[Mean Platelet Volume in Children with Acute Gastroenteritis Caused by Entamoeba histolytica]

OBJECTIVE

Mean platelet volume (MPV) is a marker of platelet activation, which is a determinant of inflammation. The first aim of the present study was to investigate the MPV levels in children with amebiasis and compare the MPV levels with healthy controls. The second aim of this study was to evaluate the relationship between MPV and other acute phase reactants.

METHODS

Seventy six patients with amebic gastroenteritis (mean age 2.64 ± 0.23 years) and 53 healthy controls (mean age 2.35 ± 0.28 years) were enrolled in the study. Entamoeba histolytica was determined in stool using rapid antigen test.

RESULTS

Complete blood count and C-reactive protein (CRP) levels were assessed for all children. MPV levels of patients with amebiasis were significantly higher than those of control children (8.79 ± 0.09 vs. 7.87 ± 0.09 fL, p = 0.000). Leukocyte and eosinophil counts, C-reactive protein and creatinine levels of the patients were higher than controls. Leukocyte count was positively correlated with MPV (r = 0.192, p < 0.05), platelet count (r = 0.278, p < 0.01), and CRP level (r = 0.205, p < 0.05).

CONCLUSION

In this MPV levels were significantly higher in children with amebiasis compared to controls. MPV can be used as an acute phase reactant in children with Entamoeba histolytica gastroenteritis.

Comparison of atherogenic risk factors among poorly controlled and well-controlled adolescent phenylketonuria patients

BACKGROUND

Previous studies investigating the known risk factors of atherosclerosis in phenylketonuria patients have shown conflicting results. The primary aim of our study was to investigate the serum atherogenic markers in adolescent classical phenylketonuria patients and compare these parameters with healthy peers. The secondary aim was to compare these atherogenic markers in well-controlled and poorly controlled patients.

METHODS

A total of 59 patients (median age: 12.6 years, range: 11-17 years) and 44 healthy controls (median age: 12.0 years, range: 11-15 years) were enrolled in our study. Phenylketonuria patients were divided into two groups: well-controlled (serum phenylalanine levels below 360 µmol/L; 24 patients) and poorly controlled patients (serum phenylalanine levels higher than 360 µmol/L).

RESULTS

The mean high-density lipoprotein cholesterol levels of well-controlled patients (1.0±0.2 mmol/L) were significantly lower compared with poorly controlled patients and controls (1.1±0.2 mmol/L, p=0.011 and 1.4±0.2 mmol/L, p<0.001, respectively). Poorly controlled patients had lower high-density lipoprotein cholesterol levels than healthy controls (p=0.003). Homocysteine levels of both well-controlled (9.8±6.4 µmol/L) and poorly controlled (9.2±5.6 µmol/L) patients were higher compared with controls (5.8±1.8 µmol/L, p<0.01). The mean platelet volume of well-controlled patients (9.5±1.1 fL) was higher than that of poorly controlled patients and controls (8.9±0.8 fL, p=0.024 and 7.7±0.6 fL, p<0.001, respectively).

CONCLUSION

Lower high-density lipoprotein cholesterol and higher homocysteine and mean platelet volume levels were detected in phenylketonuria patients. In particular, these changes were more prominent in well-controlled patients. We conclude that phenylketonuria patients might be at risk for atherosclerosis, and therefore screening for atherosclerotic risk factors should be included in the phenylketonuria therapy and follow-up in addition to other parameters.

Depression and anxiety among parents of phenylketonuria children

Objective:

To investigate the existence of depression and/or anxiety with underlying risk factors among parents of children with classical phenylketonuria (PKU).

Methods:

This cross-sectional study was conducted in the Division of Pediatric Metabolism, Ankara Children’s Hospital, Dokuz Eylul University, Kırıkkale University, and Erzurum Local Research Hospital, Turkey, between January and July 2014. Parents of 61 patients and 36 healthy controls completed the self-report questionnaires. We used Beck Depression Inventory (BDI) to assess the parental depression and State-Trait Anxiety Inventory S-T (STAI S-T) to assess parental anxiety.

