血清胆固醇及纤维蛋白原在评估肾病综合征患儿肾小球硬化风险中的意义

目的 探讨血清胆固醇及纤维蛋白原（FIB）在评估肾病综合征患儿肾小球硬化风险中的意义。方法 将63例原发性肾病综合征患儿按其病理类型分为微小病变肾小球病（MCG,n=39）组及局灶节段性肾小球硬化症（FSGS,n=24）组,回顾性分析两组患儿血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、非高密度脂蛋白胆固醇（non-HDL-C）、FIB及24 h尿蛋白定量的水平。结果 FSGS组中TC、non-HDL-C及LDL-C水平均较MCG组增高（均PP>0.05）。Logistic回归分析结果显示LDL-C、non-HDL-C和TC是影响肾小球硬化的危险因素（均PPP>0.05）。结论 血清胆固醇水平尤其是non-HDL-C对评估肾小球硬化的风险有重要意义;血浆FIB的水平尚不足以来评估或预测肾小球硬化的风险。     

Ocena profilu lipidowego i leptynemii u zdrowych donoszonych noworodków

IntroductionThe existence of a relation between the leptin concentration – a hormone taking part in the metabolism of the organism, and the lipids and lipoproteins seems undoubted, till now it has not yet been defined for newborns.AimThe aim of the study was to determine the value of the lipid profile parameters: ApoA, ApoB, TC, LDL-C, HDL-C, TG, albumines and leptin in healthy, full-term newborns, as well as to analyze the relation between leptin concentration and the values of the lipids parameters.Material and MethodsSerum Concentrations of TC, HDL-C, LDL-C, TG, ApoA, ApoB, albumines and leptin were assesed in the serum between 3–7 day of life 35 healthy, full term newborns with appropriate birth weight.ResultsIn female newborns significantly higher LDL-C concentration was found (p=0.03). The girls had a higher concentration of ApoA, ApoB, TC, HDL-C and leptin than boys (p=0,03). Positive correlation between the leptin serum concentrations and body weight (r=0.3681, p=0.03) and length of newborns (r=0.4714, p=0.004) was stated. Numerous correlations between the lipids parameters and a significant (p<0.5) decrease of ApoA (r = ?0.4598), TC (r = ?0.3635), HDL-C (r = ?0.3473) and LDL-C (r = ?0.3398) in serum concentrations accompanied by an increase in leptin concentrations were found.Conclusions1. The full-term healthy newborns have a significant correlation between leptin concentration and the values of ApoA, TC, HDL-C and LDL-C. 2. Newborns show a positive correlation between leptin concentration and body weight and length at birth. 3. The sex of full-term healthy newborn may be the factor modulatory the values of the lipid profile parameters.     

Serum lipids in epileptic children treated with carbamazepine and valproate

Serum total cholesterol (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) and very low-density lipoprotein cholesterol, triglyceride, apolipoproteins A1 and B levels were studied in 57 healthy children and in 39 children with epilepsy who had been receiving carbamazepine (CBZ) (23 children) for 1.58 ± 1.10 years or valproic acid (VPA) (16 children) for 1.34 ± 1.11 years. In patients receiving CBZ, mean TC level, mean LDL-C level, mean TC/HDL-C ratio and mean LDL-C/HDL-C ratio were significantly higher than controls. None of the mean levels of serum lipids evaluated in patients receiving VPA was significantly different from the corresponding control group mean. Changes in serum lipids correlated with neither duration of therapy or plasma antiepileptic levels nor age or gender. Conclusion Our results suggested that CBZ, a hepatic-enzyme-inducing drug, affects serum lipid status. Long-term prospective studies are necessary to determine whether chronic CBZ therapy is a risk factor for atherosclerotic disorders. Received: 15 October 1996 / Accepted: 5 February 1997     

