. After 20 to 30 minutes of hypoxic exposure, V(T) remained elevated with N(HCl), but the earlier elevation of (E) seemed to be attenuated due to a decrease in f at 20 minutes of exposure to hypoxia. DISCUSSION: Thus, endogenous opioids modulate both resting (E) and the ventilatory response to sustained hypoxia in obese, but not in lean, Zucker rats by acting specifically on opioid receptors located within the central nervous system.     

Assessment of oxygen-consumption by use of reverse Fick-principle and indirect calorimetry in critically ill patients

Oxygen consumption was measured simultaneously by the reverse Fick-principle (V02FICK) and by indirect calorimetry ("Metabolic Measurement Cart Horizon") (V02MMC) in 31 critically ill patients; 24 men and 7 women. Seventeen patients were breathing spontaneously, 14 patients were on mechanical ventilation. The fractional inspiratory oxygen concentration (FI02) in ventilated patients ranged from 0.21 to 0.4 (mean 0.302). Total oxygen consumption as measured by indirect calorimetry was 286.7 +/- 59.7 ml/min (mean +/- SD), and measured by reverse Fick-principle 258.9 +/- 52.2 ml/min (mean +/- SD). The coefficient of correlation between the two methods was r = 0.873. The absolute difference of oxygen consumption between reverse Fick-method and indirect calorimetry was 11.3%. Regression analysis according to Theil revealed a similar regression between spontaneously breathing and mechanically ventilated patients for the studied FI02 values below 0.4. It is concluded that indirect calorimetry is a reliable method for measuring oxygen consumption in spontaneously breathing as well as mechanically ventilated critically ill patients.     

Electrocardiographic and echocardiographic findings in malnourished children

OBJECTIVE: To compare heart abnormalities in a group of malnourished children with a control group and to describe their predictive variables. METHODS: Thirty children with malnutrition were matched with thirty healthy children. Anthropometry, plasma levels of albumin and electrolytes were determined. Among others, corrected QT interval (QTc) and QT dispersion (QTd: difference between the maximum and the minimum QT) were measured in 12-lead electrocardiogram; and left ventricular mass (LVm) and left ventricular mass index (LVmi) were measured by echocardiography. Regression analyses were performed with cardiac findings as dependent variables and anthropometric and biochemical data as independent variables. RESULTS: Plasma levels of albumin, potassium and calcium were lower in malnourished children. QTc and QTd were significantly greater in patients with malnutrition than in controls (QTc: 445.9 +/- 31.4 vs. 400.9 +/- 17.7 ms, p = 0.000; QTd: 76.4 +/- 34.1 vs. 47.9 +/- 10.2 ms, p = 0.000). LVm and LVmi were significantly lower in malnourished children (LVm: 55.3 +/- 10.3 vs. 71.4 +/- 6.9 g, p = 0.000; LVmi: 46.5 +/- 6.6 vs. 60.5 +/- 4.9 g/m2, p = 0.000). The body mass index (kg/m2) was the most powerful predictor of the variability in QTc (39.1%), LVm (48.1%) and LVmi (51.2%). CONCLUSIONS: Important electrocardiographic and echocardiographic abnormalities have been found in malnourished children associated with their nutritional status. Special precaution must be taken about the possibility of occurrence of arrhythmias and sudden death related with malnutrition.     

Oxidative stress status in patients with diabetes mellitus: relationship to diet

OBJECTIVE: To investigate the relationship between dietary intakes and in vivo oxidative stress (OS) status in diabetic patients. DESIGN: Case-control study. SETTING: Outpatient-Clinic and Laboratory Endocrinology, University Antwerp. SUBJECTS AND METHODS: A total of 30 patients (24 type 1 diabetes mellitus (T1DM)/6 type 2 diabetes mellitus (T2DM) were asked to complete a 2 weekdays+1 weekend day food consumption questionnaire during the week preceding their yearly diabetes control consultation, when samples were collected for the assay of oxidative stress (OS) (blood levels of antioxidants, peroxides, malondialdehyde (MDA) and minerals). Blood samples were also collected from 25 age- and sex-matched healthy controls. RESULTS: Diabetic patients had lower glutathione (5.80+/-1.15 vs 6.75+/-1.03 micromol/g Hb in the controls, P=0.002) and higher MDA (0.687+/-0.212 vs 0.545+/-0.101 micromol/l, P=0.002). Although the group average intakes were within the Belgian RDA, intakes of fat >35% energy, fibre <15 g/1000 kcal, fruit <2 portions and vitamin E <10 mg/day were seen in more than 20 patients. Blood antioxidants did not correlate with intakes of energy, fat, protein or fibres or of their respective antioxidant. Vitamins A and E correlated with serum lipids (r=0.58, P <0.0005 between serum alpha-tocopherol and cholesterol). Blood peroxide levels were only related to intakes of saturated fat and cholesterol (P<0.05). In diabetic subjects but not in controls (P<0.05) MDA was related to glutathione and uric acid. CONCLUSIONS: In diabetic patients, blood levels of antioxidants are not related to their dietary intakes but to serum lipids. Levels of oxidative damage products are only related to intakes of saturated fats and cholesterol and to levels of endogenous antioxidants.     

空气污染对儿童部分免疫及肺通气功能的多因素分析

目的：探讨空气污染儿童健康影响，方法：根据1988－1998年大气污染物[SO2,NOx,总悬浮颗粒（TSP），CO]监测资料，选择唐山市工业区（污染区）和相对清洁区（对照组）7－15岁学龄儿童656人和712人进行局部非特异免疫功能[唾液溶菌酶和分泌型免疫球蛋白A（SIgA)]和肺功能（肺活性（VC），用力肺活量（FVC），1s用力呼气容积（FEV），25％，50％和75％用力肺活量呼气流速（V25,V50和V75)最大通气量（MVV）进行检测并开展问卷调查，结果：污染区大气SO2，NOx和TSP均显著高于对照区（P＜0．05或P＜0．01），多因素分析显示，除SIgA外其他指标均与生理因素有关，其中主要与年龄呈正相关（t=5.130-9.698,P=0.0001)，唾液溶菌酶、SIgA,VC,FVC,MVV,V25,V50和V75，主要与空气NOx可SO2浓度显负相关（P＝0．0005－0．0086），结论：空气污染尤其室外空气污染可导致儿童局部非特异免疫功能及肺通气功能降低。