Subject(s)
Estrogen Replacement Therapy , Menopause , Humans , Female , Follicle Stimulating Hormone , Hormone Replacement TherapyABSTRACT
OBJECTIVE: Although transient hyperphosphatasemia (TH) has been well known for decades, its etiology and pathophysiology remain unclear. We aimed to study the clinical characteristics of children diagnosed with TH compared to older studies in order to expand our knowledge and understanding of this condition and to try and find a subgroup of children who are more prone to develop TH. METHODS: We retrospectively studied 60 children diagnosed at Maccabi Health Services and Bnai Zion Medical Center, Haifa, Israel with TH between the years 2003-08. One hundred and twenty-two children matched by age, gender and presenting symptoms served as the control group. The patients were divided into four subgroups by their presenting symptoms: infectious disease 33%, failure to thrive 28%, diarrhea 15% and other 23%. The Hydragel 7 ISO-PAL and Hydragel 15 ISO-PAL kits were used for the identification and quantification of ALP isoenzymes in human serum. RESULTS: The ALP levels of the study group were 805-8619 U\L (mean 2311 U\L), without differences between the subgroups. The mean duration of TH was 12 weeks. ALP isoenzymes levels were measured in one-third of the patients, and showed that the bone isoenzyme was elevated in most. Forty-three (71%) subjects were diagnosed in the second half of the calendar year. CONCLUSIONS: We could not establish an etiological explanation for TH. We presume that it is a complex mechanism in which different stimuli led to upregulation of the enzyme.
Subject(s)
Alkaline Phosphatase/blood , Isoenzymes/blood , Age Factors , Asthma/diagnosis , Asthma/enzymology , Bacterial Infections/diagnosis , Bacterial Infections/enzymology , Child, Preschool , Developmental Disabilities/diagnosis , Developmental Disabilities/enzymology , Diarrhea, Infantile/diagnosis , Diarrhea, Infantile/enzymology , Failure to Thrive/diagnosis , Failure to Thrive/enzymology , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/enzymology , Female , Humans , Infant , Male , Reagent Kits, Diagnostic , Reference Values , Retrospective Studies , Risk Factors , Seasons , Sex Factors , Virus Diseases/diagnosis , Virus Diseases/enzymology , gamma-Glutamyltransferase/bloodABSTRACT
BACKGROUND: A paradoxical plasma HDL-Cholesterol (HDL-C) reducing effect following combined fibrate and thiazolidinediones (TZDs) therapy was recently reported in occasional cases. As HDL-C level is inversely related to cardiovascular disease (CVD) risk, we have studied the incidence of reduced HDL-C level following mono- and combined therapy with these drugs in a large diabetic population. METHODS: This study was designed as a retrospective 5-year study. Lipid profile records of 54 000 diabetic patients were searched for transient reduction of HDL-C to levels lower than 17 mg/dL, which was correlated with fibrates and/or TZD treatment. RESULTS: Transient reduction in plasma HDL-C to values lower than 17 mg/dL was observed in 0.02% (2/11 175) of the patients treated with fibrates alone, none of the rosiglitazone-treated patients (0/3213) and in 1.39% (9/649) of patients treated with combination of fibrate and TZD. HDL-C lowering effect was reversible upon stopping either fibrate or rosiglitazone and in some patients it occurred within 2 weeks. In two of the patients, the effect was dose-dependent. CONCLUSION: Severe reduction in plasma HDL-C is not rare when TZD and fibrates are co-administrated to diabetic hyperlipidemic patients. As low plasma HDL cholesterol is a risk factor for CVD, the physician should be alert to this phenomenon.
