Abdulbaki Karaoglu

Relationship of adipokines (adiponectin, resistin and RBP4) with metabolic syndrome components in pubertal obese children

AIM To investigate the relationship between serum adiponectin, resistin and RBP4 levels and the components of metabolic syndrome. PATIENTS & METHODS Serum adiponectin, resistin and RBP4 levels were detected and analyzed in 148 8-18-year-old Turkish obese pubertal children with/without metabolic syndrome. RESULTS Adiponectin and resistin concentrations were significantly inversely correlated with BMI standard deviation score, homeostatic model assessment insulin resistance, waist circumference, triglyceride levels and diastolic and systolic blood pressure, and were directly correlated with high-density lipoprotein cholesterol. RBP4 concentrations were directly correlated with homeostatic model assessment insulin resistance, waist circumference, triglyceride levels and diastolic and systolic blood pressure, and inversely correlated with high-density lipoprotein cholesterol. CONCLUSION Adiponectin, RBP4 and, in particular, resistin levels may be used as suitable predictive biomarkers of metabolic syndrome.

Serum adiponectin, leptin, resistin and RBP4 levels in obese and metabolic syndrome children with nonalcoholic fatty liver disease

AIM To investigate the relationship of adiponectin, leptin, resistin and RBP4 levels in obese and metabolic syndrome children with nonalcoholic fatty liver disease (NAFLD). PATIENTS & METHODS Group I consisted of 63 obese children with liver steatosis, group II consisted of 12 obese children with elevated serum ALT activity from group I, and group III included 85 obese children without liver steatosis. RESULTS Leptin levels were higher in the NAFLD children than in the control group. Serum RBP4 levels in obese children with NAFLD were higher than those in obese children without NAFLD and controls. Adiponectin and resistin levels were negatively correlated and RBP4 levels positively correlated with ALT activity and ultrasonographic grading. CONCLUSION These data suggest that adiponectin, resistin and RBP4 may have a role in the pathogenesis of NAFLD in obese children. Adiponectin, leptin, resistin and RBP4 may be suitable markers for predicting metabolic syndrome and NAFLD.

Prevalence and risk factors of onychomycosis in primary school children living in rural and urban areas in Central Anatolia of Turkey

BACKGROUND Onychomycosis is a world-wide public health concern in children, requiring epidemiological data for different regions for control and prevention. AIM The aim of this study was to evaluate the predominant pathogens and risk factors for onychomycosis in school children living in Kayseri, Turkey. METHODS This study included 8122 school children, aged 5-16 years, living in the rural and urban areas around Kayseri. Onychomycosis was clinically classified as distal and lateral subungual (DLSO), proximal subungual, superficial white, endonyx and totally dystrophic onychomycosis. Nail samples from children with clinically diagnosed onychomycosis were collected, examined by direct microscopy and inoculated for culture study. The demographic features and possible risk factors were recorded and assessed by logistic regression models. RESULTS We clinically diagnosed onychomycosis in 152 out of 8,122 (0.18%) school children. DLSO was the most frequent clinical diagnosis (120/152, 78.9%). Culture-positive onychomycosis was detected in 27/152 (17.7%) children. The prevalence of culture-positive onychomycosis was determined as 0.33%. All culture-positive samples were only from toenails. The onychomycosis causative agents were dermatophytes in 17/27 cases (62.9%), including Trichophyton rubrum 12 (44.4%), Trichophyton mentagrophytes 1 (3.7%), Trichophyton tonsurans 1 (3.7%) and Trichophyton spp. 3 (11.1%) and yeasts in 10/27 cases (37.1%), including Candida glabrata 4 (14.8%), Candida parapsilosis 1 (3.7%), Trichosporon 2 (7.4%) and Rhodotorula 3 (11.1%). Age, fathers occupation, number of siblings and rooms were statistically associated with the frequency of onychomycosis. CONCLUSIONS Although to be prevalence of onychomycosis in school children in central Anatolia of Turkey seems very low degree, pediatric onychomycosis is a growing public health concern all over the world. Children having more siblings or unemployed fathers and children living in small house as well as older children should be examined carefully for onychomycosis.

