Relationship between metabolic parameters and thyroid hormones and the level of gastric peptides in children with autoimmune thyroid diseases.

Overweight and diseases connected with it are increasing problems in children and adults. We often observe change of weight in thyroid disease. It is emphasized that changes in hormones such as peptide levels are in close relationship with regulation of body mass: ghrelin increases appetite and in effect increases body mass, but obestatin decreases appetite and weight. The aim of the study was to analyze the relationship between lipid-carbohydrate metabolism parameters and thyroid hormones and the level of gastric peptides (ghrelin and obestatin) in young patients with Graves' disease, Hashimoto's thyroiditis and in children with simple goiter. The study group formed 78 patients suffering from Graves' disease (29 girls and 2 boys; aged from 6 to 21 - mean 15,2 yrs) and Hashimoto's thyroiditis (29 girls and 3 boys; aged from 9 to 18--mean 14.5 yrs). The control group consisted of children with simple goiter--13 girls and 2 boys; aged from 9 to 18 --mean 14.8 yrs. In all patients, ghrelin and obestatin levels were analyzed by the RIA method (Phoenix Pharmaceuticals, USA). In children and adolescents with untreated Graves' disease we found higher levels of insulin and HOMA-IR index compared to the group of children with simple goiter (34 +/- 8 microIU/mL vs 15 +/- 5; p < 0.03; 7.3 +/- 1.2 vs 3 +/- 0.3, p < 0.03). No significant correlations were observed of gastric hormones with antithyroid antibodies, lipids or h-CRP in patients with untreated hyperthyroidism and subclinical hypothyroidism. Positive correlation was noted of insulin and glucose levels and HOMA-IR index with ghrelin level in children with newly diagnosed Graves' disease (r = 0.109, p < 0.045; r = 0.176, p < 0.036; r = 0.174, p < 0.037). The correlation was also positive between obestatin level and HOMA-IR index in children with subclinical hypothyroidism in the course of Hashimoto's thyroiditis (r = 0.497, p < 0.011). We also examined the relationship between BMI, thyroid hormones and the level of gastric peptides. In untreated GD patients, ghrelin level exhibited a significant negative correlation with fT3 and fT4 (r = -0.38, p < 0.041; r = -0.459, p < 0.012) and positive with TSH (r = 0.38, p < 0.041) and BMI (r = 0.8, p < 0.01). In conclusion, we suggest that the disturbances in carbohydrate parameters in thyroid diseases have an essential effect on change of hormone-controlled appetite: ghrelin (in hyperthyroidism) and obestatin (in Subclinical hypothyroidism).

Serum concentration of adiponectin, leptin and resistin in obese children with non-alcoholic fatty liver disease.

PURPOSE: Obesity, insulin resistance and dyslipidemia are the most significant risk factors of non-alcoholic fatty liver disease (NAFLD) but the role of adipokines in patomechanism of this disease is not clear. The aim of the study was to evaluate the serum levels of leptin, adiponectin and resistin in obese children with NAFLD. MATERIAL/METHODS: The fasting serum levels of adipokines were determined in 44 consecutive obese children with suspected liver disease and in 24 lean controls. The degree of the ultrasound liver steatosis was graded according to Saverymuttu. RESULTS: The fatty liver was confirmed in 33 children by ultrasonography (16 of them also showed an increased ALT activity). The serum leptin level was significantly higher and adiponectin level was lower in the obese children with NAFLD when compared to controls. Only adiponectin correlated with homeostasis model assessment of insulin resistance (HOMA-IR). Significant negative correlations were found between the ultrasonographic grades of liver steatosis and adiponectin and resistin levels. Serum adiponectin and resistin levels were lower in children with an advanced liver steatosis (grade 3, n=10) compared to patients with a mild steatosis (grade 1-2, n=23). The ability of serum adiponectin and resistin to differentiate children with an advanced liver steatosis from those with mild steatosis was significant. CONCLUSIONS: These data suggest a role of both adiponectin and resistin in the pathogenesis of NAFLD in obese children and confirm the association between adiponectin and insulin resistance. Adiponectin and resistin may be suitable serum markers in predicting an advanced liver steatosis in children with NAFLD.

Differentiation of IgE-dependent and IgE-independent reactions in children with bronchial asthma on the basis of TOP CAST Paediatric Allergen Mix test.

PURPOSE: TOP CAST Paediatric Allergen Mix test is a new cellular in vitro test based on evaluation of leukotrienes synthesised by basophils under the influence of specific allergens. The aim of the study was evaluation of applicability of this test as screening examination in diagnosis of atopic asthma in children. MATERIAL AND METHODS: The study was carried out on a group of 30 children (56.7% boys and 43.3% girls) aged 6-15 yrs (mean age 8 years and 9 months, SD = 2.1) with diagnosed bronchial asthma. In children qualified for the study clinical symptoms, subject examination as well as functional examination of the respiratory system (obturation with positive reversibility test) confirmed the disease. All the children had skin prick tests performed with the most popular aero- and troph-allergens, which results were expressed (+) according to the Skandinavian scale. In 15 cases asthma had atopic origin: in 11 children--mites were responsible for the contraction of bronchi, in 3 cases--tree-pollens allergens and in 1 case--grass pollens. In 15 next cases non-atopic asthma was diagnosed. The control group consisted of 10 children without clinical manifestations of asthma and negative results of the above tests. Test TOP CAST Paediatric Allergen Mix with mixture of 21 inhalatory and food allergens was performed according to the producer's procedure. RESULTS: Statistically significant differences of the values of released leukotrienes were noted at allergen concentration of both 100 ng/ml and 10 ng/ml in children with diagnosed atopic asthma compared to those with non-atopic asthma and control group. The sensitivity of TOP CAST Paediatric Allergen Mix test was 80% at both allergen concentrations while the specificity was higher (90%) at the lower concentration. There was also correlation between the number of released leukotriens and IgEc in the examined group of children, however, no statistically significant differences were observed between the concentration of the released leukotrienes and the size of the wheal and the number of positive skin prick tests. CONCLUSIONS: 1. TOP CAST Paediatric Allergen Mix test is a good screening method in differentiation of atopic and non-atopic background of bronchial asthma in children. 2. At the present evaluation stage of this test, it may be applied as complementation of routine tests in allergological practice.

[Subclasses of IgG (IgG1-IgG4) in children during specific immunotherapy]. / Podklasy IgG (IgG1-IgG4) u dzieci w trakcie swoistej immunoterapii.

The aim of this study was determination of IgG subclasses: IgG1, IgG2, IgG3 and IgG4 in children with atopic bronchial asthma and allergy rhinitis during long-term specific immunotherapy. The results showed in crease of IgG1 at first and next IgG4 subclasses. In our opinion it's a positive reaction of specific immunotherapy. Decrease of IgG2 and in less degree of IgG3 must be very carefully observation and analyse general in children with recurrent infections in the respiratory tract during specific immunotherapy.