Cognition in specific learning disability

Objective : To compare the cognition abilities of children with specific learning disability (SpLD) viz. dyslexia, dysgraphia and dyscalculia with those of non-impaired children.Methods : The study group consisted of 95 newly diagnosed SpLD children (aged 9–14 years) and the control group consisted of 125 non-impaired children (aged 9–14 years). An academic achievement of two years below the actual grade placement on educational assessment with a Curriculum-Based test was considered diagnostic of SpLD. A battery of 13 cognition function tests based on Guilford’s Structure of Intellect Model was administered individually on each child in four areas of information viz. fieural, symbolic, semantic and behavioral. Mean scores ±SD obtained in these four areas were calculated in both groups and compared using Independent Samples t-test. A P value < 0.05 was considered significant.Results : Children with SpLD had significantly lower scores (mean ±SD) in all four areas of information: maximally in the symbolic area (18.66 ±4.83 vs. 28.30 ±4.29, mean difference 9.64, P< 0.0001, df = 218,95% Cl 8.43-10.86), followed by semantic (18.72 ±5.07vs 27.36 ±4.17, mean difference 8.64, P< 0.0001, df=218, 95% Cl 7.40 9.87), figurai (17.10 ±5.24 vs 25.14 ±3.36, mean difference 8.04, P< 0.0001, df=218, 95% CI 6.89-9.19), and behavioral (5.68 ±2.10vs 7.54 ±1.46, mean difference 1.86, P< 0.0001, df = 218, 95% C11.39-2.33) areas.Conclusion : Cognition abilities are significantly impaired in children with SpLD.     

早产儿早期血脂代谢特点及与新生儿呼吸窘迫综合征关系探讨

目的：了解早产儿早期血脂代谢特点及其与新生儿呼吸窘迫综合征（RDS）的关系。方法：将100例适于胎龄早产儿按胎龄或出生体重分组,并以40例足月适于胎龄儿作为对照组,于出生后12 h内静脉采血,测定血浆总胆固醇（TC）、甘油三脂（TG）,低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）水平;另外,分别根据胎龄及出生体重进一步比较发生RDS与未发生RDS早产儿的血脂水平。结果：随胎龄及体重增加,TG水平呈递增趋势,28~30周组及31~33周组早产儿血浆TG水平均明显低于34~36周早产儿及足月儿（P<0.01）;出生体重≤1499 g组及1500~2499 g组早产儿血浆TG水平均明显低于出生体重≥2500 g早产儿及足月儿（P<0.05）,且出生体重≤1499 g组与1500~2499 g组早产儿之间TG水平差异亦有统计学意义（P<0.01）;而各组新生儿HDL-C、LDL-C及TC水平差异无统计学意义。RDS与非RDS早产儿血浆TC、LDL-C及HDL-C水平差异亦无统计学意义;但在胎龄28~30周组,RDS早产儿的TG水平比非RDS早产儿明显降低（P<0.05）;体重≤1499 g RDS早产儿TG水平低于非RDS早产儿（P<0.05）。结论：早产儿血脂水平与胎龄及体重相关,低TG水平可能是胎龄28~30周及体重≤1499 g早产儿出现RDS的原因之一。     

Relationship of body mass index with serum lipids in elementary school students

Objective  To determine the relationship of body mass index with serum lipids in elementary students. Methods  This prospective analytic study was conducted among 954 elementary school students (9–11years), selected by multi stage random systematic method from 6 cities and their rural areas from The South Khorasan province (eastern Iran) from September to December 2006. Height and weight was measured and Body mass index was calculated. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined. Results  954 students 9–11 years old were studied. 45.4% were boys. 76.5% were living in the city. 1.8% of students were obese and 3.4% were over weight. There was no significant relation between obesity and overweight with sex, age and the area of residence. There was significant relation between BMI with TC (P= 0.003), TG (P< 0.001) and LDL-C (P= 0.04). TG was significantly higher in obese and overweight students than in normal weight students (P< 0.001). TC (0.002) and LDL-C (0.01) were significantly higher in obese students than normal weight students. The prevalence of high TG was significantly higher in obese and overweight students than normal weight students (0.003). There was no significant difference between different kinds of dyslipidemia with area of residence. Conclusion  it is necessary to measure serum lipid profile in obese and overweight children.     

