Relationship between hair cadmium levels, indoor ETS exposure and wheezing frequency in children

Background: Cadmium (Cd) is a toxic heavy metal and the components of tobacco and scalp hair effectively reflect a long-term environmental exposure. Objective: The aim of this study was to assess the concentration of Cd levels in the hair of children with recurrent wheezing, and to evaluate the predictors of elevated Cd levels with a focus on anthropometric, environmental, and dietary factors. Methods: In this case-control study, scalp hair was obtained from 65 children with recurrent wheezing (RW) and from 65 healthy children (HC). Hair Cd concentrations were determined by ICP-MS. Results: Median (IQR) hair Cd levels were 0.22μg/kg (0.10-0.35) in RW group and 0.12μg/kg (0.04-0.23) in HC group (p=0.013). Multivariable logistic regression model results showed that being a child with RW (OR=6.28; p=0.001), ETS exposure at home (OR=22.56; p<0.001), and mother's education level (OR=0.49; p=0.020), are the major predictor variables for elevated hair Cd levels (cut off >0.17μg/kg). In RW group, multivariable logistic regression results showed that hair Cd levels of >0.17μg/kg was significantly predictive of having three or more wheezing episodes in RW group after adjustment for ETS exposure at home (OR=5.48; p=0.012). Conclusion: We demonstrated that the more children are exposed to ETS at home, the more they are exposed to heavy metals like Cd. Especially children who have had three or more wheezing attacks over the last six months are much more susceptible than the other asthmatic and non-asthmatic children, and Cd exposure aggravates their asthmatic status(AU)

Relationship between hair cadmium levels, indoor ETS exposure and wheezing frequency in children.

BACKGROUND: Cadmium (Cd) is a toxic heavy metal and the components of tobacco and scalp hair effectively reflect a long-term environmental exposure. OBJECTIVE: The aim of this study was to assess the concentration of Cd levels in the hair of children with recurrent wheezing, and to evaluate the predictors of elevated Cd levels with a focus on anthropometric, environmental, and dietary factors. METHODS: In this case-control study, scalp hair was obtained from 65 children with recurrent wheezing (RW) and from 65 healthy children (HC). Hair Cd concentrations were determined by ICP-MS. RESULTS: Median (IQR) hair Cd levels were 0.22 µg/kg (0.10-0.35) in RW group and 0.12 µg/kg (0.04-0.23) in HC group (p = 0.013). Multivariable logistic regression model results showed that being a child with RW (OR = 6.28; p = 0.001), ETS exposure at home (OR=22.56; p < 0.001), and mother's education level (OR = 0.49; p = 0.020), are the major predictor variables for elevated hair Cd levels (cut off >0.17 µg/kg). In RW group, multivariable logistic regression results showed that hair Cd levels of >0.17 µg/kg was significantly predictive of having three or more wheezing episodes in RW group after adjustment for ETS exposure at home (OR = 5.48; p = 0.012). CONCLUSION: We demonstrated that the more children are exposed to ETS at home, the more they are exposed to heavy metals like Cd. Especially children who have had three or more wheezing attacks over the last six months are much more susceptible than the other asthmatic and non-asthmatic children, and Cd exposure aggravates their asthmatic status.

Specific immunotherapy improves asthma related quality of life in childhood

Background: Asthma is the most common chronic illness in childhood and really affects the everyday life of patients who suffer from it. Since asthma is a common disease, there is a great endeavour to achieve the most appropriate treatment option. Despite inhaled corticosteroids and leukotrien receptor antagonists both being routinely used in asthma treatment, specific immunotherapy is still questioned. There are numerous aspects affecting asthma-related quality of life, such as age; seasons; disease control and severity etc, which are well studied -apart from the type of treatment. With this study we aimed to stress the influence of asthma treatment on quality of life. Methods: A total of 102 children, aged 6—18 years, were assigned to classic asthma therapy (n=50) and specific immunotherapy (n=52). The quality of life is assessed using the Standardized Pediatric Asthma Quality of Life Questionnaire (PAQLQ) interviewer-administered Turkish version. Pulmonary function testing was performed on the same day, after the questionnaire was completed. Results: The PAQLQ total scores were significantly higher in the specific immunotherapy group (p<0.001). Apart from emotional function domain scores; symptoms domain and activity limitation domain scores were higher in the specific immunotherapy group. Emotional function domain scores were similar in the two groups (p>0.05). There were no statistically significant differences in pulmonary function testing results between the two groups (p>0.05). There was a linear correlation between FEV1%, FVC level and total and domain scores of PAQLQ with Spearman Correlation tests (AU)

Serum heavy metal and antioxidant element levels of children with recurrent wheezing

