Serum Levels of Glycated Albumin in Non-Diabetic and Insulin-Dependent Diabetic Children

The serum levels of glycated albumin (GA) in 83 non-diabetic children and 26 children with insulin-dependent diabetes mellitus (IDDM) were measured by high-performance liquid chromatography (HPLC). In non-diabetic children over one year, the GA levels were found to be uninfluenced by age, while the fructosamine (FRA) levels increased with age. The mean level of GA in IDDM children was 39.1±9.1%, which was significantly higher than in non-diabetic children with values of 16.1±.1% (p<0.01). The GA levels of non-diabetic and IDDM children did not overlap, whereas their FRA levels did overlap. The GA levels correlated with HbAlc levels (r=0.74, p<0.01) and FRA levels (r=0.66, p<0.01) in IDDN children. The GA levels were more closely correlated than the FRA levels with the blood glucose two and three weeks previously. Thus, the GA level is a useful indicator of shortterm control in diabetes mellitus.     

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.     

Association of Serum Soluble Triggering Receptor Expressed on Myeloid Cells Levels in Malignant Febrile Neutropenic Patients with Bacteremia and Fungemia

Objective

Infections are the major cause of morbidity and mortality in febrile neutropenic patients with malignancy. Rapid diagnostic tests are needed for prompt diagnosis and early treatment which is crucial for optimal management. We assessed the utility of soluble triggering receptor expressed on myeloid cells (sTREM-1) in the diagnosis of bacteremia and fungemia in febrile neutropenic patients.

Methods

Sixty-five febrile neutropenic children with malignancy hospitalized in Mofid Children''s Hospital during a period of one year from January 2007 were recruited for this cross sectional study (mean age 66.2± 37 months; 35 females and 30 males). Thirty patients (46.2%) had acute lymphoblastic leukemia, 2 (3.1%) acute myeloid leukemia, one (1.5%) lymphoma and 32 (49.2%) were under treatment for solid tumors. Simultaneous blood samples were collected for measurement of serum sTREM-1 levels and for blood cultures which were grown in BACTEC media. Gold standard for the presence of infection was a positive BACTEC culture as a more sensitive method compared to current blood culture techniques.

Findings

Blood cultures with BACTEC system were positive in 13(20%) patients (12 bacterial and one fungal culture). The mean serum sTREM-1 level in BACTEC positive patients was 948.2±592.9 pg/ml but in BACTEC negative cases it was 76.3±118.8 pg/ml (P<0.001). The optimal cut-off point of sTREM-1 for detecting patients with positive result of BACTEC was 525 pg/ml with sensitivity and specificity of 84.6% and 100%, respectively.

Conclusion

Our study revealed a significant association between serum sTREM-1 level and bacteremia and fungemia in febrile neutropenic patients suffering malignancy with acceptable sensitivity and specificity.     

Evaluation of Serum Lipid Levels in Children

This study aimed to establish reference values for serum levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in children. The study included samples from 4,102 healthy children (2,003 boys and 2,099 girls) ages 1–18 years. The serum levels of total cholesterol, triglycerides, and HDL-C were determined using the Advia 2400 autoanalyzer. The LDL-C levels were calculated using the Friedewald equation. The mean, standard deviation, and 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentile values of the biochemical parameters for boys and girls were detected. The total cholesterol and HDL-C levels were higher among the girls than among the boys in 15- to 18-year-old group. No significant difference was found for the other serum lipid levels among any of the age groups. This study provided pediatric reference intervals for the lipid parameters for children.     

亚临床甲状腺功能减退症患儿血脂水平变化的意义

目的探讨亚临床甲状腺功能减退症患儿血脂水平变化的意义。方法选取30例亚临床甲状腺功能减退症(亚临床甲减)患儿(亚临床甲减组)及30例体检健康儿童(健康对照组)。应用罗氏全自动生化分析仪P800和罗氏化学发光免疫分析仪E170分别检测其总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、脂蛋白a[LP(a)]和促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)水平。结果亚临床甲减组儿童血清TC[(4.14±0.88)mmol.L-1]、TG[(1.88±0.42)mmol.L-1]及LP(a)[(209.9±122.92)mg.L-1]水平显著高于健康对照组(Pa<0.01)。亚临床甲减组FT3、FT4与健康对照组比较差异无统计学意义;TSH水平与健康对照组比较差异有统计学意义。结论亚临床甲减可引起儿童血脂代谢异常。     

北京地区肥胖儿童青少年血脂状况调查

目的 通过大样本流行病学调查,了解北京地区肥胖儿童青少年血脂状况,为早期预防心血管疾病的发生提供科学依据.方法 对北京市4个市区包括东城、西城、海淀、朝阳,3个郊区包括大兴、平谷、延庆共7个城郊区县的6～19岁儿童青少年进行横断面的流行病学调查,共19 450例.男9 727例,女9 723例;年龄(12.59±3.25)岁.城区儿童青少年10 292例,郊区儿童青少年9 158例.测量所有对象的体质量、身高,计算体质量指数(BMI),参照<中国学生超重、肥胖BMI筛查标准>,根据BMI将被调查人群分为肥胖组(n=2 220)、超重组(n=1 690)和正常组(n=15 540),应用Accutrend GCT诊断仪检测各组周围血总胆固醇(TC)和三酰甘油(TG).应用SPSS 13.0软件进行统计学分析.结果 肥胖组TC、TG水平均显著高于超重组及正常组(Pa<0.01).在正常组中,女生TC、TG显著高于男生,城区人群TC水平显著高于郊区,而郊区人群TG水平显著高于城区(Pa<0.01).在超重组中,男生和女生TC水平无显著性差异,TG水平女生显著高于男生(P<0.01),城区人群TC水平显著高于郊区(P<0.05),而城区、郊区人群TG水平无显著性差异.在肥胖组中,男生和女生TC水平及TG水平均无显著性差异,城区、郊区人群间比较TC、TG水平均无显著性差异.结论 肥胖儿童青少年血TC、TG水平显著升高,血脂水平存在城郊区间及性别间的分布特征.     

