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1.
iScience ; 27(7): 110325, 2024 Jul 19.
Article in English | MEDLINE | ID: mdl-39055941

ABSTRACT

The study explores the long-term effects of necrotizing enterocolitis (NEC) on gut microbiota in preterm infants by analyzing stool samples from 5-year-old children using shotgun metagenomic sequencing. It compares children with a history of NEC, treated surgically or medically, to preterm controls without NEC. Findings reveal persistent gut microbiota dysbiosis in NEC children, with reduced species diversity and evenness, especially in those treated surgically. The surgical NEC group had a lower Shannon index, indicating less microbial diversity. Significant differences in taxonomic profiles were observed, mainly influenced by surgical treatment. These results underscore the lasting impact of NEC and its treatment on gut microbiota, suggesting a need for strategies addressing long-term dysbiosis.

2.
Sci Rep ; 13(1): 11634, 2023 07 19.
Article in English | MEDLINE | ID: mdl-37468555

ABSTRACT

MicroRNAs (miRNAs) are short non-coding RNAs that are involved in post-transcriptional control of gene expression and might be used as biomarkers for diabetes-related complications. The aim of this case-control study was to explore potential differences in circulating miRNAs in young individuals with long-duration type 1 diabetes (T1D) compared to healthy controls, and how identified miRNAs are expressed across different tissues. Twelve adolescents, age 15.0-17.9 years, with T1D duration of more than 8 years (mean 11.1 years), were enrolled from the Swedish diabetes quality registry. An age-matched control group was recruited. Circulating miRNAs (n = 187) were analyzed by quantitative PCR. We observed that 27 miRNAs were upregulated and one was downregulated in T1D. Six of these miRNAs were tissue-enriched (blood cells, gastrointestinal, nerve, and thyroid tissues). Six miRNAs with the largest difference in plasma, five up-regulated (hsa-miR-101-3p, hsa-miR-135a-5p, hsa-miR-143-3p, hsa-miR-223-3p and hsa-miR-410-3p (novel for T1D)) and one down-regulated (hsa-miR-495-3p), with P-values below 0.01, were selected for further in-silico analyses. AKT1, VEGFA and IGF-1 were identified as common targets. In conclusion, 28 of the investigated miRNAs were differently regulated in long-duration T1D in comparison with controls. Several associations with cancer were found for the six miRNAs with the largest difference in plasma.


Subject(s)
Circulating MicroRNA , Diabetes Mellitus, Type 1 , MicroRNAs , Humans , Adolescent , Circulating MicroRNA/genetics , Diabetes Mellitus, Type 1/genetics , Case-Control Studies , MicroRNAs/genetics , Gene Expression Regulation
3.
Pediatr Res ; 93(4): 924-931, 2023 03.
Article in English | MEDLINE | ID: mdl-35974161

ABSTRACT

BACKGROUND: Necrotizing enterocolitis (NEC) affects the intestine of preterm infants. Preterm infants risk inadequate bone mineralization. This risk may increase if the intestinal uptake of minerals is affected after NEC. METHODS: This is a study of growth, bone mineral density (BMD), bone mineral content (BMC), and body composition at 5 years of age among Swedish children born before gestational week 37 + 0 with a history of NEC, minimum stage IIA, compared to matched controls. Fifty children, 25 NEC cases and 25 controls, were examined with dual energy X-ray absorptiometry (DXA) and DXA with laser. RESULTS: The NEC cases had lower weight, -1.3 SDS vs -0.7 SDS, a lower fat mass and fat percent, 23.4 vs 29.1%, compared to the controls. NEC cases had lower BMC total body head excluded, 355.6 g vs 416.7 g. BMD Z-scores were lower among NEC cases in total body head excluded, -0.7 vs -0.1, and in lumbar spine. CONCLUSIONS: Preterm NEC survivors at 5 years of age had reduced growth, an altered body composition, and indications of a lower bone mass compared to matched controls. The study suggests that preterm infants diagnosed with NEC need special attention during childhood regarding growth and bone health. IMPACT: A follow-up longitudinal study of growth, bone health, and body composition at 5 years of age among children born preterm with a history of NEC compared to matched controls. The NEC cases had lower weight than controls. NEC cases had an altered body composition with lower fat mass compared to controls. The DXA results showed that the NEC cases had lower bone mineral content and a tendency to lower bone mineral density. The study suggests that preterm infants diagnosed with NEC need special attention at follow-up regarding growth and bone health compared to preterm infants without NEC.


