Nutritional state of Polish prepubertal children assessed by population-specific and international standards

OBJECTIVE

To assess the frequency of obesity, overweight and underweight (thinness) in Polish 7-9-year-old children using a population specific definition as compared to the French, US and IOTF references based on body mass index (BMI).

DESIGN

Height and weight were measured and BMI was calculated in a randomly selected representative sample of 7-9-year-old Polish children (N = 2916; 1445 girls; 1471 boys) to define their nutritional status. Overweight (including obesity) was estimated according to four and underweight (thinness) according to three definitions Polish national references; French references; United States references and International Obesity Task Force references.

RESULTS

According to Polish, French, U.S. and IOTF references overweight (including obesity) was found in 12.1, 14.3, 20.7 and 15.4% of children, respectively; 3.5, 9.4 and 3.6% of children were obese according to national, U.S. and IOTF references, respectively while underweight (thinness) was present in 6.9, 2.6 and 4.2% of children according to Polish, French and U.S. references, respectively. A trend of decreasing overweight and increasing underweight through age classes was observed.

CONCLUSION

The rates of underweight (thinness), overweight and obesity in Polish 7-9-year-old children calculated according to the national, French, U.S. and IOTF references were significantly different. Therefore even if the IOTF reference is considered superior for international epidemiological studies, population specific standards should probably coexist for clinical practice.

[Influence of birth weight on pubertal development of fourteen years old children]

Intrauterine growth restriction may have a life-long impact on growth and general health status. The aim of the study was to evaluate the influence of birth weight on height, BMI and pubertal stage in fourteen years old children. The study was carried out in 437 children (230 girls and 207 boys) in the mean age of 14.2+/-1.1 years. Data of parental height, mothers' age of menarche and family socioeconomic status were obtained through the inquiry. A significant correlation between the birth weight and height of 14 years old girls and boys was found, but there was no correlation of birth weight with their BMI. Age of the first menses in girls correlated with mothers' menarche only - neither birth weight nor socioeconomic factors influenced it significantly. Birth weight did not correlate with pubertal stage attained by the children examined, however in girls with low birth weight, as opposed to the girls with birth weight >2500 g, there was no acceleration of menarche. The results of the study indicate that birth weight may influence height but it has no influence on weight and pubertal staging in 14 years old children.

[Growth dynamics in the first six years of life in respect to the birth weight]

The aim of the study was to examine growth dynamics in girls and boys during the first six years of life and to establish how and to what extend it can be modified by their birth weight. The study was carried out in 437 children (230 girls and 207 boys). Growth dynamics during first two years, between 2 and 4 and 4 and 6 years of life was established and compared between the groups of children with birth weight below 2500 g, 2501-3500 g and above 3500 g. In girls with lowest birth weight highest dynamics of the body mass accretion was found between birth and 2 years of life. Their linear growth velocity was highest between 2 and 4 years of life. In boys no relation of the birth weight and dynamics of body mass increase was found. However, in boys with lowest birth weight linear growth velocity was highest between 2 and 4 years of life. It is concluded that high growth velocity between the second and fourth year of life can be beneficial for the "catch-up" growth in children with low birth weight who remain short at the end of the 2nd year of life.

Lipid profiles in Polish adolescents from high- and low-risk families: tracking unfavourable lipid levels over a one-year period