Results:

Depression and anxiety scores were significantly higher in the case group (BDI 12.3±9.1; STAI-S: 38.2±9.6; STAI-T: 43.2±6.9) than controls (BDI: 5.4±4.1 p=0.000; STAI-S: 31.8±7.6 p=0.001; STAI-T: 37.0±7.2 p=0.000). Mothers of the patients had higher scores than the other parental groups (BDI: p=0.000, STAI-S: p=0.001 and STAI-T: p=0.000). Logistic regression analysis showed that low educational level of the parent was the only independent factor for depression (OR 9.96, 95% CI: 1.89-52.35, p=0.007) and state anxiety (OR: 6.99, 95% CI: 1.22-40.48, p=0.030) in the case group.

Conclusion:

A subset of parents with PKU patients have an anxiety or depressive disorder. Supportive services dealing with the parents of chronically ill children such as PKU are needed in order to reduce the level of anxiety.

Evaluation of the intraocular pressure in obese adolescents

AIM

The aim of this study was to evaluate the intraocular pressure (IOP) levels of children with normal and high Body Mass Index (BMI) and to find out the potential correlation between glaucoma and obesity.

METHODS

Thirty obese and thirty healty children were enrolled in this study. Physical examinations and anthropometric measurements of all patients and controls were performed. Obesity was defined as a BMI exceeding the 95th percentile for the patients according to age and sex. All participants were underwent a complete eye examination. The results of these measurements were considered for statistical analysis.

RESULTS

Mean age was 13.5±2.1 years in obese group and 13.3±2.0 years in control group. Mean BMIs were 28.1±3.9 kg/m2 and 19.7±1.2 kg/m2 in obese and control groups, respectively. No significant difference was found in mean IOP levels of both right and left eyes between two groups (P=0.837 and P=0.755, respectively). There was no significant difference in cup/disc ratios of each eyes and mean central corneal thickness of both right and left eyes between obese patients and controls. In visual field analysis, no statistically significant difference in mean false negativeness and mean false positiveness were found between two groups. There were not also any significant correlations in both mean deviation of each eyes (P=0.78 and P=0.94, respectively) and pattern standart deviation of right and left eyes (P=0.89 and P=0.90, respectively) between obese cases and controls.

CONCLUSION

In this study, there were no significant difference in IOP measurements, central corneal thicknesses, cup/disc ratios and visual field parameters between obese and normal children. No significant correlation was found between obesity and glaucoma or elevated IOP in children.

Fecal calprotectin: can be used to distinguish between bacterial and viral gastroenteritis in children?

OBJECTIVE

Fecal calprotectin is used as a good indicator of intestinal mucosal inflammation. The aim of this study is to evaluate the diagnostic value of fecal calprotectin (f-CP) for the etiology of acute gastroenteritis in children.

MATERIALS AND METHODS

All patients presenting with acute diarrhea (<18 years) who had 3 or more soft or watery stools per day were enrolled in this study. Stool microscopic examination and cultures for bacteria and parasites were performed. Polymerase chain reaction test was also applied to stool samples for viruses (Rotavirus, Adenovirus, Norwalk, and Astrovirus). The level of f-CP was carried out by using enzyme-linked immunosorbent assay test.

RESULTS

Eighty-four patients with diarrhea were enrolled. The f-CP level was higher in patients with microscopic examination positive (n=17) (median with interquartile range, 1610.0 [908.8-2100] mg/L) than in patients with microscopic examination negative (n=67) (123.8 [25.0-406.3] mg/L) (P<.001). Concentrations of f-CP in patients with stool culture positive (1870.0 [822.5-2100] mg/L) were significantly elevated compared with the concentrations of the patient with virus detected in stool (95.0 [21.3-240.9] mg/L) (P<.001). In the diagnosis for bacterial acute gastroenteritis, the area under the receiver operating characteristic curve for f-CP was 0.867 (95% confidence interval, 0.763-0.971), sensitivity was 88.9%, and specificity was 76.0% if the threshold was taken as 710 mg/L.

CONCLUSION

We conclude that f-CP, which is useful, valuable, noninvasive, easily and rapidly measured laboratory test along with simple microscopic examination of stool, can be used as an indicator of intestinal inflammation and to distinguish the bacterial gastroenteritis from the viral gastroenteritis.