Subject(s)
Enterocolitis, Necrotizing , Infant, Newborn, Diseases , Infant , Child , Female , Infant, Newborn , Humans , Child, Preschool , Bone Density , Infant, Premature , Longitudinal Studies , Body Composition
4.
J Bone Miner Metab ; 40(6): 974-989, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35960382

ABSTRACT

INTRODUCTION: Anorexia nervosa (AN) increases the risk of impaired bone health, low areal bone mineral density (aBMD), and subsequent fractures. This prospective study investigated the long-term effects of bone and mineral metabolism on bone and biomarkers in 22 women with AN. MATERIALS AND METHODS: Body composition and aBMD were measured by dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography. Total and free 25-hydroxyvitamin D (25OHD), C-terminal collagen cross-links (CTX), osteocalcin, bone-specific alkaline phosphatase (BALP), leptin, sclerostin, and oxidized/non-oxidized parathyroid hormone (PTH) were analyzed before and after 12 weeks of intensive nutrition therapy and again 3 years later. An age-matched comparison group of 17 healthy women was recruited for the 3-year follow-up. RESULTS: Body mass index (BMI) and fat mass increased from baseline to 3 years in women with AN. Sclerostin decreased during nutrition therapy and further over 3 years, indicating reduced bone loss. CTX was elevated at baseline and after 12 weeks but decreased over 3 years. BALP increased during nutrition therapy and stabilized over 3 years. Free 25OHD was stable during treatment but decreased over 3 years. Non-oxidized PTH was stable during treatment but increased over 3 years. Trabecular volumetric BMD in AN patients decreased during the first 12 weeks and over 3 years despite stable BMI and bone biomarkers implying increased BMD. CONCLUSION: Our findings highlight the importance of early detection and organized long-term follow-up of bone health in young women with a history of AN.


Subject(s)
Anorexia Nervosa , Bone Density , Humans , Female , Follow-Up Studies , Prospective Studies , Absorptiometry, Photon , Parathyroid Hormone , Biomarkers , Alkaline Phosphatase
6.
Acta Paediatr ; 111(9): 1722-1728, 2022 09.
Article in English | MEDLINE | ID: mdl-35490381

ABSTRACT

AIM: To determine whether adolescents born before 28 gestational weeks have an increased risk for renal impairment. METHODS: Swedish infants, born before 28 gestational weeks in 2001 and 2002, were identified from a local register. A total of 16 children, 12 females and 4 males, were examined at 16-17 years of age with 51 Cr-EDTA clearance. A comparison group (n = 26) was used. RESULTS: Most study participants (n = 13) had normal blood pressure; one individual had hypertension stage 1. All study participants had results within the reference interval for ionised calcium, parathyroid hormone, intact fibroblast growth factor-23 and for urinary albumin-to-creatinine ratio. Four out of 16 participants (25%) had a 51 Cr-EDTA clearance less than 90 ml/min/1.73 m2 , indicating a reduced kidney function. Measured 51 Cr-EDTA clearance values were significantly lower in the study group than in the comparison group (p = 0.0012). Five study participants (31%) were referred for further investigations. CONCLUSION: Swedish children born before 28 gestational weeks have an increased risk of renal impairment later in life, suggesting that the kidney function in these individuals should be assessed, at least once, during adolescence.