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??Abstract?? Objective??To explore the normal value of serum lipids and the correlation between atherogenic index and serum lipid in healthy children aged 2 to 14. Methods??The serum TG?? TC?? HDL-C and LDL-C were detected by Siemens 2400 automatic biochemical analyzer in 988 healthy children. The atherogenic index LDL-C/ HDL-C and ??TC??HDL-C??/HDL-C were calculated. Results????1??The diagnostic criteria of lipid disorder were as follows?? 2?? < 4-year-old?? TC > 4.02 mmol / L?? TG > 1.25 mmol / L?? HDL-C < 0.83 mmol / L?? LDL-C > 2.26 mmol / L?? 4?? < 7-year-old?? TC > 4.47mmol / L?? TG > 1.35mmol / L?? HDL-C < 0.90 mmol / L?? LDL-C > 2.55 mmol / L?? 7?? < 10-year-old?? TC > 4.78 mmol / L?? TG > 1.42 mmol / L?? HDL -C < 0.99 mmol / L?? LDL-C > 2.49 mmol / L?? 10?? < 13 -year-old?? TC > 4.71 mmol / L?? TG > 1.49 mmol/L?? HDL-C < 0.89 mmol / L?? LDL-C > 2.44 mmol / L?? 13??14 -year-old?? TC > 5.00 mmol / L?? TG > 1.48 mmol / L?? HDL-C < 0.95 mmol / L?? LDL-C > 2.96 mmol/L. ??2??The criteria of atherosclerosis index in children aged 2 ????4?? ?? 7 ?? ?? 10 ?? and 13 ?? 14-year-old were?? LDL-C/HDL-C > 2.38?? > 1.98?? > 1.95?? > 2.35 and > 2.28?? ??TC??HDL-C??/ HDL-C > 2.59?? > 2.55?? > 2.11?? > 2.46 and > 2.50?? respectively. ??3??The levels of serum TC?? TG?? HDL-C and LDL-C increased with age. ??4??The atherosclerosis index had significant positive correlation with TG and LDL-C. Conclusion??Criteria of serum lipids for children aged 2 to 14 years in Chongqing are established. The level of serum lipids is a dynamic process for children. The predictive value of atherosclerosis index should be noted in children with lipid disorder.     

Effects of ketogenic diet on vascular function

BackgroundKetogenic diet is a well-established treatment in children with difficult to treat epilepsy. Very little is known about the long-term effects on vascular atherogenic and biochemical processes of this high-fat and low carbohydrate and protein diet.MethodsWe evaluated 26 children after one year and 13 children after two years of ketogenic diet. High resolution ultrasound-based assessment was used for carotid artery intima-media thickness (cIMT), carotid artery distensibility and carotid artery compliance. Blood lipids including high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol, (LDL-C), total cholesterol (TC), apolipoprotein A (apoA), apolipoprotein B (apoB) and high-sensitivity C-reactive protein (hsCRP) were analysed.ResultsA gradual decrease in carotid distensibility and an increase in LDL-C, apoB and the TC:LDL-C and LDL-C:HDL-C ratios were seen at three and 12 months of KD-treatment. These differences were not significant at 24 months. cIMT, BMI and hsCRP did not show any significant changes.ConclusionsThe initial alterations in lipids, apoB and arterial function observed within the first year of KD-treatment appear to be reversible and not significant after 24 months of treatment.     