Aminotransferase elevations in rotavirus positive and negative acute gastroenteritis and its relation with disease severity

BACKGROUND

The aim of this study was to investigate the frequency of elevated alanine (ALT) and aspartate aminotransferase (AST) levels in children with rotavirus positive and negative gastroenteritis as well as the average time to normalization of liver enzymes.

METHODS

Into the study 298 patients with rotavirus positive and 321 patients with rotavirus negative gastroenteritis were enrolled.

RESULTS

Mean AST (56.9±2.1 and 40.2±0.9 U/L, respectively, P=0.000) and ALT (33.1±1.7 and 22.4±0.8 U/L, respectively, P=0.000) levels were significantly higher in the rotavirus positive than rotavirus negative patients. Logistic regression analysis showed that rotavirus positivity was significant independent factor for both AST and ALT elevation. Severity of gastroenteritis was another significant independent factor for ALT elevation. The average transaminase normalization time for AST and ALT levels were similar both rotavirus positive and negative groups.

CONCLUSIONS

Rotavirus positivity and severity of gastroenteritis were independent risk factors for elevated ALT levels in children with gastroenteritis.

A novel mutation in the mitochondrial DNA cytochrome b gene (MTCYB) in a patient with Prader Willi syndrome

In recent years, it has been suggested that defects in energy metabolism may accompany Prader Willi syndrome. Mutations in the mitochondrial cytochrome b gene have been commonly associated isolated mitochondrial myopathy and exercise intolerance, rarely with multisystem disorders. The authors describe a novel mutation (mt. 15209T>C) in mitochondrial cytochrome b gene in a 2-year-old girl with Prader-Willi syndrome with a clinical history of lactic acidosis attacks, renal sodium loss, hepatopathy, progressive cerebral atrophy, and sudden death. The authors suggest that atypical clinical findings in patients with Prader-Willi syndrome should direct the physician to search for a mitochondrial disease.

Obesity, fatty liver disease and intestinal microbiota

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disorder that is increasing in prevalence with the worldwide epidemic of obesity. NAFLD is the hepatic manifestation of the metabolic syndrome. The term NAFLD describes a spectrum of liver pathology ranges from simple steatosis to steatosis with inflammation nonalcoholic steatohepatitis and even cirrhosis. Metabolic syndrome and NAFLD also predict hepatocellular carcinoma. Many genetic and environmental factors have been suggested to contribute to the development of obesity and NAFLD, but the exact mechanisms are not known. Intestinal ecosystem contains trillions of microorganisms including bacteria, Archaea, yeasts and viruses. Several studies support the relationship between the intestinal microbial changes and obesity and also its complications, including insulin resistance and NAFLD. Given that the gut and liver are connected by the portal venous system, it makes the liver more vulnerable to translocation of bacteria, bacterial products, endotoxins or secreted cytokines. Altered intestinal microbiota (dysbiosis) may stimulate hepatic fat deposition through several mechanisms: regulation of gut permeability, increasing low-grade inflammation, modulation of dietary choline metabolism, regulation of bile acid metabolism and producing endogenous ethanol. Regulation of intestinal microbial ecosystem by diet modifications or by using probiotics and prebiotics as a treatment for obesity and its complications might be the issue of further investigations.

Evaluation of serum xenin and ghrelin levels and their relationship with nonalcoholic fatty liver disease and insulin resistance in obese adolescents

AIM

Xenin is a peptide of the neurotensin/xenopsin/xenin family secreted from gastric cells and other tissues. The first aim of this study was to investigate the serum xenin and ghrelin levels in obese children and compare the patients with healthy controls. The second aim was to compare the xenin levels in patients with nonalcoholic fatty liver disease (NAFLD) and also with insulin resistance with the patients without these complications.

METHODS

62 obese adolescents (27 with NAFLD) and 32 healthy controls were enrolled in the study. Obesity was defined as a body mass index exceeding the 95th percentile for the patients' age and sex. NAFLD was diagnosed via ultrasonographic examination. The insulin resistance was calculated by a homeostasis model assessment (HOMA-IR) index. Serum xenin and ghrelin levels were assessed by enzyme-linked immunosorbent assay.

