Ricardo Fernando Arrais

Plasma lipid profile and lipid peroxidation in overweight or obese children and adolescents

OBJECTIVE To study the plasma lipid profile and lipid peroxidation in overweight or obese children and adolescents receiving care at the pediatric endocrinology clinic in HOSPED/UFRN, a university hospital. METHODS Three groups were studied: overweight (n = 15), obese (n = 30) and control (n = 21) children and adolescents. To evaluate plasma lipid profile, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels were measured. Lipid peroxidation was determined by measuring malondialdehyde concentration. Data were analyzed using Students t test, Tukey test, ANOVA and Pearsons correlation. RESULTS Altered levels of total and LDL-cholesterol were observed mainly in overweight or obese males. HDL-cholesterol was borderline in the overweight and obese groups of both sexes. Obese females had the highest levels of triglycerides. Increased plasma lipid peroxidation was observed mainly in obese males. CONCLUSION In the present population, the greatest alterations in lipid profile were observed in obese and overweight males. Plasma lipid peroxidation was more evident in obese males and females.

Avaliação da dieta habitual de crianças e adolescentes com sobrepeso e obesidade

OBJECTIVE: The aim of this study was to investigate the usual diet of obese and overweight children and adolescents, attended at the Pediatric Endocrinology Ambulatory of the Universidade Federal do Rio Grande do Norte, Natal, Brazil. METHODS: Overweight (n=15), obesity (n=30) and control (n=21) groups were constituted. The anthropometric evaluation was obtained by Body Mass Index and the usual diet was investigated by self-register. The diet was analysed using the Virtual Nutri 1.0 software. RESULTS: In the female obesity group the intake of total calories and fiber was significantly smaller than in the male control group. There was a high average of protein intake in male overweight and female obesity groups. Negative correlation between Body Mass Index and diet fiber was observed in female obesity group. CONCLUSIONS: In general, the usual diet of obese and overweight children and adolescents was inadequate in relation to protein, lipids and fiber.

Low bone mineral density is associated to poor glycemic control and increased OPG expression in children and adolescents with type 1 diabetes

AIMS To investigate early alterations on bone mineral density (BMD) and RANK, RANKL and OPG mRNA expression in peripheral blood leukocytes (PBL) in children and adolescents with type 1 diabetes (T1D) and the relationship with glycemic control and bone biomarkers. METHODS This cross-sectional study included 75 children and adolescents with T1D and 100 individuals without diabetes (normoglycemic-NG) aged 6-20 years old. T1D individuals were considered to have good (T1DG) or poor (T1DP) glycemic control according to the values of HbA1c. Phosphorus, magnesium, total and ionized calcium, osteocalcin, alkaline phosphatase and tartaric-resistant acid phosphatase (TRAP) values were determined in blood samples. BMD was measured by DEXA. RANK, RANKL and OPG mRNA expression was measured in PBL by real-time PCR. RESULTS Osteocalcin values were decreased in diabetic groups in comparison to NG group (p<0.05), and a negative correlation with both serum glucose (r=-0.265, p<0.01) and Hb1Ac (r=-0.252, p<0.01) in T1D group was found. BMD was lower in diabetic groups in comparison with NG group (p<0.05) and a negative correlation was observed between BMD and both serum glucose (r=-0.357, p<0.01) and HbA1c (r=-0.351, p<0.01) in T1D group. OPG mRNA expression was significantly increased in T1D and T1DP groups in comparison with NG group (p<0.05). In conclusion, children and adolescents with early onset T1D presented low bone mineral density associated to unsatisfactory glycemic control, increased OPG mRNA expression and low osteocalcin concentration.

Effects of zinc supplementation in patients with type 1 diabetes

The purpose of this study was to identify the effect of oral zinc supplementation in patients with type 1 diabetes (T1DM) on metabolic control and zinc blood concentrations. The sample consisted of 20 patients with T1DM and a control group (n=17). Metabolic control was evaluated by glycemia at fast, 24 h glycosuria, and HbA1c. Zinc concentrations were measured in plasma and erythrocytes. After the first collection of biological material, oral zinc supplementation was initiated and continued for 4 mo in T1MD patients (T1). Daily dosages were established based on Dietary Recommended Intakes (DRIs), considering zinc intake based on data from other studies previously performed with this population. All analyses were repeated after supplementation (T2). Metabolic control was unsatisfactory, with an HbA1c increase at T2. There was no difference in zinc concentrations in plasma and erythrocytes between patients with T1DM and control. Zinc concentrations in plasma were within the normal range in T1MD before and after supplementation and the control. Zinc concentrations in erythrocyte presented lower than normal values for all groups. A zinc increase in erythrocyte after supplementation was observed in T1DM patients, although without statistical significance. More studies are needed to confirm oral zinc supplementation as nutritional management in diabetes.

