Albuminuria and low bone mineral density in paediatric patients with type 1 diabetes.

AIM: To evaluate glycaemic control and its influence on albuminuria and bone mineral density (BMD) in children and adolescents with type 1 diabetes (T1D). METHODS: We collectively assessed 84 T1D children/adolescents (T1D group), aged between 6 and 17 years, and then divided them into two groups according to their glycaemic profile (T1D with good glycaemic control (T1DG group) and T1D with poor glycaemic control (T1DP group)). Serum glucose, glycated haemoglobin, serum urea, serum creatinine, urinary albumin-to-creatinine ratio (ACR), estimated glomerular filtration rate and BMD levels were assessed. RESULTS: Of the patients studied, 77% presented with poor glycaemic control. Patients with T1DP showed an increased ACR (P < 0.001) and a low BMD (P = 0.025) when compared to the T1DG group. In addition, five patients in the T1DP group presented with concomitant albuminuria and a low BMD for their chronological age. Significant negative correlations were identified between the ACR and glycated haemoglobin (r = 0.655, P < 0.001), BMD and glycated haemoglobin (r = -0.262, P = 0.047) and BMD and the ACR (r = -0.631, P = <0.001). In linear regression analysis, the ACR showed a negative effect on BMD (P = 0.044) in the T1D patient group. CONCLUSION: Poor glycaemic control was correlated with albuminuria, suggestive of a negative effect on bone tissue, leading to a low BMD in children and adolescents with T1D.

RADIOACTIVE DISEQUILIBRIUM AND DYNAMIC OF NATURAL RADIONUCLIDES IN SOILS IN THE STATE OF PERNAMBUCO-BRAZIL.

Environmental radioactivity studies have been allowed establishing radiometric patterns in several area of the earth's crust. The work was conducted through radiometric analyses of regions with high levels of radionuclides and others with no history of anomalies. The research allowed establishing the radiometric profile of soils in the state of Pernambuco, Brazil, using a gamma spectrometry system. The specific activities ranged from 16.5 to 287.5 Bq kg-1 for 238U, 2.0 to 191.7 Bq kg-1 for 226Ra, 1.3 to 281.4 Bq kg-1 for 232Th and from 5.0 to 2600.9 Bq kg-1 for 40K. The results showed areas with low levels of ionizing radiation. However, for 40K some points presented high values, although non-representative of the number of samples investigated. The 226Ra/238U and 232Th/238U ratios allowed to determine the radioactive imbalance condition and to obtain information about aspects of soil availability providing an assessment of the dynamics of these radionuclides.

Influence of terrestrial radionuclides on environmental gamma exposure in a uranium deposit in Paraíba, Brazil.

One of the main natural uranium deposits in Brazil is located in the municipality of Espinharas, in the State of Paraíba. This area may present high levels of natural radioactivity due to the presence of these radionuclides. Since this is a populated area, there is need for a radioecological dosimetry assessment to investigate the possible risks to the population. Based on this problem, the objective of this study was to estimate the environmental effective dose outdoors in inhabited areas influenced by the uranium deposit, using the specific activities of equivalent uranium, equivalent thorium and 40K and conversion factors. The environmental assessment was carried using gamma spectroscopy in sixty-two points within the municipality, with a high-resolution gamma spectrometer with HPGe semiconductor detector and Be window. The results obtained ranged from 0.01 to 19.11 mSv y-1, with an average of 2.64 mSv y-1. These levels are, on average, 23 times higher than UNSCEAR reference levels and up to 273 times the reference value of the earth's crust for primordial radionuclides. Therefore, given the high radioactivity levels found, we conclude that there is need for further investigation to evaluate the levels of radioactivity in indoor environments, which will reflect more closely the risks of the local population.

Relationship between glycemic control and OPG gene polymorphisms with lower bone mineral density in patients with type 1 Diabetes mellitus

ABSTRACT The aim of the present study was to investigate the bone mineral density (BMD) of patients with type 1 Diabetes mellitus (T1DM). We also assessed the association between osteoprotegerin (OPG) genetic polymorphisms and BMD. Genotyping was performed for 1181G>C and 163A>G OPG polymorphisms by allelic discrimination in 119 patients with T1DM and 161 normoglycemic (NG) individuals, aged 6 to 20 years old. Glycemic control, serum parameters of bone metabolism and BMD were evaluated. T1DM patients showed low BMD, poor glycemic control and decreased total calcium values when compared to controls (p < 0.05). For all the polymorphisms studied, the genotype and allele frequencies in patients with T1DM were not significantly different from the controls. In patients with T1DM, carriers of OPG 1181CC showed higher concentrations of ionized calcium compared to patients with GG+GC genotypes. These results suggest that low BMD is associated with poor glycemic control in T1DM. Despite the lack of a detected association between OPG polymorphisms and BMD in these patients, the increased ionized calcium in those carrying OPG 1181CC suggests a possible increase in osteoclastogenesis, a conclusion that may be supported by the lower BMD observed in these subjects.

Low bone mineral density is associated to poor glycemic control and increased OPG expression in children and adolescents with type 1 diabetes.

AIMS: To investigate early alterations on bone mineral density (BMD) and RANK, RANKL and OPG mRNA expression in peripheral blood leukocytes (PBL) in children and adolescents with type 1 diabetes (T1D) and the relationship with glycemic control and bone biomarkers. METHODS: This cross-sectional study included 75 children and adolescents with T1D and 100 individuals without diabetes (normoglycemic-NG) aged 6-20 years old. T1D individuals were considered to have good (T1DG) or poor (T1DP) glycemic control according to the values of HbA1c. Phosphorus, magnesium, total and ionized calcium, osteocalcin, alkaline phosphatase and tartaric-resistant acid phosphatase (TRAP) values were determined in blood samples. BMD was measured by DEXA. RANK, RANKL and OPG mRNA expression was measured in PBL by real-time PCR. RESULTS: Osteocalcin values were decreased in diabetic groups in comparison to NG group (p<0.05), and a negative correlation with both serum glucose (r=-0.265, p<0.01) and Hb1Ac (r=-0.252, p<0.01) in T1D group was found. BMD was lower in diabetic groups in comparison with NG group (p<0.05) and a negative correlation was observed between BMD and both serum glucose (r=-0.357, p<0.01) and HbA1c (r=-0.351, p<0.01) in T1D group. OPG mRNA expression was significantly increased in T1D and T1DP groups in comparison with NG group (p<0.05). In conclusion, children and adolescents with early onset T1D presented low bone mineral density associated to unsatisfactory glycemic control, increased OPG mRNA expression and low osteocalcin concentration.

Rhinocerebral zygomycosis in a diabetic patient.

Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.

Rhinocerebral zygomycosis in a diabetic patient / Zigomicose rinocerebral em paciente diabética

Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.

Zigomicose rinocerebral é a forma mais frequente das infecções fúngicas causadas por membros da classe Zygomicetes. É relatado um caso fatal de zigomicose rinocerebral por Rhizopus (oryzae) arrhizus com diagnóstico histopatológico e micológico, em paciente diabética.