RESULTS

The mean serum xenin concentration was significantly higher in obese adolescents than the healthy peers (68.15 ± 0.63 vs 16.54 ± 0.07 pg/mL, p = 0.000). Serum xenin levels were not different between the patients with and without NAFLD and also between the patients with and without IR (p > 0.05). There was a positive correlation between xenin levels and relative weight (r = 0.663, p < 0.001) and HOMA-IR (r = 0.612, p < 0.001). Ghrelin was negatively correlated with relative weight (r = -0.283, p < 0.05).

CONCLUSION

In this study, serum xenin levels of both groups of obese patients were found higher than controls. On the other hand, xenin levels were not different in patients with and without NAFLD. High levels of xenin may be in relation with obesity.

Investigation of adropin and leptin levels in pediatric obesity-related nonalcoholic fatty liver disease

AIM

Nonalcoholic fatty liver disease (NAFLD) is the accumulation of excess fat in the liver in the absence of alcohol consumption, which is commonly associated with obesity and increased risk of atherosclerosis as well as insulin resistance. Adropin is a recently identified protein encoded by the gene related with energy homeostasis, which is expressed in the liver and the brain and has a role in preventing insulin resistance and obesity. The aim of this study was to investigate the serum adropin and leptin levels in obese adolescents and compare the patients with, and without, NAFLD and with healthy controls.

METHODS

Sixty-four obese adolescents (30 with NAFLD, 34 without NAFLD) and 36 healthy controls were enrolled in the study. Serum adropin and leptin levels were evaluated by sandwich enzyme-linked immunosorbent assay.

RESULTS

Serum adropin levels were significantly lower in obese children than healthy controls (3.2±1.0 and 9.2±1.2 ng/mL, respectively, p=0.001). Serum leptin levels were significantly higher in patients than in controls (12.4±1.1 and 4.1±3.1 pg/mL, respectively; p=0.000). Serum adropin levels of patients with NAFLD were significantly lower than in patients without NAFLD (2.9±0.5 and 3.5±1.2 ng/mL, respectively; p=0.023) and healthy controls (p=0.000). Logistic regression analysis showed that a decrease in adropin levels was the only independent factor for fatty liver disease in obese adolescents (odds ratio: 3.07, 95% confidence interval 1.14-8.2, p=0.026). Leptin, relative weight and HOMA-IR of the patients were not independent risk factors for NAFLD.

CONCLUSIONS

In this study, serum adropin levels were significantly lower in obese adolescents with fatty liver disease compared to patients without fatty liver disease and healthy controls. Lower adropin level was an independent risk factor for NAFLD in obese adolescents in logistic regression analysis. Assessment of serum adropin concentrations may provide a reliable indicator of fatty liver disease in obese adolescents.

Leptin-to-adiponectin ratio in obese adolescents with nonalcoholic fatty liver disease

The leptin-to-adiponectin (L/A) ratio has been used to show insulin resistance (IR) in recent years. The aim of this study was to investigate the L/A ratio in obese adolescents and compare this ratio in patients with and without nonalcoholic fatty liver disease (NAFLD) and also with healthy controls. The second aim was to search the possible correlations between the L/A ratio with the markers of IR and inflammation. A total of 47 obese (mean age: 13.1±2.1 years) and 19 healthy children (mean age: 13.8±0.3 years) were included in the study. The presence of fatty liver was identified by ultrasonography. Cases were divided into three groups as NAFLD (+) and NAFLD (-) obese patients and controls. Liver biochemistries, insulin and serum lipids, C-reactive protein, tumor necrosis factor-alpha (TNF-alpha), interleukin-6, adiponectin, and leptin were determined. The L/A ratio was calculated. IR was estimated according to the homeostasis model assessment of insulin resistance (HOMA-IR). The L/A ratio was significantly higher in NAFLD (+) patients than in the other two groups, and in NAFLD (-) patients than the healthy peers. Moreover, L/A ratio correlated more strongly with weight for height (r: 0.528, p<0.0001), alanine aminotransferase (ALT) (r: 0.499, p<0.0001), triglyceride (r: 0.591, p<0.0001), and HOMA-IR (r: 0.574, p<0.0001) than did either leptin and adiponectin alone. This study shows that the L/A ratio is a noninvasive predictor of NAFLD in obese children and correlates with weight for height, ALT, triglyceride, and HOMA-IR better than each single adipokine.

