Zinc supplementation in infants with asymmetric intra uterine growth retardation; effect on growth, nutritional status and leptin secretion.

OBJECTIVES: To analyse the effect of zinc supplementation in growth and nutritional status of a homogeneous group of newborns with intra uterine growth retardation and asymmetric growth. The effect of changes of zinc status on growth and leptin serum concentrations was also analysed. POPULATION AND METHODS: A double blind, randomised clinical trial was designed in order to detect differences in growth between zinc and placebo groups during the first 6 months of life. 31 infants were included either to the zinc group (n = 14) (38.8+/-1.4 weeks GA, 2,171+/-253 g body weight) or the placebo group (n = 17) (38.9+/-1.1 weeks GA, 2,249+/-220 g body weight). The zinc group received a supplement of 3 mg elemental zinc per day (as zinc sulphate). RESULTS: There were not significant differences between groups for anthropometric measurements through the study period. We found a significant effect of the study group, in hair zinc concentrations, but not in serum zinc concentrations; post-hoc comparisons for hair zinc revealed that there were significant differences between groups at 1, 2, and 6 months of age. Changes in serum and hair zinc concentrations from baseline to 6 months, showed significant correlations with changes in weight/age and length/age z-scores, in the supplement group. Changes in leptin serum concentrations during follow-up, showed significant correlations with changes in sum of 4 skinfolds and weight/age z-score, in the placebo group. Changes in hair zinc concentration through the study period showed significant correlations with changes in leptin serum concentrations from baseline to 6 months of follow-up. CONCLUSIONS: In a homogeneous group of intra uterine growth retardation infants with asymmetric growth, 3 mg/day zinc supplementation do not show significant improvements in weight and length growth. Changes in zinc status were related with changes in weight and length during the first 6 months of life. Changes in leptin serum concentrations were related with changes in the anthropometric indices of body fat accretion.

Skinfold measurements at birth: sex and anthropometric influence.

Weight, length, and skinfold thicknesses were measured in 4634 term and preterm neonates. Sex and weight/length ratio were important determinants of the amount and distribution of the subcutaneous fat store at birth. Gestational age, weight, length, and other ponderal indices did not explain subcutaneous fat variability.

Micro-environmental and socio-demographic determinants of childhood obesity.

AIM: To review the available data in Spain about the socio-demographic and home environmental determinants in children and adolescents. METHOD: Review of the main studies conducted in Spain that have analysed the relationship between overweight and socio-economic and environmental determinants in children and adolescents. RESULTS: In children aged 6-7 y from Aragon (Spain), the socio-demographic determinants of childhood overweight were size of municipality, year of examination, gender, and province; in adolescents aged 13-14 y, the socio-demographic determinants were year of examination, type of school, size of municipality, gender, and province; overweight showed a significant positive main effect with public schools and low municipality size. In a nationally representative sample of Spanish adolescents from 13 to 18.5 y (AVENA Study), there was a significant relationship between overweight and socio-economic status in males but not in females; in males, the lowest overweight prevalences were observed in both extreme socio-economic groups; moreover, overweight prevalences increased when socio-economic status decreased, from the high to the medium-low socio-economic group. The studied variables related with family environment did not show any significant effect in overweight prevalence. CONCLUSION: Better knowledge of the relationship between social class and childhood obesity would lead to clearer hypotheses for the relationship in adults and might improve the preventive measures by identifying children at risk.

[The levels of IgG subclasses in respiratory allergic pathology in the childhood]. / Niveles de subclases de IgG en la patología alérgica respiratoria infantil.

OBJECTIVES: To assess the existence of immunologic alterations, referring to IgG subclasses, in the respiratory allergic pathology in the childhood. MATERIAL AND METHODS: This is a prospective study that compares the IgG subclasses levels in a sample of patient with allergic breathing illness (n = 169) and a group control (n = 130) with ages range from one month to 13 years old. The statistical analysis includes a descriptive statistic and a comparative statistic carrying out comparison of means between both groups with the Welch test and the Student's T test. RESULTS: The mean rate of IgG1 in the group with breathing allergic pathology being of 578,1 mg/dl and in the control group, being of 632,78 mg/dl. The mean rate of IgG2 in the group with breathing allergic pathology being of 106,12 mg/dl and in the control group, being of 142,38 mg/dl. The mean rate of IgG3 in the group with breathing allergic pathology being of 53,73 mg/dl and in the control group, being of 63,78 mg/dl. The children with breathing allergic pathology have significantly decreased IgG1, IgG2, IgG3 levels in comparison to the control group (p < 0.001). The mean rate of IgG4 in the group with breathing allergic pathology being of 25,86 mg/dl and in the control group, being of 13,89 mg/dl. The children with breathing allergic pathology have significantly elevated IgG4 levels in comparison to the control group (p < 0.001). CONCLUSIONS: The findings obtained suggest that an relation exists in the breathing allergic processes with the IgG subclasses levels disturbances and also that there is an alteration of the immune response maturation in relation to subclasses IgG1, IgG2, IgG3. The valuation of the levels of these immunoglobulins can be useful in the pathogenic diagnosis of the allergic processes.

