Search results for: Insulin%20Delivery%20rate

Authors: Moushira Zaki, Wafaa Ezzat, Yasser Elhosary, Omnia Saleh

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Nonalcoholic fatty liver disease (NAFLD) has increased in conjunction with obesity. The accuracy of risk factors for detecting NAFLD in obese adolescents has not undergone a formal evaluation. The aim of this study was to evaluate predictors of NAFLD among Egyptian female obese adolescents. The study included 162 obese female adolescents. All were subjected to anthropometry, biochemical analysis and abdominal ultrasongraphic assessment. Metabolic syndrome (MS) was diagnosed according to the IDF criteria. Significant association between presence of MS and NAFLD was observed. Obese adolescents with NAFLD had significantly higher levels of ALT, triglycerides, fasting glucose, insulin, blood pressure and HOMA-IR, whereas decreased HDL-C levels as compared with obese cases without NAFLD. Receiver– operating characteristic (ROC) curve analysis shows that ALT is a sensitive predictor for NAFLD, confirming that ALT can be used as a marker of NAFLD.

Keywords: Adolescents, Egyptians, obesity.

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Authors: Abdulrahim Aljamal

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Bay leaves have been shown to improve insulin function in vitro but the effects on people have not been determined. The objective of this study was to determine if bay leaves may be important in the prevention and/or alleviation of type 1 diabetes. Methods: Fifty five people with type 1 diabetes were divided into two groups, 45 given capsules containing 3 g of bay leaves per day for 30 days and 10 given a placebo capsules. Results All the patients consumed bay leaves shows reduced serum glucose with significant decreases 27% after 30 d. Total cholesterol decreased, 21 %, after 30 days with larger decreases in low density lipoprotein (LDL) 24%. High density lipoprotein (HDL) increased 20% and Triglycerides also decreased 26%. There were no significant changes in the placebo group. Conclusion, this study demonstrates that consumption of bay leaves, 3 g/d for 30 days, decreases risk factors for diabetes and cardiovascular diseases and suggests that bay leaves may be beneficial for people with type 1 diabetes.

Keywords: bay leave, cholesterol, diabetes, triglycerides

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Authors: A. T. Nakysh, A. S. Idrisov, S. A. Baidurin

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This work presents the results of a study the incidence of metabolic syndrome (MetS) in women with impaired reproductive function (IRF) according to the data of Astana, Kazakhstan. The anthropometric, biochemical and instrumental studies were conducted among 515 women, of which 53 patients with MetS according to IDF criteria, 2006, were selected. The frequency of occurrence of the IRF, due to MetS is 10.3% of cases according to the data of Astana. In women of childbearing age with IRF and the MetS, blood pressure (BP), indicators of carbohydrate and lipid metabolism were significantly higher and the level of high density lipoprotein (HDL) significantly lower compared to the same in women with the IRF without MetS. The hyperandrogenism, the hyperestrogenemia, the hyperprolactinemia and the hypoprogesteronemia were found in the patients with MetS and IRF, indicating the impact of MetS on the development of the polycystic ovary syndrome in 28% of cases and hyperplastic processes of the myometrium in 20% of cases.

Keywords: Dyslipidemia, insulin resistance, metabolic syndrome, reproductive disorders, obesity.

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Authors: I. Struhár, L. Dovrtělová, M. Kumstát

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Regular exercise promotes reduction in blood pressure, reduction in body weight and it also helps to increase in insulin sensitivity. Participation in physical activity should always be linked to medical screening which can reveal serious medical problems. One of them is high blood pressure. Hypertension is risk factor for one billion people worldwide and the highest prevalence is found in Africa. Another component of hypertension is that people who suffer from hypertension have no symptoms. It is estimated that reduction of 3mm Hg in Systolic Blood Pressure decreases cardiac morbidity at least 5%. The most of the guidelines suggest aerobic exercise in a prevention of cardiovascular diseases. On the other hand, it is important to emphasize the impact of resistance training. Even, it was found higher effect for reduction on the level of systolic blood pressure than aerobic exercise.

Keywords: Coronary artery disease, physical activity, prevention, resistance training.