Assessment of atherosclerosis in obese adolescents: positive correlation of mean platelet volume and carotid intima media thickness

AIMS

This study aims to assess the correlation of mean platelet volume (MPV) and common carotid artery (CCA) thickness in a population of obese adolescents.

METHODS

Sixty-eight patients and 23 controls were enrolled. Anthropometric measurements, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, hemoglobin, white blood cell count, platelet count, MPV and insulin resistance by homeostasis model of assessment of insulin resistance were investigated. Furthermore, CCA thickness was measured by high-resolution ultrasound.

RESULTS

MPV and the left CCA thickness were significantly higher in obese adolescents than the healthy controls. The association between MPV and left CCA was checked by linear regression analysis. MPV explained 19% of the variation in left CCA (P < 0.001). At multiple regression analysis, MPV maintained a positive association with the left CCA thickness (P = 0.002) independently of fatty liver grade, relative weight, total cholesterol and homeostasis model of assessment of insulin resistance.

CONCLUSION

MPV is significantly correlated with CCA thickness in obese adolescents.

Evaluation of neutrophil gelatinase-associated lipocalin in pediatric patients with acute rotavirus gastroenteritis and dehydration

Background

Dehydration caused by acute rotavirus gastroenteritis is a frequent finding in pediatric patients. The most important treatment modality in these patients is recognising and treating dehydration, electrolyte imbalance and acute kidney injury. Neutrophil gelatinase-asssociated lipocalin (NGAL) is used widely as a biomarker for the diagnosis of acute or chronic renal injury in numerous clinical studies. It is recognized as an early marker of acute renal failure before the elevation of routine biochemical tests such as creatinine. The aim of this study is to investigate the plasma and urine NGAL concentrations in mildly or moderately dehydrated patients with acute rotavirus gastroenteritis.

Material and methods

A total of 30 patients (13 girls, mean age 62.5 ± 46.2 months) with diarrhea and mild/moderate dehydration and 35 healthy controls (17 girls, mean age 81.1 ± 41.8 months) were enrolled in the study. Plasma and urine NGAL levels of the two groups were compared.

Results

The mean age, gender and serum creatinine levels of the patients and healthy controls were similar. The mean plasma and urine NGAL levels of the patients were significantly higher than controls (plasma: 118.6 ± 81.2 vs. 66.5 ± 11.3, p = 0.001 and urine: 17.7 ± 17.5 vs. 10.6 ± 7.9, p = 0.035, respectively).

Conclusion

Mildly or moderately dehydrated children have higher plasma and urine NGAL levels compared to control subjects. Plasma and/or urine NGAL levels can be used for the early prediction of renal impairment in children with mild or moderate dehydration.

Resveratrol reduces matrix metalloproteinase-2 activity induced by oxygen-glucose deprivation and reoxygenation in human cerebral microvascular endothelial cells

The main pathophysiology in cerebral ischemia is the structural alteration in the neurovascular unit, coinciding with neurovascular matrix degradation. Among the human matrix metalloproteinases (MMPs), MMP-2 and -9, known as gelatinases, are the key enzymes for degrading type IV collagen, which is the major component of the basal membrane that surrounds the cerebral blood vessel. In the present study, we investigated the effects of resveratrol on cytotoxicity, reactive oxygen species (ROS), and gelatinases (MMP-2 and -9) in human cerebral microvascular endothelial cells exposed to 6 hours of oxygen-glucose deprivation and a subsequent 24 hours of reoxygenation with glucose (OGD/R), to mimic ischemia/reperfusion in vivo. Lactate dehydrogenase increased significantly, in comparison to that in the normoxia group. ROS was markedly increased in the OGD/R group, compared to normoxia. Correspondingly, ROS was significantly reduced with 50 μM of resveratrol. The proMMP-2 activity in the OGD/R group showed a statistically significant increase from the control cells. Resveratrol preconditioning decreased significantly the proMMP-2 in the cells exposed to OGD/R in comparison to that in the OGD/R group. Our results indicate that resveratrol regulates MMP-2 activity induced by OGD/R via its antioxidant effect, implying a possible mechanism related to the neuroprotective effect of resveratrol.

