A study on the association between vitamin D status and ultrasonic bone mineral density among children / 预防医学

Objective To evaluate vitamin D nutritional status and its relationship with ultrasonic bone mineral density among children in Wenzhou City.Methods Overnight fasting venous blood samples of 546 children were collected to measure the concentration of serum 25 -hydroxyvitamin D (25 (OH)D),and bone mineral density was measured.Results The average concentration of serum 25 (OH)D was 25. 42 ±0. 590 ng/mL,25. 09% of participants were found with sufficient vitamin D,the rate of severe deficiency,deficiency and insufficiency were 1. 47%,32. 60% and 40. 84%respectively.The concentration of 25 (OH)D in different age groups was statistically significantly different (P<0. 01 ). Vitamin D nutritional status of the older groups was poor than that of the younger ones.In the group of children aged 7 to 1 1 and 11 to 14,the levels of 25(OH)D of boy was significantly higher than that of girl.Compared to those with sufficient vitamin D,children with vitamin D deficiency or insufficiency had lower bone mineral density(BMD)(P<0. 05 ).The level of 25(OH)D was correlated with BMD (r=0. 197,P<0. 01).After adjusted age and BMI,there was still a positive correlation between 25(OH)D level and BMD (r=0. 115,P<0. 01).Conclusions The vitamin D level of children in Wenzhou area is low.The level of serum 25 (OH)D may be related to BMD .More attention should be paid to the supplementation of vitamin D.

Effects of gonadotropin releasing hormone analog and growth hormone on height in girls with idiopathic central precocious puberty / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To determine the effect of gonadotropin releasing hormone agonist (GnRHa), by itself alone or in combination with recombinant human growth hormone (rhGH), on height in young girls (bone age≥10 years) with idiopathic central precocious puberty (ICPP).</p><p><b>METHODS</b>Eighty girls with ICPP (9.0±0.7 years old) from six medical centers across Southeast and Southwest China participated in this study. They were allocated to treatment with GnRHa+rhGH (n=31) and GnRHa (n=49) respectively. Girls in the GnRHa+rhGH group (bone age 11.18 ±0.53 years) were treated with GnRHa for 25.29±6.92 months and rhGH for 12.87±7.02 months. Girls in the GnRHa group (bone age 11.03 ±0.50 years) were treated with GnRHa for 25.96±8.95 months. The height standard deviation for bone age (HtSDS-BA), predicted adult height, near-adult height and net height increase before and after treatment were recorded for girls in both groups.</p><p><b>RESULTS</b>HtSDS-BA was significantly improved after treatment for both groups (P<0.01) and the HtSDS-BA value was superior in the GnRHa+rhGH group over the GnRHa group (P<0.01). Values in near adult height (157±6 cm vs 157±4 cm), net height increase after treatment (4.68 cm vs 3.89 cm), and predicted adult height after drug withdrawal (161±5 cm vs 158±5 cm) were higher in the GnRHa+rhGH group than the GnRHa group, but the differences were not significant.</p><p><b>CONCLUSIONS</b>Both GnRHa plus rhGH and GnRHa alone can improve the near adult height in girls with ICPP with a bone age ≥10 years to a similar extent. Adult height predicted based on bone age in ICPP girls following drug withdrawal is usually overestimated and precautions should be taken when this parameter is used.</p>

Analysis of hepatitis B surface antibody in 3022 children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the positive rate of hepatitis B surface antibody (HBsAb) in children.</p><p><b>METHODS</b>Blood samples from 3022 children who received a physical examination in outpatient departments from 2009 to 2011 were subjected to serological test using ELISA to measure the positive rate of HBsAb.</p><p><b>RESULTS</b>The positive rate of HBsAb decreased with age (P<0.01). There was no significant difference in the positive rate of HBsAb between boys and girls (P>0.05), however the positive rate of HBsAb in boys aged one year and over was lower than in girls of the same age (P<0.01). The positive rate of HBsAb in boys aged between 3 and 4 years was higher than in girls of the same age (P<0.01). The positive rate of HBsAb decreased with age in boys, and was lower in those aged two years and over than in those aged one year and over (P<0.01). The positive rate of HBsAb also decreased with age in girls, with significant differences between different age groups (P<0.01).</p><p><b>CONCLUSIONS</b>The positive rate of HBsAb decreases with age in children, so younger children have a higher risk of infection with hepatitis B virus. Serological monitoring of hepatitis B needs to be enhanced.</p>

Effects of obstructive sleep apnea hypopnea syndrome in children on multiple systems / 中华儿科杂志

