Screening for Celiac Disease in Children with Dental Enamel Defects

Background. Dental enamel defects (DEDs) are seen in celiac disease (CD). Aim was to detect frequency of CD among such patients. Methods. This study included 140 children with DED. They were tested for CD. Gluten-free diet (GFD) was instituted for CD patients. A cohort of 720, age and sex-matched, normal children represented a control group. Both groups were evaluated clinically. Serum calcium, phosphorus, alkaline phosphatase, serum IgA, and tissue transglutaminase (tTG) IgG and IgA types were measured. Results. CD was more diagnosed in patients with DEDs (17.86%) compared to controls (0.97%) (P < 0.0001). Majority of nonceliac patients showed grade 1 DED compared to grades 1, 2, and 3 DED in CD. Five children had DED of deciduous teeth and remaining in permanent ones. After 1 year on GFD, DED improved better in CD compared to nonceliac patients. Gastrointestinal symptoms did not vary between celiac and nonceliac DED patients. Lower serum calcium significantly predicted CD in this cohort. Conclusion. CD is more prevalent among children with DED than in the general population. These DEDs might be the only manifestation of CD; therefore, screening for CD is highly recommended among those patients especially in presence of underweight and hypocalcemia

Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea

BackgroundWe performed the study to examine the impact of hemoglobin A1c (HbA1c) criterion on the screening of increased risk for diabetes among health check-up subjects in Korea.MethodsWe retrospectively analyzed clinical and laboratory data of 37,754 Korean adults (age, 20 to 89 years; 41% women) which were measured during regular health check-ups. After excluding subjects with previously diagnosed diabetes mellitus (n=1,812) and with overt anemia (n=318), 35,624 subjects (21,201 men and 14,423 women) were included in the analysis.ResultsAmong the 35,624 subjects, 11,316 (31.8%) subjects were categorized as increased risk for diabetes (IRD) by fasting plasma glucose (FPG) criteria, 6,531 (18.1%) subjects by HbA1c criteria, and 13,556 (38.1%) subjects by combined criteria. Therefore, although HbA1c criteria alone identifies 42% [(11,316-6,531)/11,316] fewer subjects with IRD than does FPG criteria, about 20% [(13,556-11,316)/11,316] more subjects could be detected by including new HbA1c criteria in addition to FPG criteria. Among the 13,556 subjects with IRD, 7,025 (51.8%) met FPG criteria only, 2,240 (16.5%) met HbA1c criteria only, and 4,291 (31.7%) met both criteria. Among subjects with impaired fasting glucose, 65% were normal, 32% were IRD, and 3% were diabetes by HbA1c criterion. In receiver operating characteristic curve analysis, cutoff point of HbA1c with optimal sensitivity and specificity for identifying IRD was 5.4%.ConclusionAlthough HbA1c criteria alone identifies fewer subjects with IRD than does FPG criteria, about 20% more could be detected by addition of HbA1c criteria. Further studies are needed to define optimal cutoff point of HbA1c and to establish screening and management guidelines for IRD

ARTEMIN Promotes De Novo Angiogenesis in ER Negative Mammary Carcinoma through Activation of TWIST1-VEGF-A Signalling

10.1371/journal.pone.0050098PLoS ONE711