Chanarin-dorfman syndrome with multi-system involvement in two siblings

Chanarin-Dorfman syndrome (CDS) is a very rare autosomal recessive inherited neutral lipid metabolism disorder associated with congenital ichthyosis and multi-system involvement. Observation of lipid vacuoles in neutrophils (Jordan’s anomaly) in peripheral blood smears in patients with ichthyosiform erythroderma is diagnostic. Herein we present 2 siblings with CDS that were referred to Dokuz Eylul University School of Medicine Department of Pediatrics due to ichthyosis. They had hepatomegaly, cataract, growth retardation, and sensorineural hearing loss. Some lipid vacuoles in neutrophils were noted in peripheral blood smear evaluation. Genetic analysis showed homozygous N209X mutation in both patients. They were put on a low-fat high-carbohydrate diet supplemented with medium-chain fatty acids. During 6 months of follow-up, no improvement was observed in both patients. In conclusion, although CDS is a rare lipid storage disease, it should always be a consideration in patients with congenital ichthyosis, especially those with extracutaneous symptoms or signs. The diagnosis of CDS is made based on a very simple test-peripheral blood smear.

Conflict of interest:None declared.

Identification of seven novel SMPD1 mutations causing Niemann-Pick disease types A and B

Niemann-Pick disease (NPD) types A and B are autosomal, recessively inherited, lysosomal storage disorders caused by deficient activity of acid sphingomyelinase (E.C. 3.1.4.12) because of mutations in the sphingomyelin phosphodiesterase-1 (SMPD1) gene. Here, we present the molecular analysis and clinical characteristics of 15 NPD type A and B patients. Sequencing the SMDP1 gene revealed eight previously described mutations and seven novel mutations including four missense [c.682T>C (p.Cys228Arg), c.1159T>C (p.Cys387Arg), c.1474G>A (p.Gly492Ser), and c.1795C>T (p.Leu599Phe)], one frameshift [c.169delG (p.Ala57Leufs*20)] and two splicing (c.316+1G>T and c.1341delG). The most frequent mutations were p.Arg610del (21%) and p.Gly247Ser (12%). Two patients homozygous for p.Arg610del and initially classified as phenotype B showed different clinical manifestations. Patients homozygous for p.Leu599Phe had phenotype B, and those homozygous for c.1341delG or c.316+1G>T presented phenotype A. The present results provide new insight into genotype/phenotype correlations in NPD and emphasize the difficulty of classifying patients into types A and B, supporting the idea of a continuum between these two classic phenotypes.

Evaluation of serum neopterin levels and its relationship with adipokines in pediatric obesity-related nonalcoholic fatty liver disease and healthy adolescents

AIM

Nonalcoholic fatty liver disease (NAFLD) is associated with inflammation and increased risk of atherosclerosis. Neopterin is regarded as a biochemical marker of cell-mediated immunity, which is secreted by monocytes and macrophages, mainly in response to interferon-gamma. The aim of the present study was to investigate the serum neopterin levels in obese adolescents and compare the neopterin levels in patients with and without NAFLD and also with healthy controls. The second aim of the study was to research the possible relationship between neopterin levels and adipokines (leptin, adiponectin, resistin, and ghrelin).

METHODS

Ninety-three obese adolescents (39 with NAFLD, 54 without NAFLD) and 55 healthy controls were enrolled in the study. Serum levels of neopterin and adipokines were measured with high-performance liquid chromatography and sandwich enzyme-linked immunosorbent assay, respectively.

RESULTS

Serum neopterin levels were significantly higher in patients with NAFLD (3.20 ± 0.09 nmol/L) than in their healthy peers (2.91 ± 0.08 nmol/L) (p=0.020). Neopterin levels were positively correlated with leptin levels in obese patients (r=0.380, p<0.001) and in the group comprising all individuals (r=0.206, p<0.05). There was no correlation between neopterin concentrations and relative weight, alanin aminotransferase, adiponectin, resistin, and ghrelin levels.