Subject(s)
Parturition , Adolescent , Blood Pressure/physiology , Child , Edetic Acid , Female , Gestational Age , Humans , Infant , Infant, Newborn , Kidney Function Tests , Male , Pregnancy , Sweden/epidemiology
7.
J Am Nutr Assoc ; 41(6): 594-599, 2022 08.
Article in English | MEDLINE | ID: mdl-34283000

ABSTRACT

OBJECTIVE: The aim of this prospective study was to investigate the potential influence of the fat mass and obesity-associated gene (FTO), SNP rs9939609, on body mass index (BMI) and body composition in women with anorexia nervosa (AN) undergoing intensive nutrition therapy. METHOD: Twenty-five female patients with AN (20.1 ± 2.3 years; BMI, 15.5 ± 0.9 kg/m2) were included for 12 weeks of treatment with a high-energy diet. FTO was genotyped and body composition parameters were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography at baseline and after 12 weeks. RESULTS: The distribution of the different FTO genotypes were as follows: AA, 24%; TA, 48%; and TT, 28%. Patients gained a median of 9.8 kg (range, 5.5-17.0 kg) and BMI increased to 19.0 ± 0.9 kg/m2. The increase in BMI, fat mass, and the quotient fat/muscle area was significant for the TT and TA genotype groups. Total lean mass was stable in all genotype groups. We could not demonstrate any difference among the 3 FTO genotypes related to the increases in BMI during nutrition therapy when the additive, dominant, and recessive models of inheritance were applied. CONCLUSIONS: Irrespective of the FTO genotype, there was no difference in weight response during nutrition therapy. Hence, in this small study there was limited support for individualized nutrition therapy for AN based on FTO genotype.


Subject(s)
Anorexia Nervosa , Nutrition Therapy , Alpha-Ketoglutarate-Dependent Dioxygenase FTO/genetics , Anorexia Nervosa/genetics , Body Composition/genetics , Female , Humans , Polymorphism, Single Nucleotide/genetics , Prospective Studies , Sweden
8.
Clin Nutr ; 40(10): 5391-5398, 2021 10.
Article in English | MEDLINE | ID: mdl-34563763

ABSTRACT

BACKGROUND & AIMS: Patients with anorexia nervosa (AN) restrict their dietary intake leading to malnutrition. Information is scarce on nutrition status during recovery. The aim of the study was to investigate dietary intake, body composition, biochemistry, and status in young women three years after hospital treatment due to severe restrictive AN. METHODS: Dietary intake from four-day food records were compared to a reference group and the Nordic Nutrition Recommendations. Body composition was assessed by dual-energy X-ray absorptiometry (DXA). Serum levels of vitamin A, E, D, folate, and ferritin were assessed. RESULTS: Three years after hospital treatment for AN, 12 subjects (60%) were recovered or in partial remission from AN. Subnormal values of body fat and skeletal muscle mass were present in 30% and 25%. Energy intake was 1730 kcal/day (min-max 705-2441) or 33 kcal/kg/day (16-54). Most (80%) had a total energy intake/day below the estimated needs and 6 (32%) had energy intakes below 1550 kcal/day. Micronutrient intakes from food were low; 16 (85%) had intakes below recommendations of iron, folate, and vitamin D. Serum levels of vitamins A, E, D, and folate were on average adequate; but a subnormal value (<50 nmol/L) of vitamin D was found in 20%. Ferritin levels were significantly lower at follow-up, and 25% had values below reference range. Return of menstruation was dependent of energy intake and body fat. CONCLUSIONS: A regular and careful assessment of nutritional status along with nutritional counseling during recovery is recommended to reduce malnutrition in patients with AN.


Subject(s)
Anorexia Nervosa/therapy , Body Composition , Diet , Energy Intake , Micronutrients/administration & dosage , Nutritional Status , Adult , Body Weight , Cohort Studies , Diet Records , Female , Follow-Up Studies , Humans , Micronutrients/blood , Nutritional Requirements , Recovery of Function , Sample Size , Young Adult
9.
Sci Rep ; 10(1): 22367, 2020 12 22.
Article in English | MEDLINE | ID: mdl-33353965

ABSTRACT

To investigate bone health and body composition in young women with long-duration type 1 diabetes (T1D) in relation to matched controls. Twenty-three Swedish women, age 19.2-27.9 years, with a T1D duration of 10 years or more were recruited from the Swedish National Diabetes Registry (NDR). An age-, gender- and geography-matched control group was recruited. Bone mass and body composition were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Data was retrieved from the NDR and SWEDIABKIDS registries. T1D individuals had a mean diabetes duration of 19 years. T1D individuals had reduced lean mass (40.0 ± 6.1 kg vs. 43.9 ± 4.9 kg) and were shorter (1.66 ± 0.06 m vs. 1.71 ± 0.06 m) although comparable BMI. Subjects with T1D had lower muscle area (P = 0.0045). No differences were observed for fractures; physical activity; total, lumbar spine or femur areal bone mineral density. The cortical bone strength strain index was lower for TD1 patients (1875 ± 399 mm3 vs. 2277 ± 332 mm3). In conclusion, young women with long-term diabetes duration showed reduced cortical bone strength, decreased periosteal circumference, endosteal circumference and altered body composition. These factors contribute to the health burden of TD1, which warrants further attention for advancing bone health in women with T1D.