In a country with a high cardiovascular mortality rate, lipid profiles were studied in 929 adolescents (440 from affected and 489 from non-affected families for cardiovascular disease and hypercholesterolaemia). In 334 children with elevated or borderline total cholesterol level, lipid profiles were re-measured after a 1-y period. In boys from affected families, in contrast to boys from non-affected families, significantly higher total cholesterol levels (4.36 +/- 0.81 vs 4.19 +/- 0.78 mmol/L, p < 0.05) and LDL-C level (2.1 +/- 0.72 vs 1.89 +/- 0.79 mmol/L, p < 0.05) and significantly lower HDL-cholesterol levels (1.81 +/- 0.34 vs 1.93 +/- 0.38 mmol/L, p < 0.05) were found. The odds ratio for being in the most unfavourable decile for LDL-cholesterol was significantly higher for girls from affected families (2.17, p = 0.02). A relatively high HDL-C level as well as a favourable TC/HDL-C ratio was demonstrated in all groups, being lowest in boys from affected families. A significant correlation was found between baseline lipids and their values re-measured after 1 y. It is concluded that (1) adolescents with a positive family history are at increased risk for unfavourable lipid profile, (2) adolescents with elevated total cholesterol and LDL-cholesterol levels remain hypercholesterolaemic after a 1-y period and are therefore candidates for further biochemical and clinical monitoring, and (3) children with elevated total cholesterol may not be at high risk for cardiovascular disease owing to the favourable TC/HDL-C ratio. The study results do not indicate that general cholesterol screening in Polish adolescents is necessary, as the proportion of children with elevated LDL-cholesterol is relatively low.

Particular fractions of microproteinuria in patients with stabile angina pectoris and without a clinical nephropathy

The determination of microalbuminuria is a valuable method in the diagnosis of renal and vascular diabetes or hypertension complications. Recently, microalbuminuria appeared to be the predictor of coronary heart diseases (CHD). The presented study comprised 26 patients with stable angina pectoris (AP) and 27 healthy volunteers. We simultaneously evaluated microproteinuria during the first morning and afternoon miction and the 24-h blood pressure. Amongst patients with AP all urine protein concentrations were increased (results in g/mol creatinine): alpha-1-microglobulin (1.04 + 0.13 vs. 0.47 + 0.05, p < 0.001) albumin (0.95 + 0.15 vs. 0.61 + 0.05, p < 0.05) and IgG (1.00 + 0.17 vs. 0.55 + 0.05, p < 0.01) were higher, in comparison to control group values. Indices for diurnal blood pressure rhythm were significantly lower in the AP group for both systolic (1.07 + 0.01 vs. 1.14 + 0.01 p < 0.001) and diastolic (1.09 + 0.02; vs. 1.21 + 0.03 p < 0.01) pressures. A physiological increase of albumin from the afternoon sample was only observed in the control group. Thus, our AP patients demonstrated signs of subclinical nephropathy in both the proximal tubuli and glomeruli.

Day/night ratio of microproteinuria and blood pressure rhythm in type II diabetes

The paper discusses the results of the studies conducted with a group of patients with type II diabetes without clinical nephropathy. The aim of the study was to attempt to determine the markers for early stages of diabetic nephropathy in NIDDM patients. The following examinations were carried out: the level of selected microproteinuric components, 24 h monitoring of arterial blood pressure, and electrocardiogram (ECG). Among the patients examined, the level of alfa-1-microglobulin, albumin and immunoglobulin G (IgG) in diabetic patients was higher than in the control group, and the increased activity of beta NAG was observed. The 24 h profile of blood pressure and the ratio afternoon/night of albumin excretion flattened in the majority of diabetic patients. The results of the study suggest that the proximal tubules and the membranes of renal glomeruli are damaged as early as during the period of subclinical diabetic nephropathy.

[Microproteinuria and circadian rhythm of blood pressure in patients with arterial hypertension]

Microproteinuria is a recognized sign of early nephropathy in the course of arterial hypertension. There is few data concerning the excretion of proteins other than albumin in this group of patients. The aim of the study was to examine circadian rhythm of alfa-l-microglobulin (AlMG), albumin (ALB), immunoglobulin G (IgG) excretion and N-acetyl-beta-glukosaminidase (beta NAG)-activity, then to compare the results with the results of 24 hour ambulatory monitoring of arterial blood pressure in patients with arterial hypertension. The study comprised 28 patients. The control group included 27 healthy volunteers. Albumin concentration was determined by Beckman ICS2 nephelometer, using Beckman and Dako reagents. Blood pressure and ECG were monitored by analysis with ABP-system (AMP-USA). In patients with arterial hypertension significantly higher levels of ALB, AlMG, IgG and increased beta NAG activity were observed in morning urine samples. Despite hypotensive treatment blood pressure values were slightly, though significantly higher than in the control group. Among patients in the study circadian BP rhythm was disturbed. The results obtained suggest that in this group of patients subclinical nephropathy develops involving renal glomeruli and proximal tubules--probably resulting from vascular and humoral disorders, with accompanied hypertension.

