Assessment of the Relationship between Body Mass Index and Gross Motor Development in Children.

OBJECTIVE: Obesity is a growing epidemic and public health problem in children. The purpose of this study was to determine the effect of body mass index (BMI) on the gross motor development. MATERIALS & METHODS: In this cross-sectional study conducted in 2012-13 in Gorgan, northern Iran, the gross motor development of 90 children 3-5 yr old in three groups of lean, normal and obese/overweight were evaluated by the ages and stages questionnaires (ASQ) and Denver 2 scale. RESULTS: Totally, 90 children were enrolled and their developmental level was assessed with two ASQ and Denver II indices. The mean and standard deviation of the ASQ scores of the children was 53.11± 11.06 and based on Denver index, 9 children (10%) were at developmental delay status, 15 (16.7%) in the caution conditions, and 53 (58.9%) at normal developmental status. The developmental level was lower in obese/overweight group comparing with other groups according to both Denver and ASQ and there was a significant difference between obese/overweight group and normal group based in Denver and ASQ, respectively. There was no significant difference between underweight and normal and obese and underweight groups. CONCLUSION: Overweight and obesity could affect on the gross motor development.

Effect of vitamin d3 supplement in glycemic control of pediatrics with type 1 diabetes mellitus and vitamin d deficiency.

BACKGROUND: Glycemic control prevents microvascular complications in patients with type I diabetes mellitus such as retinopathy, nephropathy and neuropathy that influences quality of life. Some studies show the immunomodulatory effect of vitamin D in synthesis and secretion of insulin. AIMS: In this study we evaluate glycemic changes after vitamin D3 supplement in children with type I diabetes mellitus and vitamin D deficiency. MATERIALS AND METHODS: In children with type I diabetes mellitus, level of vitamin D and HbA1C was measured. Patients with type I diabetes mellitus who had vitamin D deficiency (25OHD < 50 nmol/lit) treated with 300,000 units of vitamin D3. Calcium supplement (40mg/kg/day) divided in two doses in order to avoid hungry bone was also used. After three months, 25OHD and HbA1C were measured again. Differences, in mean ± SD HbA1C and 25OHD were evaluated before and after the study. RESULTS: Mean ± SD HbA1C was 9.73±1.85 before the study which was diminished to 8.55±1.91 after vitamin D3 supplement treatment. This decline has a significant difference (p-value < 0.0001). Mean ± SD 25OHD was 17.33±8.97 nmol/lit before the study which is increased to 39.31±14.38 nmol/lit after treatment with vitamin D3 supplement. This increase also has a significant difference (p-value < 0.0001). Vitamin D3 supplement causes the improvement of HbA1C in all groups of glycemic control including HbA1C <7.8, 7.8-9.9, and >9.9. This supplement transfer patients toward better glycemic control for the entire group (p-value < 0.0001). CONCLUSION: Vitamin D3 supplement improves HbA1C in pediatrics with type I diabetes mellitus and vitamin D deficiency.

Relationship between 25-Hydroxy Vitamin-D and Obesity in 2-7 years old Children Referred to a Paediatric Hospital in Iran.

BACKGROUND: Obesity is increasing in children and it can cause many complications in adulthood, such as Diabetes mellitus (DM) and metabolic syndrome. In observational studies, vitamin-D was one of the factors which were found to be associated with obesity. AIMS: To determine the association between body mass index (BMI) and serum level of vitamin-D in children who were outpatients at Taleghani Paediatric Hospital, Iran. SETTINGS AND DESIGN: This was a cross-sectional observational study done on 215 children who were 2 to 7 y old, who were referred to Taleghani Hospital in winter (1391 solar calendar) 2013. MATERIALS AND METHODS: In this cross-sectional study, anthropometric indices: weight, height and waist circumference were measured by using identical instruments. BMI was also determined as per CDC 2000 criteria. Vitamin-D levels were estimated by ELISA. STATISTICAL ANALYSIS: Vitamin-D levels which were less than 20 nmol/L were considered as a deficiency, levels which were 20-30 nmol\L were considered as inadequate and those which were equal to or greater than 30 nmol\L were considered as sufficient. t-test, ANOVA and Pearson's correlation coefficient at a significant level of 0.05 were applied and data were analysed by using SPSS (version 16). RESULTS: One hundred and twenty five children (47.4%) were males and the rest were females. One hundred eighty four children (85.6%) had vitamin-D deficiency and only 31 had adequate levels of vitamin-D. The prevalence of obesity and overweight were 27%, but considering the vitamin-D status, it was found to be insignificant. However, there was a linear relationship between waist circumference and serum vitamin-D (p<0.01). The means and standard deviations of serum vitamin-D levels in girls and boys were 22.76 ±11.62 and 23.46 ± 9.30 nmol/L and this difference was not significant. Vitamin-D levels found in the three ethnic groups of Fars, Turkmen and Sistani showed significant differences (p<0.002). CONCLUSIONS: There was a high prevalence of vitamin-D deficiency in 2 to 7 year olds. There was no significant relationship between BMI and vitamin-D, but it was recorded in ethnic groups, and there was a correlation between waist circumference and vitamin-D levels. More exposure to sunlight and prescription of vitamin supplements were recommended.