Serum free fatty acid level in children with primary hypertension北大核心CSCD

目的研究儿童原发性高血压血清游离脂肪酸(free fatty acid,FFA)的水平,探讨其在儿童原发性高血压发病和防治中的临床意义。方法回顾性选取2021年1—6月首都儿科研究所附属儿童医院初治的34例原发性高血压儿童为高血压组,以同期体检的血压正常儿童32例为对照组。比较2组的空腹血清FFA、空腹血清三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)和非高密度脂蛋白胆固醇(non-high-density lipoprotein cholesterol,non-HDL-C)水平。采用多因素logistic回归分析探讨血清FFA对原发性高血压发病的影响。结果高血压组体重指数(body mass index,BMI)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)高于对照组,差异有统计学意义(P<0.05)。高血压组血清FFA、TG、LDL-C、non-HDL-C高于对照组,而血清HDL-C低于对照组,差异均有统计学意义(P<0.05)。高血压组血清FFA升高(女性>0.45 mmol/L,男性>0.60 mmol/L)率和传统血脂异常(血清TG、TC、LDL-C、HDL-C、non-HDL-C中至少一项异常)率均高于对照组,差异有统计学意义(P<0.05)。纳入年龄、性别、BMI、血清FFA升高、传统血脂异常等指标构建多因素logistic回归方程,结果显示血清FFA升高是儿童原发性高血压的独立危险因素(OR=17.560,95%CI:1.964~157.003,P<0.05)。结论原发性高血压儿童血清FFA明显升高;血清FFA升高可增加儿童原发性高血压的发病风险。     

Associations of non-high-density lipoprotein cholesterol with metabolic syndrome and its components in Korean children and adolescents: the Korea National Health and Nutrition Examination Surveys 2008–2014

Background

In this study, we aimed to investigate the relationship between single-gender Korean references for non-high-density lipoprotein cholesterol (non-HDL-C) and metabolic syndrome (MetS) in childhood.

Methods

A total of 5742 Korean children aged 10–18 years who participated in a national survey were included. The subjects were classified into three groups based on single-gender non-HDL-C levels as follows: <?120 mg/dL (desirable), ≥?120 and <?150 mg/dL (borderline high), and ≥?150 mg/dL (high).

Results

Males in the borderline high non-HDL-C group had odds ratios (ORs) of 2.86 (95% confidence interval, 2.30–3.56) for elevated triglycerides (TG), 1.73 (1.08–1.79) for reduced high-density lipoprotein cholesterol (HDL-C) and 1.73 (1.08–2.78) for MetS compared with males in the desirable non-HDL-C group after adjusting for covariates. Males in the high non-HDL-C group had ORs of 1.65 (1.14–2.41) for elevated blood pressure (BP), 6.21 (4.27–9.05) for elevated TG, and 3.29 (1.49–7.26) for MetS compared with males in the desirable non-HDL-C group. Females in the borderline high non-HDL-C group had ORs of 3.03 (2.43–3.76) for elevated TG, 1.63 (1.13–2.35) for reduced HDL-C, and 4.53 (2.47–8.31) for MetS compared with females in the desirable non-HDL-C group. Females in the high non-HDL-C group had ORs of 1.43 (1.00–2.04) for elevated BP, 6.36 (4.45–9.08) for elevated TG, and 7.64 (3.65–15.96) for MetS compared with females in the desirable non-HDL-C group.

Conclusion

Our results suggest that, in a Korean population, a non-HDL-C level of 120 mg/dL for males and 150 mg/dL for females is the threshold between borderline high and high risk for MetS.

