ABSTRACT
Obesity is a common and increasing problem all over the world. It has deleterious effects on many organ systems especially on the cardiovascular system. Dyslipidemia is the basic underlying factor for arteriosclerosis. Soluble adhesion molecules are suggested to play a role in early stages of thermogenesis. The aim of this study was to investigate the changes in serum lipids, fasting blood sugar, blood pressure and echocardiographic findings in obese children and to determine which of the currently applied clinical parameters for assessment of childhood obesity best predicts these changes. The study aimed also to investigate whether the soluble adhesion molecules, slCAM-1 and sVCAM-1, are related to the serum lipid profile in obese children. The study was carried out on 36 obese children. Their age ranged from 7 to 13 years [mean = 8.78 +/- 7.58 years]. Twenty-two normal non-obese children were included as a control group. Obesity was defined as BMI above 95" percentile for age and sex. Anthropometric measurements [including weight, height, waist circumference, hip circumference, mid- arm circumference, and triceps skin fold thickness], and blood pressure were measured. Fasting blood sugar and serum lipids [triglycerides, total cholesterol, HDL-C, LDL- C] were determined colorimetric ally, while serum soluble adhesion molecules slCAM-1 and sVCAM-1 were determined by ELlSA technique. Echocardiographic examination was done for each child. The results showed that obese children had significantly higher systolic and diastolic blood pressure [119.4, 79.5 vs. 110.8, 69.6 mm Hg], fasting blood sugar [78.1 vs. 66.9 mg/dL], triglycerides [103.5 vs. 83.6 mg/dL], and total cholesterol [159.9 vs. 136.5 mg/dL], but had significantly lower HDL-C [62.06 vs. 73.75 mg/dL] respectively than control children did. Obese children had significantly increased left ventricular posterior waN thickness [0.92 vs. 0.59 mm], interventricular septum thickness [7.02 vs. 0.59 mm], left ventricular end-diastolic dimension [4.03 vs. 3.78 mm] and ejection fraction [70.6% vs. 68.1%] compared with normal children. BMI was the best obesity parameter that correlated well with most of the cardiovascular risk factors [r ranged from .39 to .76]. Waist and mid-arm circumferences were still good parameters correlating with cardiovascular risk factors. Serum levels of SICAM-1 and sVCAM-1 were correlated with triglycerides levels [P=4.04 and 0.02], while sVCAM-1 levels were negatively correlated with HDL-C [P = 0.006]. So adhesion molecules may play a role in early atherogenesis secondary to dyslipidemia. Preventive and therapeutic measures are highly needed to control childhood obesity and its complications. Additional studies are clearly needed to establish normal values for adhesion molecules in childhood to allow the identification of children who would be mostly benefited by the implementation of preventive and therapeutic programs to decelerate the evolution of atherosclerotic process
ABSTRACT
Perinatal hypoxia is a major risk factor for abnormal outcome in the neonatal period. Despite the potential severity and prevalence of this condition, the diagnosis is usually based on nonspecific clinical criteria. Identifying the extent of hypoxic insult is necessary to provide medical management that optimizes the medical and neurologic outcome. During hypoxia, reactive oxygen species cause lipid peroxidation of cell membrane, yielding oxidative products, the most abundant product being malondialdehyde [MDA]. The objective of this study was to investigate the concentration of malondialdehyde excreted in urine during the first day of life in term infants following acute hypoxia, and to demonstrate to what extent it would be correlated with other parameters of perinatal hypoxia. The study was conducted on twenty-four full term infants with acute perinatal hypoxia admitted to Neonatal Intensive Care Unit. Diagnosis of asphyxia was based on Apgar score < 5 at 5 minute and arterial cord blood pH < 7.2. Sixteen normal non-hypoxic full term infants were included as a control group. All newborns were subjected to detailed history and clinical examination, umbilical cord arterial bIood gases determination and cranial ultrasonographic examination. Urinary malondialdehyde was deterrminated in urine samples collected on the first day of life by measuring thiobarbituric acid-reacting substances levels using a spectrophotometric assay. The results proved that urinary MDA levels were significantly higher on hypoxic infants [8.11 +/- 3.92 ng/mg creatinine] compared to normal infants [5.53 +/- 2.97 ng/mg creatinine - P= 0.031]. Hypoxic infants with meconium in amniotic fluid, who needed resuscitation immediately after birth, those who developed hypoxic ischemic encephalopathy, and those with persistent cranial ultrasonographic findings had significantly higher urinary MDA levels than hypoxic infants without these risk factors [P= 0.028, 0.035, 0.01 and 0.015 respectively]. Significant correlations were found between urinary MDA levels and one-minute [r = 0.441] and five-minute Apgar scores [r = 0.537], but not with umbilical arterial blood pH [r = 0.332]
Conclusion: Determination of urinary malondialdehyde [by measuring thiobarbituric acid-reacting substances] in the first day of life provides a reliable, easy and early marker of the severity of acute perinatal hypoxia. Further studies are needed to show its value in prediction of the long-term outcome of birth asphyxia
ABSTRACT
This work was carried out to address the relationship between serum levels of prolactin and the development of respiratory distress syndrome as well as its relation to duration of mechanical ventilation. The study divided 50 neonates into two groups. Group I included 30 neonates suffering from respiratory distress syndrome [RDS] who were mechanically ventilated; their mean gestational age was 32.1 +/- 2.2 weeks and their mean birth weight was 1.7 +/- 0.6 kg and group II included 20 healthy neonates free from RDS taken as controls; their mean gestational age was 35.3 +/- 2.4 weeks and their mean birth weight was 2.4 +/- 0.5 kg. All neonates were subjected to full medical history taking and full clinical examination. Neonates with RDS were subjected to plain X-ray chest, blood gases and C reactive protein [CRP] measurement. Serum prolactin [RRL] estimation was done using ELISA technique on the 1st day of life for both patients and controls. Follow up values on the 7th day of life were obtained for patients only. It was concluded that PRL hormone is important in the neonatal period, the deficiency of which is closely related to the development of RDS. These findings greatly raised the possibility of the role of PRL in fetal lung maturation and perhaps surfactant synthesis. Also, it confirmed the strong association between low serum PRL and prolonged respiratory disease in neonates with RDS resulting in prolonged duration of mechanical ventilation