Trace elements in febrile seizure compared to febrile children admitted to an academic hospital in iran, 2011.

BACKGROUND AND AIM: Pathogenesis of Febrile Convulsion (FC) is unknown but some elements and genetic predispositions have been considered in the top list. This case-control study was designed to compare some trace elements in paediatrics who were admitted with FC and those in febrile ones without seizure attacks at an academic hospital in northeast of Iran. MATERIAL AND METHODS: This case-control study was done from June 2010 to July 2011 on 160 paediatrics (6-months to 5-years old) who were diagnosed with FC and on 160 age-matched febrile children as control group. Data on the age, gender, past history of fever and convulsion, age at the first episode of seizure and family history of FC were gathered by using a designed checklist. Complete Blood Count (CBC), serum iron, Total Iron Binding Capacity (TIBC), zinc, magnesium and calcium were tested after taking informed consents from the parents. Serum levels of trace elements were measured by a photometric method. Independent t-test or non-parametric Mann-Whitney test were used to compare means between two groups. RESULTS: There were no significant differences between the cases and controls with regards to the gender or age. TIBC and magnesium were lower in FC, but calcium, iron and zinc were higher in FC as compared to those in the other group (not significant). CONCLUSIONS: So, it could be said that deficiency of trace elements was not significantly related to febrile convulsion in our study and it seemed that these tests were not necessary in FC cases. But further investigations on other trace elements are needed.

Obesity and metabolic syndrome among a representative sample of Iranian adolescents.

Metabolic syndrome (MetS) increases the risk of developing many chronic diseases and originates early in life; its prevalence varies by population. The present study investigated the prevalence of MetS and the association between MetS and obesity in a population of adolescents in northern Iran. A total of 450 Iranian high school students (50% boys), aged 15-18 years, were enrolled in the study. Physical examination and biochemical analyses were conducted according to standard protocols; MetS was defined according to the modified NHANES III criteria. The prevalence of MetS among subjects was 3.3%. Eight percent of subjects had a body mass index (BMI) >75th percentile, and 10.5% had a BMI >85th percentile. Overall, 42.1% of students did not have any components of MetS. Waist circumferences (WC), Body Mass Index (BMI), serum level of triglycerides (TG) and high density lipoprotein-cholesterol (HDL-C) were significantly higher among girls than boys. Systolic blood pressure (SBP) and fasting blood sugar (FBS) were significantly higher among boys than girls. The associations between a BMI > or = 85th percentile and MetS (OR 6.97; 95%CI 2.41-20.16) and between a BMI > or = 75th percentile and MetS (OR 6.74; 95%CI 2.10-21.57) were statistically significant. The association between an increased WC and MetS was also statistically significant (OR 21.64; 95%CI 6.7-69.81). This study confirms the high prevalence of components of MetS among apparently Iranian adolescents, even among those not overweight. The high prevalence of MetS among adolescents with generalized and abdominal obesity underscores the need for primary prevention of MetS in early life.

An assessment of urinary and breast milk iodine concentrations in lactating mothers from Gorgan, Iran, 2003.

Dietary iodine is essential for the production of thyroid hormones. Breast-fed infants are reliant on maternal iodine intake. The aim of this study was to evaluate iodine sufficiency in lactating women in Iran. The sample consisted of 100 lactating mothers referred to the Taleghani Hospital of Gorgan, Iran. Goiter was graded according to World Health Organization (WHO) classification. Spot urine and breast-milk samples were collected for the measurement of iodine concentrations. Urine iodine concentrations (UIC) less than 100 and breast-milk iodine concentrations (MIC) less than 50 microg/L were considered consistent with iodine deficiency. Forty-three percent of women had grade 1 and 2 goiters, respectively. The median UIC was 259 microg/L. UIC was less than 100 in 16%. Grade 1 and 2 goiters were each present in 8% of mothers with UIC less than 100 microg/L. The median MIC was 93.5 microg /L. MIC was less than 50 microg /L in 19%. Grade 1 and 2 goiters were present in 11% and 8%, respectively, of women with MIC <50 mg/L. MIC and UIC levels were significantly correlated (r = 0.44, p < 0.0001). Iodine deficiency and goiter were associated (p < 0.0001). UIC and MIC concentrations are sufficient in Gorgan, Iran. However, individual infants remain at risk for low iodine intake via breast milk.

Endocrine gland abnormalities in thalassemia major: a brief review.

Thalassemia major (beta-thalassemia) affects a significant segment of the population in certain areas of the world. Alterations in migration patterns have changed the geographic distribution of this disease and made it a worldwide health problem. Over the course of the past 2-3 decades hypertransfusion therapy has significantly increased the life expectancy, and improved the quality of life of these patients. At the same time there has been an increase in the frequency of complications of this therapy caused by iron overload. Endocrine gland abnormalities contributed little to the morbidity or mortality of beta-thalassemia in the past. As a result of hypertransfusion therapy and increased longevity, however, endocrinopathies have become more common and contribute significantly to morbidity in these patients. In this article we briefly review the current understanding of endocrine gland abnormalities, primarily caused by iron overload, in patients with thalassemia major.