Subject(s)
Body Weight , Bone Density , Cortical Bone , Diabetes Mellitus, Type 1 , Registries , Absorptiometry, Photon , Adult , Cortical Bone/diagnostic imaging , Cortical Bone/metabolism , Diabetes Mellitus, Type 1/diagnostic imaging , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 1/physiopathology , Female , Humans , Superior Sagittal Sinus , Sweden
10.
Curr Osteoporos Rep ; 18(5): 471-479, 2020 10.
Article in English | MEDLINE | ID: mdl-32696294

ABSTRACT

PURPOSE OF REVIEW: To summarize the last 10 years of literature regarding the effects of whole-body vibration (WBV) on bone in children, and if WBV results in increased bone acquisition. RECENT FINDINGS: WBV intervention appears to be a safe intervention with beneficial effects on bone mass in some diseases and syndromes, but there is still low evidence for WBV in clinical practice. The positive effects on muscle strength, balance, and walking speed are more conclusive. One of the takeaways of this review is that well-trained individuals may not further improve bone mass with WBV; thus, interventions are more beneficial in pediatric individuals with Down syndrome or severe motor disabilities with low bone mass and reduced activity levels. WBV appears to be a safe non-pharmacological anabolic approach to increase bone mass in some pediatric populations; however, longer (> 6 months) and larger prospective studies are needed to elucidate the efficacy of WBV on bone health in young individuals.


Subject(s)
Cerebral Palsy/rehabilitation , Muscular Dystrophy, Duchenne/rehabilitation , Osteogenesis Imperfecta/therapy , Osteoporosis/prevention & control , Osteoporotic Fractures/prevention & control , Sedentary Behavior , Vibration/therapeutic use , Child , Exercise , Humans , Muscle Strength , Osteogenesis , Osteoporosis/therapy
11.
Eat Weight Disord ; 25(5): 1387-1397, 2020 Oct.
Article in English | MEDLINE | ID: mdl-31531762

ABSTRACT

AIM: Tartrate-resistant acid phosphatase (TRAP) exists as isoforms 5a and 5b. TRAP 5a is a biomarker of chronic inflammation and influences adipose tissue and 5b associates with bone metabolism/pathologies. The aim was to investigate the association of serum TRAP 5a/5b isoforms with fat and bone markers and anthropometric parameters in patients with anorexia nervosa (AN) during weight gain therapy. METHODS: Twenty-five Swedish female AN patients, age 16-24 years, were treated for 12 weeks with a high-energy diet with six meals daily. Serum TRAP 5a/5b, markers of fat/glucose metabolism, markers of bone resorption and formation were measured. Parameters of bone and body composition were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. RESULTS: BMI increased from median 15.4 kg/m2 to 19.0 kg/m2, p < 0.0001. TRAP 5a and 5a/5b ratio increased but TRAP 5b decreased during the study. TRAP Δ5a and Δ5b correlated with Δinsulin and Δadiponectin, respectively. TRAP 5b correlated with trabecular density at start but not at week 12. At 12 weeks, TRAP 5b correlated with CTX, and Δ decrease in TRAP 5b correlated to Δ increase in bone-specific alkaline phosphatase. CONCLUSIONS: This clinical interventional study resulted in increased BMI in patients with AN. The decreased TRAP 5b protein levels confirm a role for TRAP 5b as a marker of bone resorption, whereas increased TRAP 5a seemed to derive from systemic changes in bone as well as metabolic changes. The combined detection of TRAP 5a and TRAP 5b in serum could be an indicator of improved bone metabolism. LEVEL OF EVIDENCE: Level III, prospective interventional cohort study.


