Study of some biochemical and genetic markers in childhood simple obesity

This study was done to investigate the role of serum insulin, serum leptin, plasma adiponectin and lipoprotein lipase [LPL] Hind Ill gene polymorphism in childhood simple obesity for the development of group of disorders known as metabolic cardiovascular syndrome [MCS] which consists of an increased risk of hypertension, adverse lipid profile and early atherosclerotic lesions. This study was carried out on 20 children [6 boys and 14 girls] with simple obesity the diagnosis of simple obesity was based on the presence of body mass index [BMI] > 95[th] percentile with the exclusion of secondary obesity, their age was 8.2 +/- 2.28 years. Another 20 normal healthy children of matched age and sex served as a control group. All the studied groups were subjected to full clinical examination, anthropometric measurements, and estimation of blood glucose, lipid profile, serum insulin, serum leptin, plasma adiponectin as well as DNA analysis for detection of LPL Hind Ill gene polymorphism. Children with simple obesity showed significant increases in BMI, both systolic and diastolic blood pressure [SBP and DBP], serum triglycerides [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-c], serum insulin and serum leptin levels. On the other hand they showed significant decreases in high-density lipoprotein cholesterol [HDL-c] and plasma adiponectin levels. Adverse lipid profile [high TG and low HDL-c], and/or elevated blood pressure were positively correlated with serum insulin and serum leptin but negatively correlated with plasma adiponectin. There was no significant difference in Hind Ill LPL gene frequency between obese children and control group. Adverse lipid profile and hyperinsulinemia were associated with LPL Hind Ill polymorphism. This association was highest with [+/+] genotype, intermediate with [ +/- ] genotype and lowest with [-/-] genotype. In conclusion: hyperinsulinemia, hypeileptinemia, hypoadiponectinemia and the [H+] allele of the LPL Hind Ill polymorphism are closely correlated with the adverse lipid profile and/or elevated blood pressure in children with simple obesity that are regarded as cardiovascular risk factors for adulthood atherosclerosis which may necessitate an early periodic monitoring of blood pressure and metabolic status as well as the future application of the promising therapeutic ability of adiponectin to increase insulin sensitivity in conjunction with its anti-inflammatory and anti-atherogenic properties

Cardiac troponin-T as a diagnostic marker in children with rheumatic carditis

Rheumatic carditis is the most serious major manifestation of acute rheumatic fever in children. Cardiac Troponin-T [cTnT] is established as a new specific marker of myocardial damage or injury. The present work was carried out to study the value of cTnT as a diagnostic marker of myocardial injury in children with rheumatic carditis, and to compare it to established parameters of myocardial injury such as creatine kinase [CK] and its MB isoenzyme. Forty-five children with acute rheumatic fever were enrolled in the study; classified into 3 groups: group [A]: 15 children with rheumatic carditis without cardiomegaly, group [B]: 15 children with rheumatic carditis and cardiomegaly and group [C]: 15 children with other rheumatic presentations. Fifteen normal healthy children were enrolled as a control group. All children included in the study were subjected to diagnostic laboratory and radiological investigations, including serum total CK, CK-MB isoenzyme% [using electrophoresis] and cTnT [by immunoassay test]. Our results showed significant elevation of cTnT, total CK and CK-MB isoenzyme in children with rheumatic carditis [groups A and B], as compared to the control group [P < 0.05]. These values were significantly higher in group [B] children [with cardiomegaly], as compared to group [A] children [P<0.05]. Also, the ideal cut-off point for cTnT was found to be 0.1 micro g/L with a sensitivity 100%, while the sensitivity for CK-MB was 86.7% and that for total CK was 53.3%.we conclude that cardiac troponin-T [cTnT] can be used as a diagnostic marker of myocardial injury in children with rheumatic carditis, with a higher sensitivity than CK and its MB isoenzyme