Determinants of resting energy expenditure in obese and non-obese children and adolescents.

Resting energy expenditure (REE) is the largest component of total daily energy expenditure. Objectives of this study were to examine whether differences in REE exist after obesity develops in a group of children and adolescents, and to determine the effects of body composition, gender, age, pubertal development and parental obesity on REE. In 116 Caucasian children and adolescents (57 obese and 59 non-obese), aged 7.8 to 16.6 years, REE was assessed by open-circuit indirect calorimetry and different anthropometric variables and bioelectrical impedance were obtained (weight, height, skinfold thicknesses, waist and hip circumferences). Anthropometric indices and body compartments were calculated: the body mass index, surface area (SA), fat-free mass (FFM), fat-mass (FM) and percentage of FM. Differences between obese and non-obese subjects were tested and stepwise multiple regression analysis was performed with REE as dependent variable. Results show that REE was significantly higher in obese than in non-obese children and adolescents but REE/FFM ratio was not significantly different between these groups. In the non-obese group, FFM explained 73.1% of the variability in REE and gender, age and SA added 3.8%, 2.6%, and 2.6% to it, respectively. In the obese group, FFM was also the most powerful predictor of REE with 72.3%, followed by waist circumference and age with 2.5% and 2.1%, respectively. These results show that REE differences between obese and lean children do not seem to justify the maintenance of obesity. The main determinant of REE is FFM in both groups. No significant contribution of FM, pubertal development or parental obesity in REE was found in children and adolescents.

Changes in body composition during the initial hours of life in breast-fed healthy term newborns.

Newborns usually lose 5-10% of their initial weight during the first 4 days of life. Our aim, using bioelectrical impedance (BI), was to study the body composition of healthy term newborns and the nature of the changes which accompany this physiological weight loss. Forty-three healthy term newborns, all with adequate weight for their gestational age, were studied during the first 3 days of life. Weight and BI were taken on the 1st, 2nd, and 3rd days of life, always at the same time of the day. Total body water (TBW), percentage of total body mass hydration (%TBW), and amount of body solids were calculated. Average weight at birth was 3,297+/-381 g, length 50.04+/-1.75 cm, and gestational age 39.9+/-0.84 weeks. Weight, TBW, and body solids decreased progressively during the first 3 days of life (p<0.000). By day 3, weight loss represented 5.67+/-1.98% of birth weight, but %TBW increased slightly (1.72%; p<0.000). These results suggest that, during physiological weight loss, body composition modifications are produced in the term newborn by a decrease in TBW and loss of body solids. The level of body hydration increases slightly, since the loss of body solids is greater than the loss of TBW. The use of BI can help us in the study of body composition and the short- and/or long-term changes produced therein, in the newborn.

[Brachial measurements as nutritional indicators in health term newborns]. / Medidas braquiales en recién nacidos término sanos como índices nutricionales.

OBJECTIVE: Our objective was to study the correlations between weight and length and weight index and brachial areas in healthy term newborns as indicators of nutritional status. PATIENTS AND METHODS: We studied 794 consecutive Caucasian newborns, 377 male and 417 females, with gestational ages of 39 +/- 09 weeks and adequate weights. We measured weight, length, weight/length index, body mass index and weight index. Measurements of the arm perimeter and tricipital skinfold were used to calculate the fatty, lean and total areas by two different methods. Mean, standard deviation and percentiles were utilized in the measurements. The Student's t-test was used to calculate differences and Pearson's test for correlations. RESULTS: We found that weight, length and weight/length indexes were higher in males than in females, except for the weight index. Brachial areas and parameter were higher in females, except for the lean area. We did not find significant differences between gender in brachial measurements calculated by the different methods. Among the males, we found a high degree of correlation between weight and the weight/length index (r = 0.963; p < 0.0001), and weight and total body area (r = 0.649; p < 0.0001). Similar data were obtained among females, where in addition a high correlation was found between the fat percentage and the body mass index (BMI, r = 0.223; p < 0.0001), as well as between brachial areas and BMI in both genders (p < 0.0001). CONCLUSIONS: In normal newborns, the brachial areas, taken as indicators of body composition, are statistically significantly correlated with the anthropometric parameters widely used to measure the nutritional status of newborns.