     

Oxidized LDL metabolites with high family risk for premature cardiovascular disease

Objective: Considering the importance of primary prevention of Cardiovascular Disease (CVD) from childhood, especially in children with high family risk for premature atherosclerosis, and also the importance of oxidized LDL in the process of atherosclerosis, the main metabolites of ox-LDL i.e. Malondialdehyde (MDA) and Conjugated diene (CDE) have been measured in children of high risk families and compared with a control group.Methods: Children and adolescents (6–18 years) of parents with premature myocardial infarction (Ml ≤ 55y in men and ≤ 65y in women), were selected as the case group. The control group included neighbors of the case group matched for age and socioeconomic status. All samples have been selected by simple random sampling. Both the case and control groups were divided in two subgroups : those with a total cholesterol and/or LDL-C ≥95th centile and those with normal lipid levels. Each subgroup consisted of 32 subjects, so 128 subjects were studied (64 in the case and 64 in the control group). MDA and CDE were measured by spectrophotometry using molar absorbivity. Data were analyzed by SPSS_v10/Win software using ANOVA, Bon-ferroni, Scheffe-Duncan, Tukey-HSD, and the Student’s t-test.Result: The mean MDA value in the case and control groups was significantly different (1.84 ± 0.43 vs. 1.67 ± 0.41 Μmol/L, p=0.03), but this difference was not significant regarding the mean CDE level (0.50 ± 0.05 vs. 0.47 ± 0.04 Μmol/ L, p>0.05). The mean MDA level in the case group with hyperlipidemia was significantly higher than that in the case group without hyperlipidemia (1.985 ± 0.516 vs. 1.690 ± 0.366, Μmol/L, P=0.02) and also higher than control group with or without hyperiipidemia (1.985 ± 0.516 vs. 1.720 ± 0.389,1.615 ± 0.429 Μmol/L respectivety, P<0.05). The mean CDE level in the case group with hyperiipidemia was significantly higher than the case group without hyperlipidemia (0.542 ± 0.034 vs. 0.494 ± 0.049 Μmol/L, P=0.04) and higher than the control group with or without hyperiipidemia (0.542 ± 0.034 vs. 0.464 ± 0.051, 0.484 ±0.048 Μmol/L respectively, p<0.05). In case boys with hyperiipidemia, the mean MDA (2.03 ± 0.2 Μmol/L) and the mean of CDE (0.56 ± 0.04 Μmol/L) was significantly higher than other subgroups (P<0.05).Conclusion: Considering the increased susceptibility of LDL to oxidation in children with high family risk for premature CVD, special attention should be paid to consumption of foods and seasoning containing antioxidants from childhood especially in high risk families.     

Effects of Intracerebroventricular Injection of Recombinant Leptin on Food Intake, Body Weight and Blood Lipids in Diet-induced Obese Rats

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Association of Mediterranean diet adherence during pregnancy with maternal and neonatal lipid,glycemic and inflammatory markers: The GESTAFIT project

To examine the association of Mediterranean diet (MD) adherence during pregnancy with maternal and neonatal lipid, glycemic, and inflammatory markers. This study included 152 women from the GESTAFIT trial and a subsample of 35 newborns. The Mediterranean Diet Score, derived from food frequency questionnaires, was employed to assess MD adherence. Total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides, and glucose were assessed in the mother (at the 16th and 34th gestational weeks [g.w.]) and in cord arterial and venous serum with standard procedures using an autoanalyzer. Pro-inflammatory and anti-inflammatory cytokines (interleukin [IL]−6, IL-8, IL-10, IL-1beta, interferon gamma, and tumour necrosis factor alpha [TNF-α]) were measured with Luminex xMAP technology. A greater MD adherence was associated with higher HDL-C and lower LDL-C, LDL-C/HDL-C ratio, triglycerides, triglycerides/HDL-C ratio, and TNF-α in the mother at the 16th and the 34th g.w. (|β|: 0.191–0.388, p < 0.05). A higher intake of whole grain cereals, fruits, vegetables and fish and a lower intake of sweets were associated with higher HDL-C and lower LDL-C, LDL-C/HDL-C ratio, triglycerides, triglycerides/HDL-C ratio, and TNF-α at the 16th and 34th g.w. (|β|: 0.188–0.334, p < 0.05). No associations were found with the cord arterial and venous serum markers (p > 0.05). A greater MD adherence during pregnancy, driven by a higher intake of whole grain cereals, fruits, vegetables and fish, and a lower intake of sweets, was positively associated with the maternal lipid and inflammatory serum markers throughout gestation. MD adherence during pregnancy was not associated with cord serum markers.     

