RESUMO
Abstract Obesity is considered an important global public health challenge, and its prevalence is rapidly increasing in children. We investigated in this study if the upper-normal TSH level may be associated with metabolic syndrome parameters, including obesity, high blood pressure, and dyslipidemia and changes in insulin sensitivity in overweight and obese children. We also investigated whether there is a relationship between BMI and these parameters. This prospective case-control study comprised 145 participants (74 females, 71 males) aged 5-18 years. Participants were divided into three groups according to their BMI z-score, as overweight, obese and control. The control group included 35 age and sex-matched healthy subjects. Thyroid stimulating hormone levels of control, overweight and obese groups were 2.14 ± 1.27, 2.97 ± 1.26 and 3.13 ± 1.11, respectively (p<0.05). There was a significant positive correlation between TSH and the BMI, BMI z-scores between overweight and obese groups (r=0.302, p=0.000), (r=0.121, p=0.004), respectively. The current study suggests that increased serum TSH levels, even within the normal range, in overweight and obese children is associated with the impairment of metabolic parameters, including dyslipidemia and insulin sensitivity. For that reason, TSH levels in the high-normal range should be considered as a risk factor for metabolic syndrome and its components.
Resumen La obesidad se considera un importante desafío de salud pública mundial y su prevalencia está aumentando rápidamente en los niños. En este estudio, se investigó si el nivel normal superior de TSH puede estar asociado con los parámetros del síndrome metabólico, incluida la obesidad, la presión arterial elevada, cambios en los lípidos y la sensibilidad a la insulina, en niños con sobrepeso y obesidad. También investigamos si existe una relación entre el IMC y estos parámetros. En este estudio prospectivo de casos y controles se incluyeron a 145 participantes (74 hembras, 71 varones) de entre 5 y 18 años. Los participantes se dividieron en 3 grupos según el puntaje z del IMC, como sobrepeso, obesidad y control. El grupo de control incluyó 35 sujetos sanos emparejados por edad y sexo. Los niveles de hormona estimulante de la tiroides de los grupos de control, con sobrepeso y obesos fueron 2,14 ± 1,27, 2,97 ± 1,26 y 3,13 ± 1,11, respectivamente (p <0,05). Hubo una correlación positiva significativa entre la TSH y el BMI, la puntuación z del IMC entre los grupos con sobrepeso y obesidad (r = 0,302, p = 0,000), (r = 0,121, p = 0,004), respectivamente. Por esa razón, el nivel de TSH en el rango normal alto debe considerarse como un factor de riesgo del síndrome metabólico y sus componentes.
RESUMO
OBJECTIVE: To show the value of serial endotracheal aspirate culture in predicting organisms causing sepsis in ventilated neonates. METHODS: We studied 100 newborns in Zeynep Kamil Maternity and Children's Training and Research Hospital Neonatal Intensive Care Unit. Endotracheal aspirate and blood cultures were taken first on the third day and then once a week till extubation. RESULTS: Blood and endotracheal cultures showed the same organism only in 17.6% of the patients. There was no relationship among 86.4% of the patients. The rate of culture positivity increased as the birth weight decreased, gestation week got smaller and the duration of intubation prolonged. CONCLUSION: The antibiotherapy arranged according to the endotracheal aspirate cultures is not suitable for a possible sepsis agent. Moreover, resistant organisms may occur in hospitals if the antibiotics used unnecessarily.