Comparative effects of rifampin and/or probenecid on the pharmacokinetics of temazepam and nitrazepam

The pharmacokinetics of nitrazepam and temazepam were investigated in 16 healthy volunteers before and after seven days of the administration of rifampin 600 mg/d and/or probenecid 500 mg/d. In order to determine the endoplasmatic reticulum enzyme function, 6-beta-hydroxycortisol excretion and antipyrine pharmacokinetic parameters were evaluated. After the administration of rifampin, the total body clearance of antipyrine and nitrazepam increased by 87% and 83%, respectively. After the combined treatment with rifampin and probenecid, the elimination of the two drugs was also increased, even though to a lesser extent (33%, 31%). After the administration of probenecid only, the total clearances of antipyrine and nitrazepam were decreased by 22% and 25%, respectively. The urinary clearance of the antipyrine metabolites also decreased. In norantipyrine and 4-OH-antipyrine, this was due to a significant reduction of glucuronide fraction (211 +/- 32 to 159 +/- 26 mg, and 259 +/- 39 to 191 +/- 25 mg). The sulphate fraction of norantipyrine increased by 18% and that of 4-OH-antipyrine by 21%. Apart from a reduced excretion of the glucuronide fraction, the pharmacokinetics of temazepam were neither altered significantly by probenecid nor by rifampin. According to the outcome of this investigation, probenecid seems to bring about not merely an inhibition of phase II but also an inhibition of phase I metabolization.

[Ability of the tissues to assimilate glucose and the pyruvate and lactate levels after intravenous glucose load in patients with peripheral facial paralysis]

In 60 control subjects and 48 patients with peripheral facial nerve palsy carbohydrate metabolism was tested performing a rapid intravenous glucose tolerance test with 0.5 g glucose per 1 kg of actual body weight and with determination of concentrations of glucose, pyruvate and lactate at rest in fasting state and after intravenous glucose load. Glucose was determined in capillary blood by the orthotoluidine method, pyruvate and lactate in venous blood by the enzymatic method. In the group of patients with facial nerve palsy a significantly lower number of subjects had a normal ability of glucose assimilation by tissues and a significantly higher frequency of pathological results of glucose tolerance test with a high prevalence of fasting hyperglycaemia. In patients with abnormal glucose tolerance test the fasting pyruvate concentration was high. After an intravenous glucose load the concentration of pyruvate in the 120th minute of the test was significantly increased (p less than 0.05) in patients with facial nerve palsy independently of the degree of glucose tolerance impairment. In patients with pathological result of the glucose tolerance test disturbances were observed also in lactate concentration. The production of lactate was decreased in the initial phase and then it was increased in the time up to 120 minutes. No direct correlation was observed between the disturbances of pyruvate concentration and the preserved ability of glucose assimilation by the peripheral tissues.

The effect of N-(3, 5, 5-trimethyl-2-pyrazolino-1-carbonimidoyl)-guanidine hydrochloride (BPC-151) on lipid metabolism of rats and pigs

The effect of BPC-151 on the lipid level in the rat and pig blood serum and on the lipid content in the homogenate of rat liver, on pyruvate and lactate in the blood serum of pigs, and on aggregation of blood platelets in pigs was investigated. Hyperlipidemia was induced by administration for 6 months a high lipid diet containing coconut oil, cholesterol and cholic acid. The hypolipemic action of BPC-151, particularly against the increase in free fatty acids, was demonstrated. The investigated compound did not affect the level of lactate in the pig blood serum but depressed the aggregation of blood platelets.