肥胖儿童血脂、载脂蛋白与心血管疾病的关系

目的分析肥胖儿童血脂状况,了解其与心血管疾病的关系。方法收集首都医科大学附属北京儿童医院营养门诊就诊的4～16岁的肥胖儿童153例。男109例,女44例;年龄4～16岁。用电阻抗法测量和计算其体脂肪率、体脂肪量、除脂肪量。用软皮尺测量其腰围和臀围,公式计算腰臀比值。用皮褶计测量其肩胛骨下、肱三头肌皮褶厚度,公式计算其肩胛骨下肱三头肌皮褶厚度比值。同时进行其血清胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白AⅠ和载脂蛋白B(ApoB)水平检测。应用SPSS11.0软件进行统计学分析。结果与心血管疾病相关的指标:高TC发生率为3.3%,高水平LDL-C发生率为6.0%,高TG发生率为24.7%,低水平HDL-C发生率为31.3%。10岁以上肥胖儿童体质量比率、体脂肪率与HDL-C水平呈弱负相关(r=-0.202,-0.211)。结论肥胖儿童血脂和载脂蛋白水平可评估心血管疾病危险因素。     

小儿常见风湿性疾病细胞因子变化及干预

目的通过检测白细胞介素(IL)-1β、IL-12、转化生长因子-β1(TGF-β1)在几种小儿常见风湿性疾病治疗前后的血清水平,了解这3种细胞因子与小儿常见风湿病病变的关系。方法对17例急性期川崎病患儿、14例活动期幼年类风湿关节炎患儿及17例急性风湿热患儿在药物治疗前和治疗2-4周及8～12周进行血清IL-1β、IL-12、TGF-β1水平检测,与20例正常小儿的细胞因子进行比较。结果此3种疾病患儿在药物治疗前,其血清IL-1β和IL-12水平皆显著高于对照组,使用药物治疗2-4周及8～12周,这2种细胞因子血清水平显著降低,同时血清TGF-β1水平显著上升和临床表现改善或消失。结论在发病初期,血清IL-1β和IL-12水平升高,对这3种常见小儿风湿性疾病起致炎作用;在疾病恢复期血清TGF-β1水平升高起抗炎作用。     

Concentration of Lipid Peroxide in Serum Lipoproteins of Insulin-Dependent Diabetic Children

Lipids, apolipoproteins and lipid peroxide were measured in the sera of 29 children with insulin-dependent diabetes mellitus. Ten non-diabetic children served as controls. High-density lipoprotein (HDL) was separated by heparin-MnCl₂ precipitation. Lipid peroxides in HDL and non-HDL fractions were estimated by fluorimetric measurement of thiobarbituric acid-reactive substances. The patients were normolipidemic, and their HDL-cholesterol was increased. Apo A₁ level in the patients was smilar to that in the controls, while levels of apo A₂ and apo B were decreased in the patients. Concentrations of lipid peroxides in the whole serum and non-HDL were unaltered, while that in the HDL was higher in the patients than in the controls. Hemoglobin A_Ic in the patients correlated with the triglyceride and urinary excretion rate of N-acetylglucosaminidase (NAG). The NAG correlated with the triglycerides. The triglycerides correlated with the atherogenic index, apo B and total cholesterol. The lipid peroxides in the non HDL correlated with the triglyceride, atherogenic index, and NAG. That in the HDL correlated with the HDL-cholesterol, apo A₁ and endogenous creatinine clearance, and inversely with the atherogenic index and apo B. Lipid peroxides in HDL and non-HDL appeared to play different physiological roles from each other, and they have provided evidence suggesting that diabetic microvascular injury is mediated by reactive oxygen species.     

Effect of Glucocorticoids on Serum Lipid Profile and Endothelial Function and Arterial Wall Mechanics

Objective

To determine the effect of glucocorticoids on lipid profile, endothelial function and arterial wall mechanics in children.

Methods

Thirty patients who had received glucocorticoids for 4 to 8 wk were compared with 30 age and sex matched healthy controls. Baseline evaluation included weight, height, body mass index (BMI), blood pressure (BP), lipid profile and Ultrasonographic evaluation of brachial artery for endothelial dependant as well as endothelial independent vasodilatation and evaluation of common carotid artery for intima media thickness (IMT) and arterial wall mechanics. All of these parameters were evaluated two more times- after 4 wk of steroid therapy and 2 wk after stopping the drug.

Results

Patients were found to have significant increase in BMI; systolic and diastolic BP; total and LDL cholesterol and carotid IMT and also a decrease in cross sectional compliance (CSC) after 4 wk of steroid therapy (oral prednisolone). However, all these parameters returned towards baseline, 2 wk after stopping the drug. No endothelial dysfunction was observed in these patients.

Conclusions

Four to eight wk of glucocorticoids use in children leads to reversible changes in BMI, systolic and diastolic BP, total and LDL cholesterol, carotid IMT and CSC.