Toll-like receptor levels and caffeine responsiveness in rat pups during perinatal period.

Infants born prematurely are prone to bronchopulmonary dysplasia which is a devastating form of chronic lung disease that develops in very low birth weight infants. Toll-like receptors (TLRs) are pattern recognition receptors that initiate innate immune responses. We tested TLR2, 4, and 9 levels in the lungs of rat pups given caffeine at the first days of postnatal life. Twenty-four rat pups equally divided into three groups. The study group received caffeine immediately after birth for ten days. The levels of TLR9 were found significantly higher in study group than control groups. We conclude that the beneficial and anti-inflammatory effects of caffeine in the lungs of newborn rats may be due to increased TLR9 levels.

Breath-holding spells may be associated with maturational delay in myelination of brain stem.

Purpose: To evaluate possible contribution of maturational delay of brain stem in the etiology of breath-holding spells in children using brain stem auditory evoked potentials. Methods: The study group included children who experienced breath-holding spells. The control group consisted of healthy age- and sex-matched children. Age, gender, type and frequency of spell, hemoglobin, and ferritin levels in study group and brain stem auditory evoked potentials results in both groups were recorded. Study group was statistically compared with control group for brain stem auditory evoked potentials. Results: The mean age of study and control groups was 26.3 ± 14.6 and 28.9 ± 13.9 months, respectively. The III–V and I–V interpeak latencies were significantly prolonged in the study group compared with the control group (2.07 ± 0.2 milliseconds; 1.92 ± 0.13 milliseconds and 4.00 ± 0.27 milliseconds; 3.83 ± 0.19 milliseconds; P = 0.009 and P = 0.03, respectively). At the same time, III–V and I–V interpeak latencies of patients without anemia in the study group compared with those of control group were significantly prolonged (2.09 ± 0.24 milliseconds; 1.92 ± 0.13 milliseconds and 4.04 ± 0.28 milliseconds; 3.83 ± 0.19 milliseconds; P = 0.007 and P = 0.01, respectively). Conclusions: Our results consider that maturational delay in myelination of brain stem may have a role in the etiology of breath-holding spells in children.

Correlation between cord blood apelin and IGF-1 levels in retinopathy of prematurity

AIM We hypothesized that circulating apelin concentrations in preterm babies might be linked with retinopathy of prematurity (ROP), similar to IGF-1 levels. PATIENTS & METHODS A total of 97 infants born with a gestational age before 32 weeks in 2007-2009 were screened for ROP at the Gata Haydarpasa Hospital (Turkey). Fourteen of them with classified ROP stage 3-5 comprised our study group. RESULTS The non-ROP group had higher apelin and IGF-1 levels than ROP neonates at birth. After 4-6 weeks, postnatal ROP subjects had lower apelin and IGF-1 levels than non-ROP controls. At the end of the study, the change in apelin levels was positively correlated with the change in IGF-1 levels (r = 0.852; p = 0.01). CONCLUSION We suggested that the pathogenesis of ROP, which is regarded as a neovascular retinal disorder, includes variations in the levels of apelin and IGF-1.

Nanoduct Sweat Conductivity Measurements in 2664 Patients: Relationship to Age, Arterial Blood Gas, Serum Electrolyte Profiles and Clinical Diagnosis

Background The Nanoduct® device has acceptable diagnostic accuracy, but there is not enough systematic data supporting its usage in the diagnosis of cystic fibrosis (CF). Methods A retrospective review of patients with an indication for the sweat test was conducted. The conductivity test was repeated in patients who had values higher than 60 mmol/L, and they were referred for sweat chloride measurements. Associations between sweat conductivity measurements and age, gender, (pH, HCO3, pCO2, Na, K, Cl), family history, consanguinity, indications for the test and number of hospitalization were studied. Results Among 2,664 patients, 16 children had sweat conductivity values higher than 80. The median age of patients diagnosed with CF was 4 months old. Age, pH, HCO3, Na, Cl, K and the sweat conductivity test were statistically related (P < 0.001). The ROC curve showed very high agreement between the 2nd conductivity test and the sweat test. Conclusions Patients suspected to have CF can be screened using the Nanoduct® conductivity device in non-qualified centers.