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Authors: N. Tadrisi Parsa, A. R. Vali, R. Ghasemi

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Diabetes is a growing health problem in worldwide. Especially, the patients with Type 1 diabetes need strict glycemic control because they have deficiency of insulin production. This paper attempts to control blood glucose based on body mathematical body model. The Bergman minimal mathematical model is used to develop the nonlinear controller. A novel back-stepping based sliding mode control (B-SMC) strategy is proposed as a solution that guarantees practical tracking of a desired glucose concentration. In order to show the performance of the proposed design, it is compared with conventional linear and fuzzy controllers which have been done in previous researches. The numerical simulation result shows the advantages of sliding mode back stepping controller design to linear and fuzzy controllers.

Keywords: Back stepping, Bergman Model, Nonlinear control, Sliding mode control.

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Authors: A. H. El-Far, R. R. Gindi, H. A. Abd El-Maksoud, Mohamed Ragaa Ragab Hassanien

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Gastric ulceration is a discontinuity in gastric mucosa, usually occurs due to imbalance between the gastric mucosal protective factors, that is called gastric mucosal barrier, and the aggressive factors, to which the mucosa is exposed. This study was carried out on sixty male Sprague-Dowely rats (12- 16 weeks old) allocated into two groups. The first control group and the second Gastric lesion group which induced by oral administration of a single daily dose of aspirin at a dose of 300 mg/kg body weight for 7 consecutive-days (6% aspirin solution will be prepared and each rat will be given 5 ml of that solution/kg body weight). Blood is collected 1, 2 and 3 weeks after induction of gastric ulceration. Significant increase in serum copper, nitric oxide, and prostaglandin E2 all over the period of experiment. Significant decrease in erythrocyte superoxide dismutase (t-SOD) activities, serum (calcium, phosphorus, glucose and insulin) levels. Non-significant changes in serum sodium and potassium levels are obtained.

Keywords: Aspirin, Gastric Ulcer, Prostaglandin E2, Superoxide dismutase

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Authors: S. Bag, S. Ramaiah, P. Anitha, K. M. Kumar, P. Lavanya, V. Sivasakhthi, A. Anbarasu

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Gene networks present a graphical view at the level of gene activities and genetic functions and help us to understand complex interactions in a meaningful manner. In the present study, we have analyzed the gene interaction of PPAR-γ (peroxisome proliferator-activated receptor gamma) by search tool for retrieval of interacting genes. We find PPAR-γ is highly networked by genetic interactions with 10 genes: RXRA (retinoid X receptor, alpha), PPARGC1A (peroxisome proliferator-activated receptor gamma, coactivator 1 alpha), NCOA1 (nuclear receptor coactivator 1), NR0B2 (nuclear receptor subfamily 0, group B, member 2), HDAC3 (histone deacetylase 3), MED1 (mediator complex subunit 1), INS (insulin), NCOR2 (nuclear receptor co-repressor 2), PAX8 (paired box 8), ADIPOQ (adiponectin) and it augurs well for the fact that obesity and several other metabolic disorders are inter related.

Keywords: Gene networks, NCOA1, PPARγ, PPARGC1A, RXRA.

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Authors: Murugan. A., Jerlin Nirmala. F .

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Life is beautiful. But, it is decided by genes, environment and the individual and shattered by the natural and / or the invited problems. Most of the global rural helpless masses are struggling for their survival since; they are neglected in all aspects of life including health. Amidst a countless number of miserable diseases in man, diabetes is becoming a dreaded killer and ramifying the entire globe in a jet speed. Diabetes control continues as a Herculean task to the scientific community and the modern society in the 21st century also. T2DM is not pertaining to any age and it can develop even during the childhood. This multifactorial disease abruptly changes the activities of certain vital biomarkers in the present rural T2DM cases. A remarkable variation in the levels of biomarkers like AST, ALT, GGT, ALP, LDH, HbA1C, C- peptide, fasting sugar, post-prandial sugar, sodium, potassium, BUN, creatinine and insulin show the rampant nature of T2DM in this physically active rural agrarian community.