Comparison between objective assessment and self-assessment of sexual maturation in children and adolescents

OBJECTIVE To assess the correlations between objective assessment and self-assessment of sexual maturation in the outpatient and school settings. METHODS Three hundred and nineteen individuals, 178 (96 boys and 82 girls) from an outpatient clinic and 141 (73 boys and 68 girls) from public schools (8.3-18.7 years), of whom 73 individuals (39 girls an d 34 boys) had a body mass index above the 85th percentile, according to 2000 CDC Growth Chart, were analyzed. All of them were examined sequentially and individually by two trained physicians after a written consent form was signed by parents or surrogates, and then submitted to self-assessment using pictures (Tanner stages). Kappa coefficients between examiners and the self-assessment were calculated based on the collected data. A p value <5%was established as statistically significant. RESULTS No significant difference was observed between correlations obtained from the outpatient clinic and schools, and both groups were combined for analysis. The correlations obtained by examiners were significantly higher than those from self-assessment, with a kappa coefficient (and confidence interval) of 0.75 (0.8-0.69) for breasts/genitals across examiners against 0.27 (0.34-0.20) and 0.29 (0.36-0.22) between the two examiners and the self-assessment (p < 0.0001). CONCLUSIONS In the studied sample, self-assessment of the pubertal stage should not replace the objective assessment made by trained professionals. Improvement of the self-assessment method may validate its use in population-based studies.

Comparação entre avaliação objetiva e autoavaliação da maturação sexual em crianças e adolescentes

OBJECTIVE: To assess the correlations between objective assessment and self-assessment of sexual maturation in the outpatient and school settings. METHODS: Three hundred and nineteen individuals, 178 (96 boys and 82 girls) from an outpatient clinic and 141 (73 boys and 68 girls) from public schools (8.3-18.7 years), of whom 73 individuals (39 girls an d 34 boys) had a body mass index above the 85th percentile, according to 2000 CDC Growth Chart, were analyzed. All of them were examined sequentially and individually by two trained physicians after a written consent form was signed by parents or surrogates, and then submitted to self-assessment using pictures (Tanner stages). Kappa coefficients between examiners and the self-assessment were calculated based on the collected data. A p value < 5% was established as statistically significant. RESULTS: No significant difference was observed between correlations obtained from the outpatient clinic and schools, and both groups were combined for analysis. The correlations obtained by examiners were significantly higher than those from self-assessment, with a kappa coefficient (and confidence interval) of 0.75 (0.8-0.69) for breasts/genitals across examiners against 0.27 (0.34-0.20) and 0.29 (0.36-0.22) between the two examiners and the self-assessment (p < 0.0001). CONCLUSIONS: In the studied sample, self-assessment of the pubertal stage should not replace the objective assessment made by trained professionals. Improvement of the self-assessment method may validate its use in population-based studies.

Assessment of copper and lipid profile in obese children and adolescents

The aim of this study was to assess erythrocyte and plasma copper concentrations and correlate them with the lipid profile of overweight and obese children and adolescents. The study was performed with 15 over-weight and 30 obese children and adolescents, and the results were compared to the control group (21), aged 6–16 yr. Anthropometric assessment was carried out using body mass index (BMI). Total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride serum levels were investigated. Erythrocyte and plasma copper levels were determined by atomic absorption spectrophotometry. Greater alterations in the lipid profile were observed in HDL-cholesterol, LDL-cholesterol, and triglyceride levels, with distinctions according to gender. The plasma copper concentrations in the overweight and obese male groups were significantly higher than those in the control group (p=0.0006). Negative correlations between plasma copper and total cholesterol (r=−0.54) and LDL cholesterol (r=−0.59) were observed in the obese male group. There was no statistical difference in copper erythrocyte concentrations. The obesity associated to disorders in lipid metabolism predisposes to changes in copper plasma concentrations, but there was no alteration in intracellular reserves, which suggests an important homeostatic control to compensate for plasma oscillations and metabolic alterations of the disease.

Association between dyslipidemia and anthropometric indicators in adolescents

The dyslipidemia associated with excess weight is a risk profile global call for cardiovascular disease (CVD). The aim of this study was to investigate the association between dyslipidemias and other risk factors for cardiovascular diseases (CVD) in adolescents, considering sexual maturation. A cross-sectional study was carried out with 432 adolescents from public schools, aged 10-19 years. The correlations between the variables from the lipid profile and the Body Mass Index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), sexual maturation, familial history and maternal education were evaluated using Pearsons correlation coefficient. Low high-density lipoprotein cholesterol (HDL-C) was the most prevalent dyslipidemia (50.5%), regardless of gender. There were significant correlations between triglycerides and BMI (r = 0.30, p<0.01), WC (r = 0.32, p < 0.01) and WHtR (r = 0.33, p < 0.01). The linear model, which took into consideration sexual maturation, age and BMI, explain about 1 to 10.4% of the lipid profile variation. The low HDL-c was the most prevalent dyslipidemia in all adolescents and hypertriglyceridemia was most prevalent in overweight adolescents. Associations between dyslipidemias and anthropometric indicators (BMI and RCA) detected in this study can generate the hypothesis of the risk factors for CVD in adolescents.

Association of polymorphisms in IL6 gene promoter region with type 1 diabetes and increased albumin-to-creatinine ratio.

Pro‐inflammatory cytokines, such as interleukin‐6 (IL‐6), have been considered as key factors in type 1 diabetes mellitus (T1DM) and diabetic nephropathy, thus, our aim was to investigate the association of IL6‐174G>C (rs1800795) and ‐634C>G (rs1800796) polymorphisms with T1DM susceptibility and diabetic nephropathy.

Increased TLR2 expression in patients with type 1 diabetes: evidenced risk of microalbuminuria

Ururahy MAG, Loureiro MB, Freire‐Neto FP, Souza KSC, Zuhl I, Brandão‐Neto J, Hirata RDC, Doi SQ, Arrais RF, Hirata MH, Almeida MG, Rezende AA. Increased TLR2 expression in patients with type 1 diabetes: evidenced risk of microalbuminuria.