Study Objectives: The aim of the study is to investigate the levels of toxic heavy metals related with environmental pollution and trace elements involved in antioxidant system in children suffering from recurrent wheezing. Study Design: One hundred children with recurrent wheezing (at least three recurrences) between the ages from 1 to 6 years took part in the study, and also 116 age- and sex- matched healthy children were involved in the study as a control group. Venous blood samples were collected and serum mercury, lead, aluminium, zinc, selenium, and copper levels were studied using ICP-MS. Results: Serum lead (0.76±0.15 vs. 0.27±0.01, p:0.001) and mercury levels (1.31±0.15 vs 0.71±0.05, p < 0.001) were higher in wheezy group than those acquired from the control group. Serum zinc (69.4±1.65 vs. 78.9±2.78, p:0.005) and selenium (115.6±1.87 vs. 125.4±2.94, p:0.008) levels were lower in wheezy group than those acquired from the control group. Serumz inc levels were found to be correlated with number of ARTIs (rp: -0.332, p: 0.001) and the number of wheezy attacks (rp: -0.776, p < 0.001) during the previous year in the wheezy group. Conclusion: Elevated levels of serum lead and mercury and low levels of zinc and selenium may suggest some disturbances in the antioxidant system in children with recurrent wheezing. This means that children with recurrent wheezing are much more susceptible to environmental pollutants and respiratory tract infections than healthy children and this heavy metal-antioxidant relationship may play a role as a contributing factor in the pathogenesis of recurrent wheezingin children (AU)

Serum heavy metal and antioxidant element levels of children with recurrent wheezing.

STUDY OBJECTIVES: The aim of the study is to investigate the levels of toxic heavy metals related with environmental pollution and trace elements involved in antioxidant system in children suffering from recurrent wheezing. STUDY DESIGN: One hundred children with recurrent wheezing (at least three recurrences) between the ages from 1 to 6 years took part in the study, and also 116 age- and sex- matched healthy children were involved in the study as a control group. Venous blood samples were collected and serum mercury, lead, aluminium, zinc, selenium, and copper levels were studied using ICP-MS. RESULTS: Serum lead (0.76±0.15 vs. 0.27±0.01, p:0.001) and mercury levels (1.31±0.15 vs 0.71±0.05, p<0.001) were higher in wheezy group than those acquired from the control group. Serum zinc (69.4±1.65 vs. 78.9±2.78, p:0.005) and selenium (115.6±1.87 vs. 125.4±2.94, p:0.008) levels were lower in wheezy group than those acquired from the control group. Serum zinc levels were found to be correlated with number of ARTIs (r(p):-0.332, p:0.001) and the number of wheezy attacks (r(p):-0.776, p<0.001) during the previous year in the wheezy group. CONCLUSION: Elevated levels of serum lead and mercury and low levels of zinc and selenium may suggest some disturbances in the antioxidant system in children with recurrent wheezing. This means that children with recurrent wheezing are much more susceptible to environmental pollutants and respiratory tract infections than healthy children and this heavy metal-antioxidant relationship may play a role as a contributing factor in the pathogenesis of recurrent wheezing in children.

Specific immunotherapy improves asthma related quality of life in childhood.

BACKGROUND: Asthma is the most common chronic illness in childhood and really affects the everyday life of patients who suffer from it. Since asthma is a common disease, there is a great endeavour to achieve the most appropriate treatment option. Despite inhaled corticosteroids and leukotrien receptor antagonists both being routinely used in asthma treatment, specific immunotherapy is still questioned. There are numerous aspects affecting asthma-related quality of life, such as age; seasons; disease control and severity etc, which are well studied -apart from the type of treatment. With this study we aimed to stress the influence of asthma treatment on quality of life. METHODS: A total of 102 children, aged 6-18 years, were assigned to classic asthma therapy (n=50) and specific immunotherapy (n=52). The quality of life is assessed using the Standardized Pediatric Asthma Quality of Life Questionnaire (PAQLQ) interviewer-administered Turkish version. Pulmonary function testing was performed on the same day, after the questionnaire was completed. RESULTS: The PAQLQ total scores were significantly higher in the specific immunotherapy group (p<0.001). Apart from emotional function domain scores; symptoms domain and activity limitation domain scores were higher in the specific immunotherapy group. Emotional function domain scores were similar in the two groups (p>0.05). There were no statistically significant differences in pulmonary function testing results between the two groups (p>0.05). There was a linear correlation between FEV1%, FVC level and total and domain scores of PAQLQ with Spearman Correlation tests.

Subepicardial adipose tissue thickness and its relation with anthropometric and clinical parameters in pubertal obese children.

AIM: To determine the relation of echocardiographic subepicardial adipose tissue (SAT) thickness with anthropometric and clinical parameters in pubertal obese children. SUBJECTS AND METHODS: A total of 52 obese pubertal subjects (13.1±1.56 yr, 27 male patients) and 39 age- and gender-matched lean pubertal subjects (13.0±1.28 yr, 16 male patients) were included in the study. Serum glucose, lipid profile, and insulin levels were measured during the fasting state. Each subject underwent a transthoracic echocardiography and the SAT thickness was measured during end-diastole from the parasternal long-axis views. RESULTS: The obese pubertal subjects had significantly higher SAT, triceps skin fold (TSF) thickness (mm), waist (WC) and mid-arm circumference (MAC) values (cm) compared with lean pubertal subjects group (p<0.05). Correlation analysis showed that SAT thickness was significantly related with age, SD score-body mass index (SDS-BMI), BMI, WC, MAC, TSF, and homeostasis model assessment of insulin resistance (HOMA-IR) (p<0.05), whereas there was no significant relation of SAT with hip circumference and waist to hip ratio (p>0.05). As an optimal cut-off point, a SAT thickness of 5.25 mm determined IR with 92% sensitivity and 62.1% specificity. CONCLUSIONS: Our study showed that SAT thickness in obese pubertal children shows a good correlation with age, SDS-BMI, BMI, WC, MAC, TSF, and HOMA-IR. In addition, our results suggest that SAT thickness might be used as a supportive data for risk stratification of metabolic syndrome in obese children.