<p><b>OBJECTIVE</b>Obstructive sleep apnea-hypopnea syndrome (OSAHS) may cause serious morbidities, such as systemic hypertension, diabetes, and cor pulmonale. However, currently no many reports on study of OSAHS in children are available. This study aimed to explore the effects of OSAHS on children's multiple systems.</p><p><b>METHOD</b>A total of 89 cases of children who came to the Sleep Treatment Center in the authors' hospital from March 2009 to December 2010 with snoring were tested with overnight polysomnography (PSG). They were classified into mild OSAHS group (n = 59, mean age of 5.71, SD = 2.46) and moderate to severe group (n = 30, mean age of 5.30, SD = 2.73) based on the PSG results, and 100 healthy children were selected as the control group (n = 100, mean age of 6 years, SD = 2.98). Data including height, weight, body mass index and blood pressure, peripheral blood routine, blood lipids, glucose and insulin, electrocardiogram and echocardiography were collected. Patients' adenoid face and abnormal occlusion were also recorded. Comparisons of the data were made among those groups.</p><p><b>RESULT</b>Mild OSAHS and moderate to severe group had significantly higher prevalence of adenoid face (23.7%, 26.7%), and abnormal occlusion (74.6%, 60.0%) than that in control group (0, 40%) (P < 0.05). There were no significant differences in terms of BMI between the OSAHS group and the control group, but the weight (kg) and height (cm) in the mild OSAHS group (23.3 ± 10.1, 114.9 ± 16.2) and moderate to severe group (21.9 ± 8.4, 110.8 ± 13.3) were lower than those of the control group (31.8 ± 10.1, 136.1 ± 15.1) (all P < 0.05). Compared with the control group, the level of HDL-C (mmol/L)and insulin (mU/L) in moderate and severe group decreased [(1.20 ± 0.30) vs. (1.40 ± 0.27), 2.79 (0.84 - 16.16) vs. 4.92 (0.76 - 16.80), P < 0.05], while the LDL-C (mmol/L) increased [(2.61 ± 0.75) vs. (2.32 ± 0.62), P < 0.05]. The red blood cell counts (× 10(12)/L) and the blood platelet counts (× 10(9)/L) in the mild OSAHS (4.93 ± 0.37, 292.92 ± 75.64) and moderate and severe OSAHS group (5.23 ± 0.22, 292.50 ± 63.05) were significantly higher in contrast to the control group (4.70 ± 0.31, 255.60 ± 69.12) (all P < 0.05), systolic blood pressure (mmHg) in mild group (98.54 ± 10.44) and moderate to severe group (99.13 ± 19.13) was significantly higher compared to control group (87.88 ± 11.37), and the heart rate (beats/min) in moderate to severe group (94.43 ± 10.64) was higher than those in control group (87.12 ± 16.20) (all P < 0.05). The mild OSAHS and moderate and severe OSAHS group had decreased right ventricular internal diameter [(14.24 ± 1.64) mm, (13.17 ± 2.07) mm ], increased main pulmonary artery diameter [(17.05 ± 3.33) mm, (16.33 ± 3.14) mm] and the thickness of right ventricular wall [(3.43 ± 0.26) mm, (3.57 ± 0.20) mm] compared to control group [ (16.10 ± 2.96) mm, (14.11 ± 2.52) mm, (3.32 ± 0.25) mm] (all P < 0.05).</p><p><b>CONCLUSION</b>OSAHS in children may be associated with craniofacial malformations, and may contribute to slow growth and development, elevated blood viscosity and blood pressure, metabolic abnormalities, and change cardiac structure.</p>

Relationship between dyslipidemia and early vascular lesions in obese children and adolescents / 中华儿科杂志

<p><b>OBJECTIVE</b>Obese children and adolescents are often complicated with the abnormalities of lipid and glucose metabolism, which are often associated with adulthood hypertension, diabetes and cardiovascular disease. In this study, the blood lipids, blood pressure and carotid arterial intima-media thickness (IMT) in obese children and adolescents were measured to investigate the relationship between the dyslipidemia and early vascular lesions.</p><p><b>METHOD</b>A total of 580 obese children and adolescents aged from 7 to 17 years of age were enrolled from 3 hospitals from Jan. 2008 to Sept. 2009. They were divided into 2 groups according to their blood lipoid levels. Ortholiposis group included 100 males and 52 females with a mean age of 10.47 years and a mean body mass index (BMI) of 28.28 kg/m(2). Dyslipidemia group included 305 males and 123 females with a mean age of 10.83 years and a mean BMI of 27.60 kg/m(2). Physical examination, and measurement of blood lipid, glucose and liver enzyme were taken. Carotid IMT was measured for 285 subjects.</p><p><b>RESULT</b>(1) Hypertension was found in 12.5% (19/152) and 20.1% (86/428) patients in ortholiposis and dyslipidemia groups, respectively, with a significant difference (χ(2) = 4.362, P = 0.037). The OR was 1.760 with 95% confidence interval of 1.030 - 3.008. Higher prevalence of hypertension was found in patients with dyslipidemia. (2) The left, right and mean common carotid IMTs of dyslipidemia group were higher than those of ortholiposis group without significant difference (all P > 0.05). The left, right and mean internal carotid IMTs in dyslipidemia group were (0.66 ± 0.15) mm, (0.65 ± 0.15) mm and (0.65 ± 0.15) mm, respectively while these in ortholiposis group were (0.62 ± 0.13) mm, (0.60 ± 0.13) mm and (0.61 ± 0.12) mm, respectively (P < 0.05 for all). (3) Bivariate correlation analysis showed that systolic blood pressure was positively correlated with age, BMI, BMI Z score, waist circumference, hip circumference, uric acid, alanine transaminase, triglyceride, fasting insulin and insulin resistance index (P < 0.05 for all). Moreover, mean carotid and internal carotid IMTs were positively correlated with age, BMI, waist circumference, hip circumference, and triglyceride (all P < 0.05). Multiple linear regression analysis showed that hip circumference and insulin resistance index were independent determinants of systolic pressure. Waist circumference was independent determinant of mean common and internal carotid IMT and triglyceride was independent determinants of mean internal carotid IMT.</p><p><b>CONCLUSION</b>(1) Vascular lesions, including hypertension and thicker tunica intima are common in obese children and adolescents. (2) Vascular lesions are closely related with dyslipidemia, and waist circumference and hypertriglyceridemia are the risk factors.</p>