Increase of serum lipoprotein (a) levels during growth hormone therapy in normal short children

We studied the effect of growth hormone (GH) therapy on serum lipoprotein levels and the atherogenic index in short children without GH deficiency. Fasting blood samples were collected from ten (eight males) normal, short, prepubertal children, aged 6–12 years, before, during a 1-year course of GH therapy (0.1 IU/Kg/day), and 3 months after the cessation of GH administration. An increase in serum lipoprotein(a) [Lp(a)] levels of (mean% ± SEM) 43 ± 14, 58 ± 18, 61 ± 17 above the baseline levels was noted at 3 months (P<0.05), 6 months (P<0.01), and 1-year (P<0.01) respectively after the beginning of GH administration. (ANOVA, P<0.01). An inverse relationship between baseline serum Lp(a) concentrations and the percentage increment in Lp(a) after 9 months of GH therapy (r=−0.65,P<0.05) was observed. GH therapy over a period of 1 year had no effect on plasma cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein cholesterol [HDL-C] concentrations and the atherogenic index. Three months after the cessation of GH therapy, serum Lp(a) levels were not significantly different from the pre-treatment values. Conclusions Serum Lp(a) concentrations remained above pretreatment values during a 1-year period of GH treatment in short children without GH deficiency and declined shortly after cessation of therapy. Since GH therapy for short children without GH deficiency usually continues for several years, we suggest that serum Lp(a) levels should be determined and followed regularly in such children under prolonged GH therapy. Received: 11 February 1997 and in revised form: 10 June 1997 / Accepted: 6 July 1997     

Cord Blood Lipid Profile in a Population of Iranian Term Newborns

Premature coronary artery disease (CAD) and its risk factors are highly prevalent in Iran. It is well documented that atherosclerosis starts in childhood and there is evidence that this association with adult levels may originate at birth, so assessment of serum lipid levels in neonates might be of importance. In this study we aimed to measure serum lipoprotein and apolipoprotein levels in a representative sample of Iranian newborns. Cord blood lipid profile, apolipoprotein A, apolipoprotein B, and lipoprotein a (LPa) were analyzed in 378 full-term, Iranian newborns. The mean values of total cholesterol (TC), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A, apolipoprotein B, and Lpa in girls were 81.4 ± 28.3, 35.9 ± 22.4, 31.1 ± 9.9, 87.9 ± 20.2, 34.2 ± 18.2, and 21.0 ± 2.8 mg/dL, respectively; these values in boys were 75.2 ± 21.1, 32.1 ± 16.3, 28.8 ± 8.7, 84.3 ± 16.0, 32.6 ± 14.2, and 19.5 ± 2.7 mg/dL, respectively. Median values of triglycerides (TGs) in boys and girls were 61 and 62 mg/dL, respectively. Female neonates had significantly higher concentrations of TC and HDL-C than males (81.4 ± 28.3 vs. 75.2 ± 21.1, p = 0.02, and 31.18 ± 9.97 vs. 28.8 ± 8.7, p = 0.02, respectively). Other biochemical factors were not significantly different between genders. The mean and median concentrations of LPa were 20.3 and 18.7 mg/dL, respectively, which are almost five times higher than those reported in some other studies. The TG concentration was 1.5–2 times higher than those previously reported. Our findings indicate that serum concentrations of LPa and TG in Iranian neonates are higher than those in previous studies; this disorder, which is likely placing Iranians at increased risk for future CADs, needs to be assessed in longitudinal studies.     