Keywords: Alanine aminotransferase, Aspartate aminotransferase, Blood urea nitrogen, Glycated haemoglobin, Thyroid stimulating hormone

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Authors: Kalakotla Shanker, G. Krishna Mohan

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Nowadays, nanoparticles are being used in pharmacological studies for their exclusive properties such as small size, more surface area, biocompatibility and enhanced solubility. In view of this, the present study aimed to evaluate the antihyperglycemic potential of biologically synthesized silver nanoparticles (BSSNPs) and Gymnema sylvestre (GS) extract. The SEM and SEM analysis divulges that the BSSNPs were spherical in shape. EDAX spectrum exhibits peaks for the presence of silver, carbon, and oxygen atoms in the range of 1.0-3.1 keV. FT-IR reveals the binding properties of active bio-constituents responsible for capping and stabilizing BSSNPs. The results showed increased blood glucose, huge loss in body weight and downturn in plasma insulin. The GS extract (200 mg/kg, 400 mg/kg), BSSNPs (100 mg/kg, 200 mg/kg) and metformin 50 mg/kg were administered to the diabetic rats. BSSNPs at a dose level of 200 mg/kg (b.wt.p.o.) showed significant inhibition of (p<0.001) blood glucose levels as compared with GS extract treated group. The results obtained from study indicate that the BSSNP shows potent anti-diabetic activity.

Keywords: BSSNP, G.sylvetre, wistar rats, antihyperglycemic activity.

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Authors: Ceren Kaya, Okan Erkaymaz, Orhan Ayar, Mahmut Özer

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Diabetes Mellitus (Diabetes) is a disease based on insulin hormone disorders and causes high blood glucose. Clinical findings determine that diabetes can be diagnosed by electrophysiological signals obtained from the vital organs. 'Diabetic Retinopathy' is one of the most common eye diseases resulting on diabetes and it is the leading cause of vision loss due to structural alteration of the retinal layer vessels. In this study, features of horizontal and vertical Video-Oculography (VOG) signals have been used to classify non-proliferative and proliferative diabetic retinopathy disease. Twenty-five features are acquired by using discrete wavelet transform with VOG signals which are taken from 21 subjects. Two models, based on multi-layer perceptron and radial basis function, are recommended in the diagnosis of Diabetic Retinopathy. The proposed models also can detect level of the disease. We show comparative classification performance of the proposed models. Our results show that proposed the RBF model (100%) results in better classification performance than the MLP model (94%).

Keywords: Diabetic retinopathy, discrete wavelet transform, multi-layer perceptron, radial basis function, video-oculography.

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Authors: E. F. Aransiola, M.O. Daramola, E. O. Iwalewa, A. M. Seluwa, O. O. Olufowobi

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Diabetes is a chronic metabolic disorder that affects the quality of life in terms of physical health, social and psychological well-being. In spite of the enormous progress in the treatment of diabetes using existing commercial drugs, such as, insulin and oral hypoglycemic agents, the quest and search for new drugs is imperative due to several limitations of the commercial drugs. In addition, the existing diabetic drugs are expensive and unaffordable by the rural populace in the developing countries. The present study demonstrates the anti-diabetic property of aqueous extract of Bryophyllum pinnatum (BP) leaves using diabetic rats (albino rats) as models. At the same time, the anti-diabetic effect of the aqueous extract was compared to that of a sample containing a mixture of the extract and a commercial diabetic medicine, glibenclamide. A specified dosage of aqueous extract of Bryophyllum pinnatum (BP) leaves was administered on the experimental diabetic rats, and their BGL was measured and recorded. The results showed a significant drop in the BGL of the diabetic rats to a value close to normal blood glucose level within 120 minutes when only aqueous extract from BP leaves was used. When a sample containing a mixture of the aqueous extract and glibenclamide was administered, a further drop in BGL was observed. Therefore, the results reveal that aqueous extract of Bryophyllum pinnatum leaves have significant anti-diabetic properties, and that the performance of the existing drugs (glibenclamide) could be enhanced with the use of the aqueous extract.

Keywords: Anti-diabetics, Bryophyllum pinnatum, Blood glucose level, albino rats.

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Authors: Kadry M. Sadek, Tarek K. Abouzed, Mousa A. Ayoub

