Health related quality of life and psychological problems in Egyptian children with simple obesity in relation to body mass index

Obesity in childhood or adolescence could affect quality of life [QOL] There is little existing information about the health-related quality of life [HRQOL] of obese children and adolescents. To assess HRQOL and psychiatric co-morbidities in obese children and adolescents; and their relationship to body mass index [BMI]. Fifty obese children and adolescents were compared to 50 healthy age-, sex- and pubertal stage-matched non obese children and adolescents serving as controls. They were assessed by child self-report and parent proxy report using a pediatric HRQOL inventory scale, also, Children Anxiety Scale and Children Depression Inventory [CDI] were assessed. Obese children had total HRQOL score: 69.1 +/- 8.4 versus 81.1 +/- 7.8 respectively, p < 0.001 and their parents had total score: 62.9 +/- 9.5 versus 74.9 +/- 7.2 respectively, p < 0.001. Obese children reported lower health-related QOL scores in all domains than controls. BMI standard deviation score [SDS] correlated negatively with total score and all domains in child self report and parent proxy report. Anxiety [mild: 8%, moderate: 38%, severe: 54%] and depression [mild: 18%, moderate: 24%, severe: 58%] were pre-existing or diagnosed in all obese children with significant positive correlations between BMISDS and each of anxiety [r = 0.81, p < 0.01] and CDI scores [r = 0.78, p = 0.01]. BMI [OR: 5.72, 95%CI: 2.57-5.9] and waist circumference [OR:2.27, 95%CI: 1.99-5.31] SDSs were independent risk factors affecting the total QOL score Obese children and adolescents have lower health-related QOL that correlated negatively with BMI, also they are more susceptible to anxiety and depression symptoms than non obese children

Impact of obesity and body fat distribution on pulmonary function of Egyptian children

Childhood obesity is an emerging global public health challenge. That is because the prevalence of obesity among children and adolescents has increased greatly in all parts of the world.[1] Overweight and obese children are at increased risk of a wide range of health conditions including respiratory diseases. A number of studies have reported an inverse relation between respiratory function and various indices of obesity or fat distribution.[2] The aim of this work: was to study the impact of obesity on pulmonary function and to assess the correlation between lung function impairment, degree of obesity and fat distribution in Egyptian children with simple obesity. Patients and method: This study was conducted on thirty children. They were divided into two groups. Group I included 20 children with simple obesity. Group II included 10 healthy normal children as a control group. All children were subjected to full history taking, thorough clinical examination, anthropometric assessment, plane x-ray left hand for bone age assessment, plane x-ray chest and pulmonary function testing including: FVC, FEV1, FEV1 / FVC or FEV1%, PEF maximum, PEF25%, 50% and 75%,: FEF25-75%, MVV. Obese children had statistically significant higher rate of chest symptoms suggestive of bronchial asthma than the control group. They had also statistically significant reductions in FVC, FEV1, PEF, and MVV. They showed also lower values of FEV1/FVC ratio FEF 25%, 50%, 75% and FEF 25-75% when compared with control group but the difference did not reach significant level. BMI had significant negative correlation with FVC, FEV1, PEF max, flow rates [FEF25%, FEF50%, and FEF25-75%] and MVV. Triceps skin fold thickness had significant negative correlation with, FEV1, FEF25%, FEF50%, PEF max, and MVV. MAC was inversely correlated with FEV1, FEF25%, FEF50%, FEF75%, PEF max, and MVV. There was no statistically significant correlation between waist circumference or WHR and all the parameters of pulmonary functions. Obese children have more respiratory symptoms than their normal weight peers. They have significant restrictive pulmonary defect, evident small airways obstruction and a defect in respiratory musculature, week effort and coordination, with increased airway resistance. BMI was inversely correlated with most of pulmonary function abnormalities. So, BMI is recommended to be used as a predictor of pulmonary function in assessment of obese children in epidemiological studies

Glutathione peroxidase enzyme and selenium level in patients with Down syndrome

In recent years, it has been hypothesized that an increase in oxidative stress in patients with Down syndrome account for the appearance of different diseases such as atherosclerosis, accelerated cell aging, cellular mutagenicity and neurological disorders that often occur in these patients. The antioxidant defense system enzymes have been shown to be altered due to increased gene dosage on chromosome 21 and overproducetion of superoxide dismutase. The purpose of this study was to investigate the activity of glutathione peroxidase enzyme [GPX] and the level of selenium [Se] as indicators of antioxidative metabolism in Down syndrome patients. The study was conducted on forty patients with Down syndrome. They were 21 males and19 females. Their ages ranged between 1 year and 11 years [mean 3.95 +/- 2.5 years]. Another group was randomly chosen as a control group, it included 10 normal infants and children, 5 males and 5 females. Their ages ranged between 1 year and 11 years [mean 3.95 +/- 4.47 years]. All cases and controls were subjected to plasma glutathione peroxidase enzyme assay and plasma selenium level determination. There was a significant increase in GPX activity in Down syndrome patients compared to the control group. There was no statistical significant difference between cases and controls as regards selenium level. In Down syndrome group, there was no significant difference in GPX and selenium levels between males and females and between different age groups. There was a significant negative correlation between GPX activity and Se level in Down syndrome patients. Down syndrome patients have increased activity of glutathione peroxidase enzyme and although they have normal plasma Se level, there is a significant negative correlation between selenium level and GPX activity. This finding suggests that the selenium requirement of the enzyme is not met and there is a relative selenium deficiency

Depression in children and adolescents with insulin dependent diabetes mellitus

This work was designed to study the presence of depressive symptoms and disorder in children with insulin dependent diabetes mellitus and their effect on glycemic control and academic performance. The study included 100 children and adolescents. They were classified into 2 groups: Group 1 included 50 children and adolescents diagnosed as IDDM treated with 2 shots of insulin per day and had no other chronic diseases and group 2 [control group] included 50 age and sex matched healthy children and adolescents. Both groups were subjected to full history taking, thorough clinical examination, socioeconomic standard [SES] estimation using the Hollingshead 2-factor index, the children's depression inventory [CDI] Arabic Version and children with high score were subjected to ICD-10 diagnostic criteria for research. Data on school performance were obtained from school records and mean glycosylated hemoglobin [HbA1c] were calculated for the last year for each child with IDDM. The study concluded that children and adolescents with type I diabetes showed higher levels of depression and depressive symptoms than the healthy controls. The risk factors included adolescence, female sex and family history of psychiatric problems. These risky patients are more liable to non adherence to treatment and diet control. The probability of complication is high and educational deterioration is expected. Early diagnosis and treatment of depression, or even depressed mood, may be helpful in the management of type 1 diabetes