载脂蛋白E基因多态性与原发性肾病综合征脂质代谢紊乱的关系

目的研究原发性肾病综合征(PNS)患儿载脂蛋白E(apoE)主要等位基因和基因型的分布规律,探讨apoE基因多态性与PNS脂质代谢紊乱的关系。方法检测PNS患儿46例和正常小儿39例血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、apoA1、apoB和apoA1/B,同时用聚合酶链反应-单链构象多态性(PCR-SSCP)结合测序的方法确定apoE基因型,并根据平衡法计算出各等位基因频率。结果1.肾病组TC、TG、HDL-C、LDL-C、apoB、apoA1/B均明显高于对照组(P均<0.01);2.肾病组apoE2/2频率显著高于对照组(χ2=4.50 P<0.05);3.肾病组不同基因型和等位基因各项血脂指标均未见明显差异。结论PNS患儿存在明显脂质代谢紊乱,apoE2/2频率显著增高,apoE基因多态性对PNS患儿血脂水平未见明显影响。     

Relationships between OPG,RANKL, bone metabolism,and bone mineral density in biliary atresia

Purpose  Osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL) have been implicated in osteoclastogenesis. However, the relationship between the OPG–RANKL system and bone status in biliary atresia (BA) has not, as yet, been clarified. Thus, the aim of this study has been to evaluate the relationship between the OPG–RANKL system and bone mineral metabolism in patients with BA. Methods  Fifty patients with BA and 13 healthy controls were investigated. The mean age of BA patients and controls was 7.3 ± 0.6 and 8.0 ± 1.1 years, respectively. Serum levels of OPG, RANKL, osteocalcin, and C-terminal telopeptide of type I collagen (CTX) were measured by sandwich enzyme-linked immunosorbent assay. Bone mineral density (BMD) of the lumbar spine was determined by dual energy X-ray absorptiometry. Results  Biliary atresia patients had significantly elevated serum OPG levels compared with controls (4.0 ± 0.3 vs. 3.0 ± 0.3 pmol/L, P = 0.02) and serum OPG levels in BA patients with jaundice were higher than in those without jaundice (4.6 ± 0.4 vs. 3.6 ± 0.4 pmol/L, P = 0.04). Likewise, serum RANKL levels were significantly higher in BA patients than in controls (2.9 ± 0.2 vs. 1.2 ± 0.7 pmol/L, P = 0.001). In addition, serum RANKL levels were increased in BA patients with jaundice compared to those without jaundice, but this difference was not statistically significant (3.2 ± 0.3 vs. 2.7 ± 0.2 pmol/L, P = 0.2). The serum osteocalcin levels in BA patients were not significantly different from those in the healthy controls, whereas the serum CTX levels were elevated in BA patients compared with the controls (0.4 ± 0.1 vs. 0.2 ± 0.1 ng/mL, P = 0.02). Furthermore, BMD of BA children with jaundice was significantly lower than that of BA children without jaundice (P = 0.0005). BMD of BA patients was inversely correlated with serum levels of OPG (r = −0.452, P < 0.001). Conclusion  Elevated serum OPG levels are associated with reduced BMD and the outcome of BA. The increase of serum OPG in BA patients with severe disease could reflect a compensatory response to bone loss. Presented at the 30th American Society for Bone and Mineral Research (ASBMR) annual meeting, Montreal, Quebec, Canada, 12–16 September 2008.     

An eight-week trial investigating the efficacy and tolerability of atorvastatin for children and adolescents with heterozygous familial hypercholesterolemia