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The presence of endocrine-disrupting compounds, such as bisphenol A (BPA), in the environment can cause serious health problems. However, there are controversial opinions. This study investigated the reproductive, metabolic, oxidative and immunologic-disrupting effects of bisphenol A in male rabbits. Rabbits were divided into five groups. The first four rabbit groups were administered oral BPA (1, 10, 50, or 100 mg/kg/day) for ten weeks. The fifth group was administered corn oil as the vehicle. BPA significantly decreased serum testosterone, estradiol and the free androgen index (FAI) and significantly increased sex hormone binding globulin (SHBG) compared with the placebo group. The higher doses of BPA showed a significant decrease in follicular stimulating hormone (FSH) and luteinizing hormone (LH). A significant increase in blood glucose levels was identified in the BPA groups. The non-significant difference in insulin levels is a novel finding. The cumulative testicular toxicity of BPA was clearly demonstrated by the dose-dependent decrease in absolute testes weight, primary measures of semen quality and a significant increase in testicular malonaldehyde (MDA). Moreover, BPA significantly decreased total antioxidant capacity (TAC) and significantly increased immunoglobulin G (IgG) at the highest concentration. Our results suggest that BPA, especially at higher doses, is associated with many adverse effects on metabolism, oxidative stress, immunity, sperm quality and markers of androgenic action.

Keywords: Bisphenol A, oxidative stress, rabbits, semen quality, steroidogenesis.

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Authors: Nadir A. Carreón, Christa Sonderer, Aakarsh Rao, Roman Lysecky

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With the advent of complex software and increased connectivity, security of life-critical medical devices is becoming an increasing concern, particularly with their direct impact to human safety. Security is essential, but it is impossible to develop completely secure and impenetrable systems at design time. Therefore, it is important to assess the potential impact on security and safety of exploiting a vulnerability in such critical medical systems. The common vulnerability scoring system (CVSS) calculates the severity of exploitable vulnerabilities. However, for medical devices, it does not consider the unique challenges of impacts to human health and privacy. Thus, the scoring of a medical device on which a human life depends (e.g., pacemakers, insulin pumps) can score very low, while a system on which a human life does not depend (e.g., hospital archiving systems) might score very high. In this paper, we present a Medical Vulnerability Scoring System (MVSS) that extends CVSS to address the health and privacy concerns of medical devices. We propose incorporating two new parameters, namely health impact and sensitivity impact. Sensitivity refers to the type of information that can be stolen from the device, and health represents the impact to the safety of the patient if the vulnerability is exploited (e.g., potential harm, life threatening). We evaluate 15 different known vulnerabilities in medical devices and compare MVSS against two state-of-the-art medical device-oriented vulnerability scoring system and the foundational CVSS.

Keywords: Common vulnerability system, medical devices, medical device security, vulnerabilities.

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Authors: Wehash, F. E., Ismail I. Abo-Ghanema, Rasha Mohamed Saleh

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This study was conducted to evaluate the anti-diabetic properties of ethanolic extract of two plants commonly used in folk medicine, Mormodica charantia (bitter melon) and Trigonella foenum-graecum (fenugreek). The study was performed on STZinduced diabetic rats (DM type-I). Plant extracts of these two plants were given to STZ diabetic rats at the concentration of 500 mg/kg body weight ,50 mg/kg body weight respectively. Cidophage® (metformin HCl) were administered to another group to support the results at a dose of 500 mg/kg body weight, the ethanolic extracts and Cidophage administered orally once a day for four weeks using a stomach tube and; serum samples were obtained for biochemical analysis. The extracts caused significant decreases in glucose levels compared with diabetic control rats. Insulin secretions were increased after 4 weeks of treatment with Cidophage® compared with the control non-diabetic rats. Levels of AST and ALT liver enzymes were normalized by all treatments. Decreases in liver cholesterol, triglycerides, and LDL in diabetic rats were observed with all treatments. HDL levels were increased by the treatments in the following order: bitter melon, Cidophage®, and fenugreek. Creatinine levels were reduced by all treatments. Serum nitric oxide and malonaldehyde levels were reduced by all extracts. GSH levels were increased by all extracts. Extravasation as measured by the Evans Blue test increased significantly in STZ-induced diabetic animals. This effect was reversed by ethanolic extracts of bitter melon or fenugreek.