Subject(s)
Anorexia Nervosa , Tartrate-Resistant Acid Phosphatase/blood , Weight Gain , Adolescent , Adult , Anorexia Nervosa/therapy , Biomarkers , Cohort Studies , Female , Humans , Isoenzymes , Prospective Studies , Young Adult
12.
J Clin Densitom ; 22(4): 567-589, 2019.
Article in English | MEDLINE | ID: mdl-31421951

ABSTRACT

Dual-energy X-ray absorptiometry (DXA) is widely used in the evaluation of bone fragility in children. Previous recommendations emphasized total body less head and lumbar spine DXA scans for clinical bone health assessment. However, these scan sites may not be possible or optimal for all groups of children with conditions that threaten bone health. The utility of DXA scans of the proximal femur, forearm, and radius were evaluated for adequacy of reference data, precision, ability of predict fracture, and applicability to all, or select groups of children. In addition, the strengths and limitations of vertebral fracture assessment by DXA were evaluated. The new Pediatric Positions provide guidelines on the use of these additional measures in the assessment of skeletal health in children.


Subject(s)
Absorptiometry, Photon/standards , Bone Density , Femur/diagnostic imaging , Forearm/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Osteoporosis/diagnosis , Spinal Fractures/diagnosis , Child , Consensus Development Conferences as Topic , Humans , Osteoporosis/complications , Spinal Fractures/etiology
13.
Pediatr Res ; 86(1): 100-106, 2019 07.
Article in English | MEDLINE | ID: mdl-30970375

ABSTRACT

BACKGROUND: The aim was to clarify whether children born preterm with a history of necrotizing enterocolitis (NEC) had an increased risk of rickets, fractures, and/or vitamin D deficiency during childhood and adolescence compared to controls without NEC, matched for gestational age. METHODS: All infants born in Sweden between 1987 and 2009 with a gestational age <32 + 0 weeks and a diagnosis of NEC were identified. Totally, 465 children with a history of NEC and 2127 controls were included. International Classification of Diseases codes for all categories of fractures, rickets, vitamin D deficiency, and malnutrition were analyzed. RESULTS: In total, 94 of the 465 children with NEC died within 28 days. Of the 2127 controls, 288 died within 28 days. Among the remaining 371 NEC cases, 39 fracture occasions were identified. The 1839 controls had 204 fracture occasions. There was no significant difference in fractures. Rickets was diagnosed in 11 (3%) of the children with a history of NEC compared to 21 (1%) of the controls (odds ratio 2.65, 95% CI 1.26-5.53, p = 0.007). CONCLUSIONS: This study showed an increased risk of rickets but not fractures during childhood and adolescence in children born preterm and with a history of NEC, compared to matched controls.


Subject(s)
Enterocolitis, Necrotizing/complications , Fractures, Bone/epidemiology , Rickets/epidemiology , Vitamin D Deficiency/epidemiology , Adolescent , Case-Control Studies , Child , Female , Follow-Up Studies , Fractures, Bone/complications , Gestational Age , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases , Longitudinal Studies , Male , Malnutrition , Odds Ratio , Proportional Hazards Models , Registries , Rickets/complications , Risk Factors , Sweden/epidemiology , Vitamin D Deficiency/complications
14.
Acta Paediatr ; 108(3): 502-513, 2019 03.
Article in English | MEDLINE | ID: mdl-30071142

ABSTRACT

AIM: New strategies are required to increase physical activity and improve metabolic profiles in children with obesity. We studied the effect of whole body vibration (WBV) on children with obesity on biochemical markers of energy and bone metabolism, anthropometric measurements, muscle parameters and calcaneal bone mineral density (BMD). METHODS: This was a randomised, prospective, controlled study of 30 children with a median age of 13 years (range 7-17) at Queen Silvia Children's Hospital, Gothenburg, Sweden, from 2013 to 2015. The target for the intervention group was to perform WBV three times a week for 12 weeks, and the study parameters were assessed at baseline and 12 weeks. RESULTS: The 16 in the WBV group achieved 51% of the planned activity, mainly at home, and were compared with 14 controls. Sclerostin, bone-specific alkaline phosphatase and carboxy-terminal collagen cross-links decreased in the WBV group (p < 0.05) and balance improved (p < 0.006), but osteocalcin and insulin remained unchanged. Anthropometric data, muscle strength and calcaneal BMD did not differ between the groups. CONCLUSION: WBV did not affect most of the clinical parameters in children with obesity, but the reduction in sclerostin implies that it had direct effects on osteocytes, which are key players in bone mechanotransduction.


