Inflammatory cytokine profile and circulating cortisol levels in malnourished children with necrotizing ulcerative gingivitis.

Necrotizing ulcerative gingivitis (NUG), a periodontal disease traditionally associated with stressful lifestyles in young adults in developed countries, is very prevalent in socioeconomically deprived Nigerian children. Random incident cases (153) of NUG, along with their neighborhood village counterparts of comparable age and without NUG, as control, were recruited for this study. Anthropometric evaluation revealed widespread malnutrition and poor health in both groups of children, with more severe stunting in NUG cases. The poor nutritional status of the village children, with and without NUG, was also confirmed by markedly reduced levels of circulating micronutrients. Compared with the neighborhood children, NUG victims showed significant (p < 0.05 or < 0.001) increases in serum levels of interleukin (IL)-8 (+ 233%), IL-18 (+ 30%), IL-6 (+ 190%), IL-1beta (+ 341%), IL-10 (+ 186%), with a small decrease in interferon (IFN)-gamma (-19%) and nonsignificant increases in soluble tumor necrosis factor (TNF) receptors (sTNFR-p55, p75). Associated with NUG was a significant, 38% (p < 0.05) increase in plasma cortisol above the already high levels observed in the neighborhood village children, as well as some micronutrient deficiencies. The findings suggest that NUG is associated with dysregulated cytokine production, with a complex interplay of elevated levels of pro- and anti-inflammatory mediators. Such changes may serve as the common link between the seemingly unrelated risk conditions (e.g. stressful life styles, smoking, microbial infections, diabetes, malnutrition, alcoholism) traditionally implicated in the genesis of NUG, and all known to promote an increase in the blood level of cortisol, as well as a Th(1) to Th(2) cytokine shift.

Anthropometric finding in Nigerian children with sickle cell disease.

PURPOSE: Sickle cell disease (SCD) subjects have been widely reported to present with various anthropometric deficits, including malocclusion and stunting, compared to their unaffected peers. This study was carried out to examine these reports in Lagos. METHODS: A hospital-based cross-sectional study was carried out in 3 outpatient SCD units of one teaching and two general hospitals. All established SCD subjects aged 1 to 18 years (n = 177) were examined on consecutive clinic days. Controls (unaffected subjects; n = 122) were obtained from well-baby and surgical emergency clinics. Facial profile, occlusion, height, weight, head and mid-upper arm (MUA) circumference measurements were noted. RESULTS: A prognathic maxillary profile was found to be more prevalent in SCD subjects (21%) than controls (4%; P < .05). Class II malocclusion was found in 21% of SCD subjects compared to 2% of controls (P < .05). The overall mean height, weight and head circumference of SCD subjects and controls were not significantly different (P > .05). However, at age 18 years, the weight of the SCD group was significantly less than that of the control group (P < .05). The mean MUA circumference was significantly higher in the control group (20.04 cm +/- 3.80) than in SCD subjects (17.91 cm +/- 2.96; P < .05). CONCLUSIONS: There was a higher prevalence of maxillary protrusion. and Class II malocclusion in SCD subjects than controls. Height and weight were not significantly different in both groups except at 18 years when SCD subjects weighed less than controls.