Passive Smoke Exposure of Female Rats Caused Aortic Atherosclerotic Precursor Lesions in Their Offspring

The aim of this study was to evaluate the presence and degree of preclinical atherosclerosis in pups of pregnant rats exposed to cigarette smoke. Abdominal aorta examined for atherosclerotic lesions and intimal medial thickness of the abdominal aorta was measured by image analysis. The study groups showed endothelial cellular losses, marked intimal injuries, elastic fiber damages, mononuclear cellular infiltration, and irregularities in internal elastic membrane, with pronounced damages as integrity losses and local fragmentations. The results provide evidence for development of an atherosclerotic process in the neonatal period, even in prenatal stage, long before the formation of smoke-related cardiovascular diseases.

Role of cyclooxygenase 2 and endothelial nitric oxide synthetase in preclinical atherosclerosis.

Cyclooxygenase-2 and endothelial nitric oxide (NO) synthase enzymes may have a role in developing preclinical atherosclerosis. Designed groups were as follows: smoke exposed rats before and during pregnancy, only before pregnancy, and controls. Cross-sectional samples of abdominal aorta were examined immunohistochemically. Cyclooxygenase-2 and eNOS expression was evaluated semi-quantitatively through staining extent (focal, diffuse) and staining intensity. Diffuse COX-2 expression was detected in study groups. Endothelial NO synthase expression was diffuse in study groups. COX-2 and eNOS may contribute to the formation of preatherosclerotic lesions in offspring of rats exposed to cigarette smoke through inflammatory response.

Hashimoto's Thyroiditis in Children and Adolescents

Hashimoto’s thyroiditis (HT) is an autoimmune disease with genetic background. It is also named as autoimmune thyroiditis or chronic lymphocytic tiroiditis. Hashimotos thyroiditis is the most common cause of thyroid diseases in children and adolescents and it is also the most common cause of acquired hypothyroidism with or without goiter. Hashimoto’s thyroiditis was first described in 1912 by Hakura Hashimoto in a series of patients with diffusely enlarged, firm thyroid glands with distinct pathologic features, classified as chronic lymphocytic thyroiditis (1). The characteristic histologic features include diffuse lymphocytic infiltration, atrophic follicles, well-developed germinal centers, and fibrosis. Hashimotos thyroiditis is the most important cause of hypothyroidism in children and adolescents. In an American population with age between 11 and 18 years, five new cases were detected out of 1,000 adolescents screened every year. It is more common among girls, varying from 4:1 to 8:1 depending on the geographical region. Although the disease can be seen before three years of age, it is usually seen after six years of age and its peak ages are 10 and 11 years (2). The prevelance of Hashimotos thyroiditis between 6-18 years old is 3% in Japan. Thirty40% of the cases have familial history of thyroid disease. It occurs far more often in women than in men (between 10:1 and 20:1), and is most prevalent between 45 and 65 years old. Autoimmune thyroid disease (AITD) has two clinical forms: a goitrous form more common in young age groups, in whom goiter may be the only clinical expression (3), often referred to as classical Hashimotos disease, and an atrophic one often called atrophic thyroiditis (4). Both are characterized by circulating thyroid autoantibodies and varying degrees of thyroid dysfunction, differing only by the presence or absence of goiter. The prognosis is not known very well, and studies reporting about long-term outcome of the disease are scarce (3,5). Thyroid function tests show variations at the time of diagnosis; mostly euthyroid or hypothyroid and rarely hyperthyroid. Hypothyroidism is thought to be a permanent sequelae of HT. Patients with overt hypothyroidism may have been recommended lifelong levothyroxine (LT4) therapy but it should be checked after puberty if LT4 therapy is still necessary or not.