Subject(s)
Adaptor Proteins, Signal Transducing/blood , Pediatric Obesity/therapy , Vibration/therapeutic use , Adolescent , Anthropometry , Blood Pressure , Bone and Bones/metabolism , Child , Female , Humans , Lipid Metabolism , Male , Muscle Strength , Pediatric Obesity/blood , Prospective Studies
15.
Bone ; 116: 144-153, 2018 11.
Article in English | MEDLINE | ID: mdl-30071306

ABSTRACT

OBJECTIVE: Growth hormone (GH) regulates both longitudinal growth and bone acquisition in children, and has profound metabolic effects. The aim was to investigate the association between proteomic biomarkers, body fat, nutrition and bone formation markers, and longitudinal growth in response to GH during the first year of treatment. The degree to which changes in these factors could explain variations in GH-dependent longitudinal growth and bone mineralization was also assessed. METHODS: The individualized GH dose trial included 128 short prepubertal children with either normal (non-GH-deficient) or reduced levels of GH secretion (GH-deficient) (mean age ±â€¯SD, 8.6 ±â€¯2.6 years; 90 boys), i.e., with a broad range of GH-secretion and GH-responsiveness, receiving GH treatment (mean 43 µg/kg/day). Blood samples were taken and dual-energy X-ray absorptiometry (DXA) measured at baseline and 1 year of treatment. Step-wise multiple regression models were constructed including three steps with different independent variables added at each step to explain the variance in outcome variables (heightSDS, bone mineral content (BMC) and bone mineral density (BMD). Independent variables included in Step I were previously identified proteomic markers related to GH treatment response, bone formation markers (intact PINP, bone-specific alkaline phosphatase and osteocalcin), variables at treatment start (GH dose mU/kg/day, GH maximum secretion, and difference between child's current and mid-parental heightSDS). Step II explored the added influence of body composition data (body mass index or DXA). Step III explored the added influence of serum nutritional markers and hormones. RESULTS: Step I variables explained 71% of the variation in first year heightSDS gain, median (minimum-maximum) 0.8 (0.24-1.67); and the proportion explained rose to 73% following inclusion of step II variables and 75% following step III. Corresponding values for total body BMC were 58%, 78%, and 80%, respectively. Proportions fell by approximately 20% when BMC was adjusted for height; 33%, 57%, and 57% for steps I, II, and III, respectively. Corresponding values for total body BMD were 29%, 39%, and 45%, respectively. CONCLUSION: For total BMC, as much as 80% of the variation during the first year of GH treatment could be explained by proteomic biomarkers, body fat, nutrition and bone formation markers, whereas for height-adjusted BMC 57% could be explained. The inclusion of information about either body composition (fat/lean mass) or nutritional markers contributed with approximately 20%. The variation in heightSDS gain could be explained to 75%. Hence, information of fat or nutrition markers was needed for explaining the variation in bone acquisition to the same magnitude as explaining the variation in height response.


Subject(s)
Biomarkers/blood , Body Composition/drug effects , Bone and Bones/drug effects , Human Growth Hormone/pharmacology , Nutritional Status/drug effects , Osteogenesis/drug effects , Proteomics , Body Height/drug effects , Bone Density/drug effects , Child , Female , Humans , Male , Regression Analysis
16.
Pediatr Transplant ; : e13253, 2018 Jul 11.
Article in English | MEDLINE | ID: mdl-29992675