CONCLUSION

The serum neopterin levels were significantly higher in obese adolescents with fatty liver disease compared to controls, and this may be related to increased cell-mediated immunity in fatty liver disease.

The protective effects of resveratrol on human coronary artery endothelial cell damage induced by hydrogen peroxide in vitro

Oxidative stress is defined as imbalance between the production and destruction of reactive oxygen species. The aim of this study was to investigate whether resveratrol could protect human endothelial cells against hydrogen peroxide damage in vitro. In this in vitro study on human coronary endothelial cells, the effects of resveratrol on the glutathione content in human coronary endothelial cells in vitro were evaluated with high performance liquid chromatography. The effects of resveratrol on protein expression of the glutamate cysteine ligase, glutathione peroxidase and glutathione reductase enzymes were evaluated with the Western blot method. Resveratrol increased the reduced glutathione contents significantly (p < 0.05). Resveratrol increased protein expression of the glutamate cysteine ligase, glutathione peroxidase-1 and glutathione reductase enzymes (p < 0.05). All data supported each other and suggested that resveratrol had a protective effect against human coronary artery endothelial cell damage. It is thought that these results could pave the way to the new therapeutic approaches to protect against oxidative stress that develops in cardiovascular diseases.

Hormones and cytokines in childhood obesity

OBJECTIVE

Obesity is a growing worldwide health problem affecting both adults and children. Effective prevention and treatment modalities can be achieved by understanding the pathogenesis of obesity better. This review addresses some of the issues related to the hormones and cytokines taking part in the pathogenesis of obesity, energy balance and inflammation.

DESIGN

We reviewed current literature on this broad subject especially concentrating on the functions of the hormones and cytokines taking part in the pathogenesis of the childhood obesity. Using the key words obesity, children, hormones, cytokines publications and cross references were evaluated from PubMed database between 1957 and 2009.

RESULTS

In children, leptin and ghrelin are two hormones which have major influence on energy balance. Leptin is responsible from long term regulation of energy balance and ghrelin functions as an appetite stimulatory signal. In contrast to ghrelin, obestatin acts as an anorexigenic hormone by suppressing food intake. Adipokines secreted from adipose tissue are the key regulators of inflammation in obesity. Increased TNF-alpha and IL-6 levels but decreased levels of adiponectin and IL-10 are associated with increased inflammation, tissue injury and complications of obesity.

CONCLUSIONS

Development, pathogenesis and complications of childhood obesity consist of complex mechanisms including numerous cytokines and hormones. New treatment modalities depend on understanding these complex mechanisms.

Fulminant hepatic failure and serum phosphorus levels in children from the western part of Turkey

BACKGROUND/AIMS

Clinical and laboratory predictors of recovery in children with fulminant hepatic failure are limited. Recently, hypophosphatemia has been reported as a laboratory indicator of recovering liver function in children with fulminant hepatic failure . We aimed to determine the incidence of hypophosphatemia and its association with clinical outcome in children in our center with fulminant hepatic failure.

METHODS

We analyzed 21 children who had been diagnosed with fulminant hepatic failure. Laboratory findings were recorded from admission date until the patient spontaneously recovered, underwent orthotopic liver transplantation or died.

RESULTS

Eight patients (38%) died, 6 (28.6%) underwent orthotopic liver transplantation, and 7 (33.3%) recovered without orthotopic liver transplantation. We identified hypophosphatemia in 57.1% of children with fulminant hepatic failure. Serum phosphorus levels were significantly lower in patients who recovered than in the orthotopic liver transplantation+death group. The presence of encephalopathy was determined at a much lower rate in the recovery group than in the orthotopic liver transplantation+death group. Serum phosphorus concentration ≥2.9 mg/dl and presence of encephalopathy were identified as independent risk factors for mortality.

CONCLUSIONS

Hypophosphatemia can be identified as a marker of recovery in children with fulminant hepatic failure. Presence of encephalopathy and a serum phosphorus level ≥2.9 mg/dl appear to indicate a poor prognosis in children with fulminant hepatic failure.