Charalampos Tsentidis

Sclerostin distribution in children and adolescents with type 1 diabetes mellitus and correlation with bone metabolism and bone mineral density

Sclerostin is an inhibitor of the Wnt/beta‐catenin bone metabolic pathway. Increased sclerostin levels and reduced bone mineral density (BMD) have been documented in adult patients with diabetes mellitus (DM), predominantly in those with type 2 diabetes mellitus (T2DM). No relative data exist on childhood type 1 diabetes mellitus (T1DM). Our objective was to study plasma sclerostin in T1DM children and adolescents and controls and its correlations with metabolic bone markers and BMD.

Immunoassay‐Based Serum Hepcidin Reference Range Measurements in Healthy Children: Differences Among Age Groups

Hepcidin is a peptide hormone that plays a key role in regulating iron absorption from the small intestine and body iron distribution. Alterations in hepcidin concentrations have been associated with chronic inflammatory conditions or inherited diseases of iron metabolism. The aim of our study was to evaluate healthy children in order to define normal reference range of serum hepcidin concentrations. The universal use of a reliable commercial ELISA kit gives the ability to compare our results with those from previous studies.

Urinary leukotriene E4 levels in atopic and non-atopic preschool children with recurrent episodic (viral) wheezing: a potential marker?

Abstract Backround: Reliable biological markers for the differentiation of asthma phenotypes in preschool children with wheezing are lacking. The purpose of the study is to assess the relationship of urinary Leukotriene E4 (U-LTE4) to particular asthma phenotypes in preschool children with recurrent episodic (viral) wheezing following upper respiratory tract infections with or without atopic predisposition. Methods: Ninety-six preschool patients with recurrent episodic wheezing participated, 52 atopic and 44 non-atopic, during exacerbation and in remission. Exacerbation was defined on clinical basis (wheeze in the presence of coryzal symptoms). Atopy was determined by specific serum IgE measurement and skin-prick testing. U-LTE4 was determined by enzyme immunoassay. Thirty-six age-matched, non-asthmatic, non-atopic children served as controls. Results: During exacerbation, U-LTE4 was significantly higher in all children with recurrent episodic wheezing in comparison to A: Remission: 642.20 ± 268 versus 399.45 ± 204, p value <0.001 and B: Controls: 642.20 ± 268 versus 271.39 ± 83, p value <0.001. Atopic patients demonstrated significantly higher levels of U-LTE4 compared to non-atopic, both during exacerbation 872.13 ± 246 versus 613.15 ± 150, p value = 0.0013 and during remission 507.59 ± 182 versus 283.59 ± 160, p value <0.001. During remission, a highly significant difference of U-LTE4 was found when controls were compared to atopic patients: 271.39 ± 83 versus 507.59 ± 182, p value = 0.002 but not when compared to non-atopic ones: 271.39 ± 83 versus 283.59 ± 160, p value = 0.432. Conclusion: U-LTE4 is strongly associated with the acute wheeze episode in preschool children, more so in atopics. Increased basal levels of U-LTE4 occur only in atopics. This suggests a potential role of U-LTE4 as a marker of atopic, virus-induced asthma in preschool children.

Serum hepcidin: indication of its role as an “acute phase” marker in febrile children

BackgroundHepcidin is classified as a type II acute phase protein; its production is a component of the innate immune response to infections.ObjectiveTo evaluate the alterations of serum hepcidin in children during and following an acute febrile infection.Materials and methods22 children with fever of acute onset (< 6 hours) admitted to the 2nd Department of Pediatrics-University of Athens. Based on clinical and laboratory findings our sample formed two groups: the viral infection group (13 children) and the bacterial infection group (9 children). Hepcidin, ferritin and serum iron measurements were performed in all subjects.ResultsSerum hepcidin values did not differ notably between children with viral and bacterial infection, but a significant reduction of hepcidin was noted in both groups post-infection.ConclusionOur study provides clinical pediatric data on the role of hepcidin in the face of an acute infection. In our sample of children, hepcidin was found to rise during the acute infection and fall post-infection.

Serum hepcidin and ferritin to iron ratio in evaluation of bacterial versus viral infections in children: a single-center study.

Background: Differential diagnosis of childhood infections is important. Several biochemical indices steer diagnosis toward bacterial agents, although the data are often not definitive. Hepcidin is a central component of blood iron, and ferritin alterations occur during infections. We measured hepcidin changes and evaluated ferritin to iron ratio (FIR) in patients with suspected infections. Methods: We studied 69 children with infection and an equal number of matched controls during a 3-year period. A bacterial agent was demonstrated in 17 and a viral pathogen in 52 of the patients. Hematologic and biochemical tests were performed on all children including ferritin, iron and hepcidin. FIR was calculated and receiver operating characteristic curve analysis was performed to evaluate the best FIR cutoff value to discriminate between patients and controls and between patients with bacterial infections and viral infections. Results: Hepcidin, ferritin and FIR were significantly higher and iron values significantly lower in febrile patients than its controls. Patients with bacterial infection had significantly lower iron and higher FIR than those with viral infection. FIR had high accuracy discriminating patients from controls but only moderate accuracy discriminating bacterial from viral infected patients. Conclusions: If further studies with larger samples confirm these observations, FIR could be used as an inexpensive, rapid and easily performed complementary index for diagnosis of bacterial infections.

Higher levels of osteoprotegerin and S-RANKL in children and adolescents with type 1 diabetes mellitus may indicate increased osteoclast activity and predisposition to lower bone mass

1Diabetic Clinic *, 2Biochemistry Laboratory*, * Second Pediatric Department University of Athens, “P&A Kyriakou” Children’s Hospital, Athens, Greece. 3Department of Bone and Mineral Metabolism, Institute of Child Health, “Aghia Sophia” Children’s Hospital, Athens, Greece Introduction: Diabetes Mellitus (DM) is a risk factor for reduced bone mass. Several bone metabolic pathways seem to be disrupted in patients with type 1 diabetes mellitus (T1DM). Materials and Methods: We evaluated 40 children and adolescents with T1DM (mean±SD age 13.04±3.53 years, mean±SD T1DM duration 5.15±3.33years) and 40 healthy ageand gendermatched controls (mean±SD age 12.99±3.3years). Osteoprotegerin (OPG), Receptor Activator of Nuclear factor-KappaB Ligand(s-RANKL), Osteocalcin, C-telopeptide crosslinks-CTX, electrolytes, PTH, total 25(OH)D were measured and total body Bone Mineral Density(BMD) was evaluated with dual energy X-ray absorptiometry (DXA).