ABSTRACT

This prospective study investigated growth and skeletal development for 3 years after kidney transplantation in pediatric patients, 3.4-15.0 years of age. Growth, BMD, bone resorption markers (CTX and TRACP5b), bone formation markers (PINP, ALP, and osteocalcin), PTH, and vitamin D were assessed at start, 3, 12, and 36 months after transplantation. Median GFR was 63 (range 37-96) mL/min/1.73 m2 after 3 years. The median height SDS increased from -1.7 to -1.1, and median BMI SDS increased from -0.1 to 0.6 over 3 years, which shows that transplantation had a favorable outcome on growth. Fat mass increased after transplantation at all time points, whereas lean mass increased after 1 year and 3 years. Total BMC increased at all time points. No changes were observed for total BMD. Bone resorption markers decreased initially after 3 months and remained stable throughout the study, whereas the bone formation markers decreased initially, but successively increased over the study period. In conclusion, this study demonstrates that height SDS and BMI SDS increased, along with the increased formation markers that reveal a positive bone acquisition after kidney transplantation, which was reflected by the significant increase in total body BMC.

17.
Acta Paediatr ; 106(7): 1097-1102, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28349558

ABSTRACT

AIM: This study investigated space-time clustering of neonatal necrotising enterocolitis over three decades. METHODS: Space-time clustering analyses objects that are grouped by a specific place and time. The Knox test and Kulldorff's scan statistic were used to analyse space-time clusters in 808 children diagnosed with necrotising enterocolitis in a national cohort of 2 389 681 children born between 1987 and 2009 in Sweden. The municipality the mother lived in and the delivery hospital defined closeness in space and the time between when the cases were born - seven, 14 and 21 days - defined closeness in time. RESULTS: The Knox test showed no indication of space-time clustering at the residential level, but clear indications at the hospital level in all the time windows: seven days (p = 0.026), 14 days (p = 0.010) and 21 days (p = 0.004). Significant clustering at the hospital level was found during 1987-1997, but not during 1998-2009. Kulldorff's scan statistic found seven significant clusters at the hospital level. CONCLUSION: Space-time clustering was found at the hospital but not residential level, suggesting a contagious environmental effect after delivery, but not in the prenatal period. The decrease in clustering over time may reflect improved routines to minimise the risk of contagion between patients receiving neonatal care.


Subject(s)
Enterocolitis, Necrotizing/epidemiology , Cohort Studies , Female , Humans , Infant, Newborn , Infant, Premature , Male , Sweden/epidemiology
18.
Eur J Nutr ; 56(6): 2061-2067, 2017 Sep.
Article in English | MEDLINE | ID: mdl-27307256

ABSTRACT

PURPOSE: Anorexia nervosa (AN) is associated with reduced bone mass and an increased fracture risk. The aim was to evaluate the vitamin D status and the association with body mass index (BMI), fat mass and bone mineral density (BMD) in patients with severe AN during a prospective intervention study of intensive nutrition therapy. METHODS: This study comprised 25 Swedish female AN patients (20.1 ± 2.3 years), who were treated as inpatients for 12 weeks with a high-energy diet. Serum 25-hydroxyvitamin D (25(OH)D), calcium, phosphate and parathyroid hormone (PTH) were measured. BMD and body composition were assessed by dual-energy X-ray absorptiometry at study start and after 12 weeks. RESULTS: Twenty-two patients completed the study. The mean weight gain was 9.9 kg and BMI (mean ± SD) increased from 15.5 ± 0.9 to 19.0 ± 0.9 kg/m2, P < 0.0001. Fat mass increased from median 12 to 27 %. The median serum 25(OH)D level was 84 nmol/L at baseline, which decreased to 76 nmol/L, P < 0.05. PTH increased from median 21.9 to 30.0 ng/L, P < 0.0001. BMC increased during the study period, P < 0.001. CONCLUSIONS: Serum 25(OH)D levels were adequate both at study start and completion, however, nominally decreased after the 12-week nutritional intervention. PTH increased subsequently, which coincide with the decreased 25(OH)D levels. The reduction in 25(OH)D could be due to an increased storage of vitamin D related to the increase in fat mass since vitamin D is sequestered in adipose tissue.