Keywords: Cidophage®, Diabetic rats, Mormodica charantia, Trigonella foenum-graecum

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Authors: Wisnu Adi Yulianto, Agus Slamet, Sri Luwihana, Septian Albar Dwi Suprayogi

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Parboiled rice was developed to produce rice, which has a low glycemic index for diabetics. However, diabetics also have a chromium (Cr) deficiency. Thus, it is important to fortify rice with Cr to increase the Cr content. Moreover, parboiled rice becomes rancid easily and has a musty odor, rendering the rice unfavorable. Natural herbs such as pandan leaves (Pandanus amaryllifolius Roxb.), bay leaves (Syzygium polyanthum [Wigh] Walp) and cinnamon bark powder (Cinnamomon cassia) are commonly added to food as aroma enhancers. Previous research has shown that these herbs could improve insulin sensitivity. The purpose of this study was to evaluate the effect of herbal extract coatings on the cooking quality and the preference level of chromium fortified - parboiled rice (CFPR). The rice grain variety used for this experiment was Ciherang and the fortificant was CrCl3. The three herbal extracts used for coating the CFPR were cinnamon, pandan and bay leaf, with concentration variations of 3%, 6%, and 9% (w/w) for each of the extracts. The samples were analyzed for their alkali spreading value, cooking time, elongation, water uptake ratio, solid loss, colour and lightness; and their sensory properties were determined by means of an organoleptic test. The research showed that coating the CFPR with pandan and cinnamon extracts at a concentration of 3% each produced a preferred CFPR. When coated with those herbal extracts the CFPR had the following cooking quality properties: alkali spreading value 5 (intermediate gelatinization temperature), cooking time, 26-27 min, color value, 14.95-15.00, lightness, 42.30 – 44.06, elongation, 1.53 – 1.54, water uptake ratio , 4.05-4.06, and solid loss, 0.09/100 g – 0.13 g/100 g.

Keywords: Bay leaves, chromium, cinnamon, pandan leaves, parboiled rice.

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Authors: Sharan Badiger, Prema T. Akkasaligar, Sandeep HM, Biradar MS

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Essential hypertension (HTN) usually clusters with other cardiovascular risk factors such as age, overweight, diabetes, insulin resistance and dyslipidemia. The target organ damage (TOD) such as left ventricular hypertrophy, microalbuminuria (MA), acute coronary syndrome (ACS), stroke and cognitive dysfunction takes place early in course of hypertension. Though the prevalence of hypertension is high in India, the relationship between microalbuminuria and target organ damage in hypertension is not well studied. This study aim at detecting MA in essential hypertension and its relation to severity of HTN, duration of HTN, body mass index (BMI), age and TOD such as HTN retinopathy and acute coronary syndrome The present study was done in 100 patients of essential hypertension non diabetics admitted to B.L.D.E.University-s Sri B.M.Patil Medical College, Bijapur, from October 2008 to April 2011. The patients underwent detailed history and clinical examination. Early morning 5 ml of urine sample was collected & MA was estimated by immunoturbidometry method. The relationship of MA with the duration & severity of HTN, BMI, age, sex and TOD's like hypertensive retinopathy, ACS was assessed by univariate analysis. The prevalence of MA in this study was found to be 63 %. In that 42% were male & 21% were female. In this study a significant association between MA and the duration of hypertension (p = 0.036) & (OR =0.438). Longer the duration of hypertension, more possibility of microalbumin in urine. Also there was a significant association between severity of hypertension and MA (p=0.045) and (OR=0.093). MA was positive in 50 (79.4%) patients out of 63, whose blood pressure was >160/100 mm Hg. In this study a significant association between MA and the grades of hypertensive retinopathy (p =0.011) and acute coronary syndrome (p = 0.041) (OR =2.805). Gender and BMI did not pose high risk for MA in this study.The prevalence of MA in essential hypertension is high in this part of the community and MA will increase the risk of developing target organ damage.Early screening of patients with essential hypertension for MA and aggressive management of positive cases might reduce the burden of chronic kidney diseases and cardiovascular diseases in the community.

Keywords: Acute coronary syndrome, Essential hypertension, Microalbuminuria, Target organ damage

