RESUMO
OBJECTIVE: Because osteopenia is a frequent complication of celiac disease, we evaluated the impact of a long-term gluten-free diet (GFD), initiated during childhood, on bone density. study design: Patients with celiac disease (n = 19; mean age, 14.2 +/- 2.6 years) were studied after 4.3 +/- 0.6 years of GFD. Bone density had been measured at diagnosis and after 1 year of GFD. We also studied 211 healthy children as a control group. Bone mineral density was measured by dual-energy x-ray absorptiometry. Intact parathyroid hormone (PTH) and bone-specific alkaline phosphatase (BALP) levels were measured in serum, and N-terminal telopeptide of type I collagen (NTx) was measured in urine. RESULTS: Although at diagnosis bone mineral content, bone area, and bone mineral density were significantly lower than in control subjects, the 3 measurements were normal after GFD. None of the patients on a GFD showed elevated values of PTH. Patients on a GFD had BALP (110.2 +/- 67.2 U/L) and NTx levels (261.9 +/- 187.8 nmol bone collagen equivalents/mmol creatinine) that were significantly higher than those of control subjects. The levels of BALP and NTx were significantly higher in patients with good compliance with the GFD, compared with patients with poorer compliance. CONCLUSIONS: This study shows that bone mineral content, bone area, and bone mineral density improve significantly with a GFD.
Assuntos
Densidade Óssea/fisiologia , Doença Celíaca/dietoterapia , Absorciometria de Fóton , Adolescente , Adulto , Fosfatase Alcalina/sangue , Doença Celíaca/sangue , Doença Celíaca/diagnóstico por imagem , Criança , Colágeno Tipo I/urina , Feminino , Humanos , Estudos Longitudinais , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Masculino , Fenômenos Fisiológicos da Nutrição/fisiologia , Hormônio Paratireóideo/sangue , Cooperação do Paciente , Estudos Prospectivos , Fatores de TempoRESUMO
OBJECTIVES: To test the hypothesis that in a healthy pediatric population body mass index (BMI) (kilograms per meter square) is a valid measure of fatness that is independent of age for both sexes. METHODS: Total body fat (TBF) (in kilograms) and percent of body weight as fat (PBF) were estimated by dual energy x-ray absorptiometry (DXA) in 198 healthy Italian children and adolescents between 5 and 19 years of age. We developed multiple regression analysis models with TBF and percent body fat as dependent variables and BMI, age, and interaction terms as independent variables. Separate analyses were conducted for boys and girls. RESULTS: BMI was strongly associated with TBF (R2 = 0.85 and 0.89 for boys and girls, respectively) and PBF (R2 =0.63 and 0.69 for boys and girls, respectively). Confidence limits on BMI-fatness association were wide, with individuals of similar BMI showing large differences in TBF and in PBF. Age was a significant covariate in all regression models. Addition of nonlinear terms for BMI did not substantially increase the R2 for TBF and PBF models in boys and girls. CONCLUSION: Our results support the use of BMI as a fatness measure in groups of children and adolescents, although interpretation should be cautious when comparing BMI across groups that differ in age or when predicting a specific individual's TBF or PBF.
Assuntos
Índice de Massa Corporal , Obesidade/diagnóstico , Absorciometria de Fóton , Adolescente , Adulto , Composição Corporal , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Análise de Regressão , Reprodutibilidade dos TestesRESUMO
We evaluated endogenous cholesterol synthesis and plasma lipid profile longitudinally from birth to 1 year old in infants who were exclusively breast-fed (n = 19) or formula-fed (n = 19) for the first 4 months of life. At 1 and 4 months of age, breast-fed infants had higher plasma total and low-density lipoprotein cholesterol and apolipoprotein B levels than formula-fed infants, whereas plasma mevalonate and lanosterol levels were not different between the two study groups.
Assuntos
Aleitamento Materno , Colesterol/sangue , Alimentos Infantis , Análise de Variância , Apolipoproteínas B/sangue , Distribuição de Qui-Quadrado , LDL-Colesterol/sangue , Feminino , Sangue Fetal/química , Seguimentos , Humanos , Recém-Nascido , Itália , Lanosterol/sangue , Estudos Longitudinais , Masculino , Ácido Mevalônico/sangue , Valores de Referência , Análise de Regressão , Distribuição por SexoRESUMO
OBJECTIVE: The features of achondroplasia, the most common form of dwarfism, includes short cranial base and midface hypoplasia; both abnormalities increased the risk of upper airway obstruction during sleep. The aim of our study was to evaluate sleep and respiratory function of children with achondroplasia and to differentiate central from obstructive apnea. We also wanted to correlate apneic events with foramen magnum stenosis. STUDY DESIGN: Sixteen children with achondroplasia (mean age, 4.7 years) were studied by noctumal polysomnography and brain computed tomography or magnetic resonance imaging. A comparison of sleep and respiratory findings was made between the study group and 25 children with adenotonsillar hypertrophy. RESULTS: The study revealed no significant difference between groups with respect to sleep architecture. We also found no relationship between apnea type and foramen magnum stenosis. Twelve children (75%) with achondroplasia had significant upper airway obstruction during sleep, with symptoms of continuous snoring and periods of brief obstructive apnea, hypopnea, or both. The mean apneahypopnea index (per hour of sleep) did not differ significantly between the two groups. However, the breathing rate during sleep was increased in children with achondroplasia. These findings indicate that the most important breathing disorder during sleep in children with achondroplasia is upper airway obstruction. CONCLUSION: We conclude that polysomnography with detailed scoring of breathing abnormalities is a useful tool in evaluating sleep-disordered breathing in children with achondroplasia.
Assuntos
Acondroplasia/fisiopatologia , Obstrução das Vias Respiratórias/fisiopatologia , Síndromes da Apneia do Sono/fisiopatologia , Acondroplasia/complicações , Obstrução das Vias Respiratórias/complicações , Obstrução das Vias Respiratórias/etiologia , Criança , Pré-Escolar , Eletromiografia , Feminino , Humanos , Lactente , Masculino , Polissonografia , Síndromes da Apneia do Sono/etiologiaRESUMO
The extent and the clinical significance of residual beta cell function has been evaluated by radioimmunoassay of C-peptide in 41 diabetic children in different stages of evolution, using an arginine tolerance test. In control subjects a significant rise of C-peptide levels occurred after the infusion with arginine. In patients at the onset of the disease and in patients not in the remission stage, C-peptide levels showed no increment and basal values were significantly lower than in healthy control children. Children during the remission phase showed basal and peak values not significantly different from controls. A positive correlation was found between highest CPR levels compared to basal CPR values and to the age at onset of diabetes; a negative correlation was found between the duration of the disease and insulin requirement.