Subject(s)
Anorexia Nervosa/blood , Anorexia Nervosa/diet therapy , Vitamin D/administration & dosage , Vitamin D/blood , Weight Gain , Absorptiometry, Photon , Adolescent , Body Composition , Body Mass Index , Bone Density , Calcium/blood , Diet , Female , Humans , Parathyroid Hormone/blood , Phosphates/blood , Prevalence , Prospective Studies , Sweden , Vitamin D Deficiency/blood , White People , Young Adult
19.
Eat Behav ; 21: 172-8, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26970731

ABSTRACT

OBJECTIVE: To describe an intensive nutrition therapy for hospitalized adolescents and young adults with anorexia nervosa (AN) in terms of body weight, body composition, energy balance and food related anxiety. METHOD: Twenty-six young females, 16-24years of age, with AN were invited to participate at admission to a specialized eating disorder unit in Göteborg, Sweden. Intensive nutrition therapy comprised 12weeks on a structured meal plan. Six meals were served daily, in combination with high-energy liquid nutritional supplements from start. Energy and nutrient intakes, energy expenditure, body composition and food related anxiety were measured during the study. A 3-month follow-up of body weight and food related anxiety was conducted. RESULTS: Twenty-one patients participated. The total daily energy intake was, during the first week of treatment, (mean±SD) 3264±196kcal (74kcal/kg), and decreased gradually during treatment to 2622±331kcal (49kcal/kg). Total daily energy expenditure was initially 1568±149kcal and increased gradually to 2034±194kcal. Patients gained on average 9.8±2.1kg and body mass index increased from 15.5±0.9 to 19.0±0.9kg/m(2). Body fat increased from 13±6% to 26±6%. Fat free mass remained unchanged, but skeletal muscle mass increased from 16.7±2.0 to 17.6±2.4kg, p=0.009. Patients' food related anxiety decreased significantly during treatment and was still unchanged 3months later. CONCLUSION: The presented intensive nutrition therapy with initially high energy and nutrient intakes produced substantial weight gain, increased fat and muscle mass and decreased food related anxiety in AN patients, without any clinical side effects.


Subject(s)
Adolescent, Hospitalized , Anorexia Nervosa/therapy , Nutrition Therapy , Adipose Tissue , Adolescent , Anorexia Nervosa/psychology , Anxiety/therapy , Body Composition , Body Mass Index , Body Weight , Dietary Supplements , Energy Intake , Energy Metabolism , Female , Food , Humans , Meals , Sweden , Weight Gain , Young Adult
20.
Bone ; 84: 230-236, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26772621

ABSTRACT

OBJECTIVE: Osteocalcin (OC), an aboundant non-collagenous bone protein, is inversely associated with parameters of glucose metabolism. Interactions between bone tissue and energy metabolism have not been thoroughly investigated during childhood. This study investigated OC, metabolic parameters and anthropometric characteristics in normal weight and overweight/obese children. METHODS: This study comprised 108 (46 normal weight/62 overweight/obese) Swedish 2-9year old children. Anthropometric data, insulin, glucose, glycosylated haemoglobin (HbA1c), HOMA index, vitamin D, adiponectin, total OC, carboxylated OC (cOC) and undercarboxylated OC (ucOC) were analysed. RESULTS: No difference was found for total OC between the normal and overweight/obese groups, with a mean (±SD) value of 82.6 (±2.8) ng/mL and 77.0 (±2.4) ng/mL, (P=0.11), respectively. Overweight children had lower cOC levels, mean 69.1 (±2.2) ng/mL, vs. normal weight children, mean 75.6 (±2.5) ng/mL (P=0.03). The mean ucOC levels of 7.9 (±0.4) ng/mL in overweight children did not differ vs. normal weight children, mean level 7.0 (±0.4) ng/mL, (P=0.067). None of the three OC forms correlated with any of the measured parameters. CONCLUSIONS: The cOC levels were lower in overweight children. There was no correlation between the three OC forms and any of the measured anthropometric or metabolic parameters. OC has been suggested to have a possible metabolic role, but in general the current study in prepubertal children does not support the hypothesis of an association between OC and a positive metabolic profile.


Subject(s)
Anthropometry , Metabolic Syndrome/metabolism , Osteocalcin/metabolism , Biomarkers/metabolism , Child , Child, Preschool , Cohort Studies , Female , Humans , Male , Metabolic Syndrome/blood , Osteocalcin/blood , Protein Isoforms/blood , Statistics, Nonparametric , Sweden
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