Association of serum alanine aminotransferase levels with cardiometabolic risk factors in normal-weight and overweight children

This study aimed to determine the prevalence of increased alanine aminotransferase [ALT], defined by a gender-specific cutoff value, among normal weight and overweight children; and to assess the relationship of increasing ALT levels with cardiometabolic risk factors. This cross-sectional study was conducted among school students, aged 6-18 years in Isfahan, Iran. Based on the body mass index [BMI] percentiles, a group of normal-weight was compared with a group of overweight and obese students. Gender differences were considered for increased levels of ALT, i.e. 19U/L and 30U/L for girls and boys respectively. The study participants consisted of 1172 students [56.2% girls], with a mean [SD] age of 12.57 [3.3] years. Among overweight/obese students the mean triglycerides [TG] and diastolic blood pressure was significantly higher in those with increased ALT than in those with normal ALT levels. The logistic regression analysis showed that among overweight/obese boys, for each 1 unit increase in ALT, the odds ratio [OR] of TG, total cholesterol and systolic blood pressure increased significantly. After adjusting for age, these associations remained significant, and the OR of high density lipoprotein cholesterol [HDL-c] decreased significantly. In the model adjusting for age and BMI, the ORs of TG and HDL-c remained significant. After adjusting for age and waist circumference, HDL-c was the only parameter with significant OR. Among overweight/obese girls, in all models applied, the OR was significant for TG and total cholesterol. A significant independent association was documented for waist circumference and increase in ALT after adjustment for BMI. This study documented significant relationship of increased ALT levels, defined by a gender-specific cutoff point, with cardiometabolic risk factors and hypertriglyceridemic-waist phenotype in Iranian children and adolescents

Normal values of thyroid gland in Isfahan, an iodine replete area

Because of different values of thyroid volume in different populations, and the effects of different trace element and geographic substances on thyroid volume, we decided to evaluate thyroid volume and its determinants using ultrasound in healthy adults of Isfahan, a centrally located city in Iran, an iodine replete area. In a cross-sectional study, 1500 healthy adults were enrolled by cluster sampling. Serum TSH level and morning urine iodine level were measured. Thyroid exam was performed according to WHO criteria and history of previous or present thyroid disease was taken. If all the mentioned results were normal they were considered clinically normal. One third of these normal subjects referred for thyroid ultrasonography. If ultrasonography of thyroid parenchyma texture was normal, and there was no nodule by sonography [thyroid incidentaloma], thyroid volume was measured using ellipsoid formula [XxYxZx[PI]/6]. Correlation between thyroid volume and age, sex, BMI, TSH level and urinary iodine concentration [UIC] was determined by Pearson correlation coefficient, t-Test and Kolmogorov-Smirnov. Thyroid volume more than 97% of this population was considered as goiter sonographically. Data expressed asonean +/- SD, unless otherwise stated. We finally studied 200 subjects [123 Males, 77 females, average age: 37.27 +/- 11.80 Years]. The overall thyroid volume was 9.53 +/- 3.68 ml. Males thyroid volume [10.73 +/- 3.44 ml] was significantly higher than the females one [7.71 +/- 2.63 ml] [P<0.001]. The thyroid volume ranges were 3-23.9 ml, 3.6-23.9 ml and 3-14.3 ml in all, males and females, respectively. Thyroid volume values more than 97 percentile of this reference range were 10.14 ml, 11.48 ml and 8.37 ml in all, males and females respectively, and were considered goiter sonographically. Thyroid volume had a positive correlation with age [r = 0.163, P = 0.022], but did not have correlation with serum TSH, UIC, and BMI, in both sexes. There was a strong correlation between thyroid volume, and height and body surface area [r = 0.48, P<0.001]. It was documented that thyroid volume is higher in male sex and increases with age, and have a positive correlation with body surface area and height

Etiology and pathology of enuresis among primary school children in Isfahan, Iran

To determine the etiology and pathogenesis of enuresis among primary school children by using a special ultrasound [US] protocol for the assessment of bladder dysfunction and to compare excretion of urinary sodium and calcium in enuretic children. We conducted this cross sectional study on 66 enuretic children aged 6-12 years from September 2005 to January 2006 in Isfahan University of Medical Sciences, Iran. Ultrasound [US] was designed for the evaluation of bladder parameters using bladder volume and wall thickness index [BVWI%], and expected percentage bladder volume index for kidney volume. Sixty children [90.9%] had nocturnal enuresis, 5 [7.5%] had diurnal enuresis and one child [1.6%] had nocturnal and diurnal enuresis. Urinary infection was detected in one child [1.5%]. The incidence of urinary system abnormalities was 10.6% in all enuretic children. Hypercalciuria was seen in 9.2% and natriuresis in 20.3%. Normal bladder function [BVWI 70% to <130%] was seen in 67%, small bladder with a thick wall [BVWI <70%] in 27% and large bladder capacity with a thin wall [BVWI >130%] was seen in 6% of children with primary nocturnal enuresis [PNE]. There was a significant difference in BVWI between children with PNE and secondary nocturnal enuresis [P=0.01]. Enuresis is a common problem among school children and associated urinary abnormalities are not uncommon. Our results show that US measured bladder parameters can provide useful clues for the underlying bladder dysfunction and may help to guide clinical management

epidemiological study of enuresis among primary school children in Isfahan, Iran

To estimate the prevalence of enuresis in primary school children in Iran and to determine the factors associated with this disorder. A cross-sectional time-ordered study was performed at the Faculty of Medicine, Isfahan Medical University, Isfahan, Iran from September 2005 to January 2006. A total of 4500 self-administered questionnaires were distributed to parents of children aged 6-12 years attending 30 primary schools. From an overall response rate of 69.9%, enuresis was reported in 216 children [7%], comprising 6.2% for nocturnal enuresis according to ICD10 and 3.3% according to DSM IV, 0.5% for diurnal enuresis and 0.8% for combined day and night wetting. Primary nocturnal enuresis was reported in 166 children [5.3%]. Seventy-one [50.7%] of the 140 children with nocturnal enuresis had ?3 wet nights per week. A positive family history in father and mother was seen in 51% and 39% of children with primary nocturnal enuresis respectively. Using logistic regression analysis, younger age [p<0.002], gender [p<0.0001] and low level of education of mother [p<0.028] were significant predictors of enuresis. Positive history of enuresis in father was a significant predictor of primary nocturnal enuresis [p<0.012]. The prevalence of nocturnal enuresis in Iran is lower than those reported in western countries, however, higher percentage demonstrated severe enuresis. The prevalence of diurnal enuresis is lower than previous studies. Age, gender and the educational level of the mother are the main risk determinants of enuresis and the prevalence of primary nocturnal enuresis appears to be significantly related to positive history of enuresis in father