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a disease with an ever-increasing prevalence throughout the world. The metabolic network associated with obesity is very complicated. In metabolic syndrome (MetS), it becomes even more difficult to understand. Within this context, hormones, cytokines, and many others participate in this complex matrix. The collaboration among all of these parameters is a matter of great wonder. Cortisol, as a stress hormone, is closely associated with obesity. Thyroid hormones are involved in the regulation of energy as well as glucose metabolism with all of its associates. Fetuin A has been known for years; however, the involvement of this parameter in obesity discussions is rather new. Recently, it has been defined as one of the new generation markers of obesity. In this study, the aim was to introduce complex interactions among all to be able to make clear comparisons, at least for a part of this complicated matter. Morbid obese (MO) children participated in the study. Two groups with 46 MO children and 43 with MetS were constituted. All children included in the study were above 99th age- and sex-adjusted body mass index (BMI) percentiles according to World Health Organization criteria. Forty-three morbid obese children in the second group also had MetS components. Informed consent forms were filled by the parents of the participants. The institutional ethics committee has given approval for the study protocol. Data as well as the findings of the study were evaluated from a statistical point of view. Two groups were matched for their age and gender compositions. Significantly higher body mass index (BMI), waist circumference, thyrotropin, and insulin values were observed in the MetS group. Triiodothyronine concentrations did not differ between the groups. Elevated levels for thyroxin, cortisol, and fetuin-A were detected in the MetS group compared to the first group (p > 0.05). In MO MetS- group, cortisol was correlated with thyroxin and fetuin-A (p < 0.05). In the MO MetS+ group, none of these correlations were present. Instead, a correlation between cortisol and thyrotropin was found (p < 0.05). In conclusion, findings have shown that cortisol was the key player in severely obese children. The association of this hormone with the participants of thyroid hormone metabolism was quite important. The lack of association with fetuin A in the morbid obese MetS+ group has suggested the possible interference of MetS components in the behavior of this new generation obesity marker. The most remarkable finding of the study was the unique correlation between cortisol and thyrotropin in the morbid obese MetS+ group, suggesting that thyrotropin may serve as a target along with cortisol in the morbid obese MetS+ group. This association may deserve specific attention during the development of remedies against MetS in the pediatric population.

Keywords: children, cortisol, fetuin A, morbid obesity, thyrotropin

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Authors: Mustafa M. Donma, Orkide Donma

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Alterations in lipid parameters as well as in the fat distribution of the body are noteworthy during the evaluation of obesity stages. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information. Ratios such as trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are derived from distinct fat distribution in these areas. In this study, lipid fractions and TLFR as well as TAFR were evaluated and the distinctions among healthy, obese (OB) and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were recorded during the physical examination. BMI values were calculated. Total, trunk, leg and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including lipid fractions were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR as well as TAFR values in MO group. When adjusted for SBP and DBP, partial correlations were calculated for LDL-TLFR as well as LDL-TAFR. Much stronger partial correlations were obtained for the same couples upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: Children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio.

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Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Obesity may lead to growing serious health problems throughout the world. Vitamin D appears to play a role in cardiovascular and metabolic health. Vitamin D deficiency may add to derangements in human metabolic systems, particularly those of children. Childhood obesity is associated with an increased risk of chronic and sophisticated diseases. The aim of this study is to investigate associations as well as possible differences related to parameters affected by obesity and their relations with vitamin D status in obese (OB) and morbid obese (MO) children. This study included a total of 78 children. Of them, 41 and 37 were OB and MO, respectively. WHO BMI-for age percentiles were used for the classification of obesity. The values above 99 percentile were defined as MO. Those between 95 and 99 percentiles were included into OB group. Anthropometric measurements were recorded. Basal metabolic rates (BMRs) were measured. Vitamin D status is determined by the measurement of 25-hydroxy cholecalciferol [25- hydroxyvitamin D3, 25(OH)D] using high-performance liquid chromatography. Vitamin D status was evaluated as deficient, insufficient and sufficient. Values < 20.0 ng/ml, values between 20-30 ng/ml and values > 30.0 ng/ml were defined as vitamin D deficient, insufficient and sufficient, respectively. Optimal 25(OH)D level was defined as ≥ 30 ng/ml. SPSSx statistical package program was used for the evaluation of the data. The statistical significance degree was accepted as p < 0.05. Mean ages did not differ between the groups. Significantly increased body mass index (BMI), waist circumference (C) and neck C as well as significantly decreased fasting blood glucose (FBG) and vitamin D values were observed in MO group (p < 0.05). In OB group, 37.5% of the children were vitamin D deficient, and in MO group the corresponding value was 53.6%. No difference between the groups in terms of lipid profile, systolic blood pressure (SBP), diastolic blood pressure (DBP) and insulin values was noted. There was a severe statistical significance between FBG values of the groups (p < 0.001). Important correlations between BMI, waist C, hip C, neck C and both SBP as well as DBP were found in OB group. In MO group, correlations only with SBP were obtained. In a similar manner, in OB group, correlations were detected between SBP-BMR and DBP-BMR. However, in MO children, BMR correlated only with SBP. The associations of vitamin D with anthropometric indices as well as some lipid parameters were defined. In OB group BMI, waist C, hip C and triglycerides (TRG) were negatively correlated with vitamin D concentrations whereas none of them were detected in MO group. Vitamin D deficiency may contribute to the complications associated with childhood obesity. Loss of correlations between obesity indices-DBP, vitamin D-TRG, as well as relatively lower FBG values, observed in MO group point out that the emergence of MetS components starts during obesity state just before the transition to morbid obesity. Aside from its deficiency state, associations of vitamin D with anthropometric measurements, blood pressures and TRG should also be evaluated before the development of morbid obesity.