[IgG subclasses: placental transfer in the full-term neonate and their evolution during the first 3 months of life]. / Subclases de IgG: paso trasplacentario en el recién nacido término y su evolución en los tres primeros meses de vida.

The authors studied the placental transfer of IgG subclasses in 43 newborns (NB) and their mothers. All the observations included low-risk pregnancies and full-term deliveries. The values expressed in arithmetric mean +/- standard deviation (means +/- SD), and referred in mg %, showed the following results: maternal Ig Gtotal 1,183 +/- 237 versus (vs.) NBG 1,179 +/- 187; maternal Ig G1 792 +/- 230 vs. NB 822 +/- 124; maternal Ig G2 138 +/- 77 vs. NB 209 +/- 70; maternal Ig G3 48 +/- 33 vs. NB 95 +/- 30, and maternal Ig G4 10 +/- 8 vs. NB 4.9 +/- 2. The relation between the average levels of maternal and cord serum was 1, 1.5, 1.9 and 0.48 for Ig G1, Ig G2, Ig G3 and Ig G4, respectively. It was also proved a maximum decrease in the levels of the subclasses in the first three months for the Ig G3, a percentage being noticed in the third month, in relation to the NB level, of 18, 29, 1.9 and 19% for Ig G1, Ig G2, Ig G3 and Ig G4, respectively. After primovaccination, a response was produced and it affected the 4 subclasses: Ig G1 845 mg %, Ig G2 229 mg %, Ig G3 38 mg % and Ig G4 7.44 mg %, with an increment in relation to prevaccination values of 5.5, 3.7, 20.7 and 12.4, respectively. The authors concluded by showing reference patterns in the active placental transfer of Ig G subclasses in normal full-term newborns.

Congenital hemihypertrophy.

We present an isolated complete left hemihypertrophy in a girl with follow-up data from birth up to the age of 5 months.

[Feeding and growth during the first year of life]. / Alimentación y crecimiento durante el primer año de vida.

345 infants (179 boys and 166 girls) have been studied during the first year of life. The social, economic and education characteristics correspond with III category of Graffar. Breast-feeding in 80 per 100% of the cases was the initial feeding. Beikost was introduced in the 5th month +/- 8 days. The increasing weight is higher in the children fed with adapted formula that those who had made it through breast-feeding, with statistical differences (p less than 0.01) in boys and girls between the third and fifth month. Girls also showed gaining in weight with significant differences between the fifth and seventh month (p less than 0.05). According to the comparative study carried out in the twelfth month those boys fed with adapted formula show higher values of the sum of the skinfold thickness and fat percentage (p less than 0.05), than those who were breast-fed for a period of live months or more; the rest of analyzed parameters (weight, length, body mass, Roher or K index) do not show any significant differences in the study carried out in both groups of infants in the first year of life.

[Urticaria pigmentosa]. / Urticaria pigmentosa.

The authors present three cases of urticaria pigmentosa (UP), one with a very early beginning and two with a late beginning. The clinical symptoms orient the diagnosis of the three cases in relation to maculopapular exanthema of a dark pink color, brown macules and, in all cases, the presence of Darier's sign. As normal, the clinical diagnosis was confirmed by the histopathological examination of the skin. The evolution of the three patients was favorable in all cases, with the disappearance of symptoms in one case. In the other two cases the process is stabilized, and at no time have systemic manifestations been found. The relative rareness of UP in infancy, an expression of a proliferation of the reticuloendothelial system (RES) on a mast cell level with different evolutional possibilities, has been the justifying factor in the presentation of these new cases.

[Insulin receptors in intrauterine growth retardation]. / Receptores de insulina en los retrasos de crecimiento intrauterinos.

This report analyses erythrocyte insulin binding and specific erythrocyte insulin receptors in the neonatal period. Authors have studied thirty normal newborns who had an adequate weight for their gestational age and another fifteen who were asymmetric intrauterine retarded growth. Cord blood samples were collected and insulin binding, insulin receptors, blood glucose concentration, serum immunoreactive insulin, serum C-peptide concentration and molar ratio of C-peptide to insulin were determined. Insulin and C-peptide sera concentrations suggest that basal insulin secretion in small for data newborns is similar to term infants. Significantly minor affinity constant (p = 0.05) and significantly major dissociation constant (p = 0.05) in small for date infants versus newborns adequately weighted for their gestational age, justify the increased sensitivity to insulin as it happens in other states of chronic undernutrition. In small for date infants, number of sites per cell correlates negatively (r = -0.57, p less than 0.05) with birth weight. Up regulation mechanism that modulates receptors concentration could explain this phenomenon.