This study aimed to assess the efficacy and tolerability of atorvastatin in Tanner stage (TS) 1 patients ages 6 to 10?years and TS ??2 patients ages 10 to <18?years with genetically confirmed heterozygous familial hypercholesterolemia (HeFH) and a low density lipoprotein cholesterol (LDL-C) level of 4?mmol/l (155?mg/dl) or higher. In this open-label, 8-week study, 15 TS 1 children were treated initially with atorvastatin 5?mg/day and 24 TS ??2 children with 10?mg/day. Doses were doubled at week 4 if the LDL-C target (<3.35?mmol/l [130?mg/dl]) was not achieved. The efficacy variables were the percentage change from baseline in LDL-C, total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), and apolipoprotein (Apo) A-I and Apo B. Safety evaluations included clinical monitoring, subject-reported adverse events (AEs), vital signs, and clinical laboratory tests. The mean values for LDL-C, TC, VLDL-C, and Apo B decreased by week 2 among all TS 1 and TS ??2 patients, whereas TG, HDL-C, and Apo A-I varied considerably from week to week. After 8?weeks, the mean reduction in LDL-C was ?40.7%?±?8.4 for the TS 1 children and ?39.7%?±?10.3 for the TS ??2 children. For the TS 1 patients, the mean reductions were ?34.1%?±?6.9 for TC and ?6.0%?±?32.1 for TG. The corresponding changes for the TS ??2 patients were ?35.6%?±?9.5 for TC and ?21.1%?±?29.7 for TG. Four patients experienced mild to moderate treatment-related AEs. No serious AEs or discontinuations were reported. Overall, no difference in safety or tolerability was observed between the younger and older cohorts. Across the range of exposures after atorvastatin 5 to 10?mg (TS 1) or atorvastatin 10 to 20?mg (TS ??2) doses for 8?weeks, clinically meaningful reductions in LDL-C, TC, VLDL-C, and Apo were observed with atorvastatin in pediatric patients who had HeFH. Atorvastatin also was well tolerated in this population.     

Serum Fructosamine and Lipid Profile in Children with Malignant Diseases

Serum levels of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and fructosamine (FA) were determined in thirty–three children with malignant diseases and twenty healthy controls aged 1–14 years. Of them, FA was the parameter measured in children with malignancy for the first time. Mean serum TC, HDL-C, LDL-C and FA showed statistically significant decreases in malignancy compared to healthy children, whereas a statistically significant increase was observed for TG concentrations in serum. From these data, we conclude that significant relations between serum lipids and lipoproteins and the state of malignancy exist in the children studied, and it should be remembered that serum FA concentrations are affected by abnormal serum protein turnover when one deals with any type of neoplastic disease.     

Effect of maternal lipid profile,C-peptide,insulin, and HBA1c levels during late pregnancy on large-for-gestational age newborns

Background

Large-for-gestational age (LGA) newborns can increase the risk of metabolic syndrome. Previous studies have shown that the levels of maternal blood lipids, connecting peptide (C-peptide), insulin and glycosylated hemoglobin (HbA_1c) were significantly different between LGA and appropriate-for-gestational age (AGA) newborns. This study aimed to determine the effect of the levels of maternal lipids, C-peptide, insulin, and HbA_1c during late pregnancy on LGA newborns.

Methods

This study comprised 2790 non-diabetic women in late pregnancy. Among their newborns, 2236 (80.1%) newborns were AGA, and 554 (19.9%) newborns were LGA. Maternal and neonatal characteristics were obtained from questionnaires and their case records. The levels of maternal fasting serum apolipoprotein A1 (ApoA1), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), C-peptide, insulin and blood HbA_1c were measured. The chi-square and Mann-Whitney U test were used to analyze categorical variables and continuous variables between the AGA and LGA groups, respectively. Binary logistic regression analysis was made to determine the independent risk factors for LGA newborns.

Results

Maternal TG, C-peptide, insulin and HbA_1c levels were significantly higher in the LGA group than in the AGA group (P<0.05). The LGA group had significantly lower levels of maternal TC, HDL-C and LDL-C than the AGA group (P<0.05). After adjustment for confounding variables, including maternal age, pre-pregnancy body mass index, education, smoking, annual household income, amniotic fluid volume, gestational hypertension, newborn gender and gestational age at blood collection, high maternal TG levels remained significantly associated with LGA newborns (P<0.05).

Conclusion

High maternal TG level during late pregnancy is significantly associated with LGA newborns.