Keywords: Children, morbid obesity, obesity, vitamin D.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B₁₂ plays essential roles in fat and protein metabolisms and its cooperation with vitamin B₉ is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B₁₂ concentrations were measured using electrochemiluminescence immunoassay. Vitamin B₉ was analyzed by an immunoassay analyzer. Values for vitamin B₁₂ < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B₉ levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B₉ and vitamin B₁₂ levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B₁₂ levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B₉ and B₁₂ may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B₁₂ metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B₁₂ and vitamin B₉ deficiency in MetS associated with the increased vitamin B₁₂ as well as vitamin B₉ deficiency metabolites may add to MetS parameters.

Keywords: Children, cobalamin, folate, metabolic syndrome, obesity.

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Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Childhood obesity, which may lead to increased risk for heart diseases in children as well as adults, is one of the most important health problems throughout the world. Prevalences of morbid obesity and metabolic syndrome (MetS) are being increased during childhood age group. MetS is a cluster of metabolic and vascular abnormalities including hypercoagulability and an increased risk of cardiovascular diseases (CVDs). There are also some relations between some components of MetS and leukocytes. The aim of this study is to investigate complete blood cell count parameters that differ between morbidly obese boys and girls with MetS diagnosis. A total of 117 morbid obese children with MetS consulted to Department of Pediatrics in Faculty of Medicine Hospital at Namik Kemal University were included into the scope of the study. The study population was classified based upon their genders (60 girls and 57 boys). Their heights and weights were measured and body mass index (BMI) values were calculated. WHO BMI-for age and sex percentiles were used. The values above 99 percentile were defined as morbid obesity. Anthropometric measurements were performed. Waist-to-hip and head-to-neck ratios as well as homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. Components of MetS (central obesity, glucose intolerance, high blood pressure, high triacylglycerol levels, low levels of high density lipoprotein cholesterol) were determined. Hematological variables were measured. Statistical analyses were performed using SPSS. The degree for statistical significance was p ≤ 0.05. There was no statistically significant difference between the ages (11.2±2.6 years vs 11.2±3.0 years) and BMIs (28.6±5.2 kg/m² vs 29.3±5.2 kg/m²) of boys and girls (p ≥ 0.05), respectively. Significantly increased waist-to-hip ratios were obtained for boys (0.94±0.08 vs 0.91±0.06; p=0.023). Significantly elevated values of hemoglobin (13.55±0.98 vs 13.06±0.82; p=0.004), mean corpuscular hemoglobin concentration (33.79±0.91 vs 33.21±1.14; p=0.003), eosinophils (0.300±0.253 vs 0.196±0.197; p=0.014), and platelet (347.1±81.7 vs 319.0±65.9; p=0.042) were detected for boys. There was no statistically significant difference between the groups in terms of neutrophil/lymphocyte ratios as well as HOMA-IR values (p ≥ 0.05). Statistically significant gender-based differences were found for hemoglobin as well as mean corpuscular hemoglobin concentration and hence, separate reference intervals for two genders should be considered for these parameters. Eosinophils may contribute to the development of thrombus in acute coronary syndrome. Eosinophils are also known to make an important contribution to mechanisms related to thrombosis pathogenesis in acute myocardial infarction. Increased platelet activity is observed in patients with MetS and these individuals are more susceptible to CVDs. In our study, elevated platelets described as dominant contributors to hypercoagulability and elevated eosinophil counts suggested to be related to the development of CVDs observed in boys may be the early indicators of the future cardiometabolic complications in this gender.

Keywords: Children, complete blood count, gender, metabolic syndrome.

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