Role of Soluble Adiponectin Receptor 2 in Non-Alcoholic Fatty Liver Disease in Children / 대한소아소화기영양학회지

PURPOSE: The incidence of non-alcoholic fatty liver disease (NAFLD) in children is gradually increasing. The aim of this study was to investigate the use of serum adiponectin and soluble adiponectin receptor 2 (soluble Adipo R2) levels for the diagnosis of fatty liver disease in obese and overweight children. METHODS: The study included 51 obese and overweight children between the ages of 6 and 18 years diagnosed with NAFLD using ultrasonography and 20 children without fatty liver disease. Patients whose alanine transaminase level was two times higher than normal (≥80 U/L) were included in the non-alcoholic steatohepatitis (NASH) group. RESULTS: NASH was observed in 11 (21.6%) of the patients with NAFLD. The incidence of obesity was higher in patients with NASH (80% and 45%, p=0.021). While the adiponectin levels were similar in patients with NAFLD and those without, they were below the normal level in the whole study group. Adiponectin and soluble Adipo R2 levels of patients with NASH were lower than those in patients without NASH; however, this difference was not statistically significant (p=0.064 and p=0.463). Soluble Adipo R2 levels in obese patients with NAFLD were higher than those in obese children without NAFLD (p<0.001). CONCLUSION: Soluble adiponectin receptor 2 level is a noninvasive marker that can be used for the diagnosis of NAFLD in obese children.

Effects of a Glutamine Enema on Anastomotic Healing in an Animal Colon Anastomosis Model

PURPOSE: Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model. METHODS: Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis. RESULTS: Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined. CONCLUSION: Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice.

Bone metabolism and mineral density in patients with beta-thalassemia major

To evaluate bone metabolism in patients with beta-thalassemia major and to determine the factors associated with the development of osteoporosis. We studied 25 patients with thalassemia major with a mean age of 18.4 years [range 5-31] and aged and gender matched 24 healthy controls who were attending the outpatient physical medicine and rehabilitation clinic of Akdeniz University Hospital between January 2004 and March 2004 in Turkey. Bone mineral density [BMD] of lumbar spine [L1-L4] and proximal femur were determined using dual x-ray absorptiometry [DXA]. Venous blood samples were obtained for determination of blood cell count and markers of bone formation and resorption. The BMD values, both at Jumbar and femoral neck levels were significantly lower in patients compared to controls. Serum N- telopeptide level was slightly higher, whereas osteocalcin was slightly lower in patients; however, these values were not statistically significant. Plasma levels of insulin like growth factor-1 [IGF-I] and insulin like growth factor binding protein-3 [IGFBP-3] were significantly lower in patients. Also, serum levels of estradiol and progesterone in females, [uteinizing hormone and follicle-stimulating hormone in both gender were significantly lower in patients. Serum levels of free testosterone and total testosterone were lower in patients, but not statistically significant. Patients also Kad significantly higher serum phosphorus levels and lower serum calcitonin levels compared to controls. The BMD is decreased in thalassemic patients. Growth retardation, growth hormone/ IGF-I/IGFBP-3 axis dysfunction, gonadal dysfunction and hypothalomo-pituitary-gonadal axis dysfunction may be responsible for the development of osteoporosis in the patients with beta-thalassemia major