Effect of acute exercise on 12,13-dihydroxy-9Z-octadecenoic acid (12,13-diHOME) levels in obese male adolescents.

OBJECTIVE: 12,13-Dihydroxy-9Z-octadecenoic acid (12,13-diHOME) is a lipokine secreted from brown adipose tissue, and it has positive effects on dyslipidemia. Acute exercise has been shown to lead to an increase in its secretion. In this study, it was aimed to investigate the relationship of 12,13-diHOME with obesity, exercise and dyslipidaemia for the first time in the adolescent age group. DESIGN: Prospective study. PATIENTS: Twenty-eight male adolescents with obesity and the same number of age-matched healthy normal-weight male controls. MEASUREMENTS: Fasting serum glucose, insulin, lipid and 12,13-diHOME levels were measured. Cardiopulmonary exercise testing was performed in all subjects using a stress test treadmill. Peak oxygen consumption (peak VO2) and anaerobic threshold heart rate (ATHR) were measured. RESULTS: Adolescents with obesity had lower 12,13-diHOME levels than normal-weight adolescents both before and after acute exercise (p = .025 and p = .019, respectively), and after acute exercise, 12,13-diHOME levels significantly increased in both groups (p = .001 for both). 12,13-diHOME levels negatively correlated with triglyceride, total cholesterol, LDL-C, and positively correlated with HDL-C. Also, peak VO2 and ATHR levels showed positive correlation with 12,13-diHOME levels. CONCLUSION: 12,13-diHOME levels were found to be lower in adolescents with obesity than normal-weight adolescents and increased with acute exercise. Also, the close relationship of this molecule with dyslipidaemia in addition to that with obesity suggests that it has an important role in the pathophysiology of these disorders. Further molecular studies will further elucidate the role of 12,13-diHOME in obesity and dyslipidaemia.

Mercury intoxication resembling pediatric rheumatic diseases: case series and literature review.

Mercury is the only metal that remains in liquid form at the room temperature. It is a very toxic metal and even short-term exposure can lead to poisoning. Mercury intoxication can affect many systems such as skin, cardiovascular, genitourinary, central and peripheral nervous, respiratory, and musculoskeletal system. Consequently, the diagnosis of mercury intoxication can be challenging due to its non-specific and multisystemic presentation. Herein, we report five pediatric cases with mercury intoxication from two families that were initially misdiagnosed as rheumatic disorders. We also performed a literature review about pediatric cases with mercury intoxication to investigate the clinical findings in children, the source of intoxication, and the current treatment preferences. As in our cases, reported patients were previously misdiagnosed as various infectious and/or rheumatic diseases before the diagnosis of mercury intoxication was established. A delay in diagnosis and treatment can cause serious morbidities and even mortality. We report this case series to emphasize the multisystemic presentation of mercury intoxication, and to remind and provide clues for physicians to recognize this rare toxicologic syndrome.