194 research outputs found

    Mechanisms of altered bone remodeling in children with type 1 diabetes

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    Bone loss associated with type 1 diabetes mellitus (T1DM) begins at the onset of the disease, already in childhood, determining a lower bone mass peak and hence a greater risk of osteoporosis and fractures later in life. The mechanisms underlying diabetic bone fragility are not yet completely understood. Hyperglycemia and insulin deficiency can affect the bone cells functions, as well as the bone marrow fat, thus impairing the bone strength, geometry, and microarchitecture. Several factors, like insulin and growth hormone/insulin-like growth factor 1, can control bone marrow mesenchymal stem cell commitment, and the receptor activator of nuclear factor-kappa B ligand/osteoprotegerin and Wnt-b catenin pathways can impair bone turnover. Some myokines may have a key role in regulating metabolic control and improving bone mass in T1DM subjects. The aim of this review is to provide an overview of the current knowledge of the mechanisms underlying altered bone remodeling in children affected by T1DM

    Body Mass Index in Children and Their Parents: A Cross-Sectional Study in a Study Population of Children from Southern Italy

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    The prevalence of overweight and obesity has increased over the last decades. Parental obesity plays an important role in determining childhood obesity. We aimed to evaluate the relationship between parental and offspring’ weight status in a population of children from South of Italy, as no data have ever been published from this area. We recruited 636 children (5.7 ± 1.5 years old) and their parents. Seventy-three (11.5%) and sixteen (2.5%) children were overweight and obese, respectively. Offspring weight status was significantly associated with parents’ weight status. The linear regression analysis showed that offspring BMI was more affected by paternal than by maternal BMI. Our data confirmed that parents’ weight status plays an important role on children’s BMI. Interestingly, in our study, parents’ height and weight were measured and not reported as in most of the previous papers, strengthening our conclusions. We suggest that intensive nutritional education and preventive programs should be performed in children with overweight / obese parents rather than in children with normal weight parent. Furthermore, nutritional education should be performed also for overweight parents to modify preventable risk factor for pediatric obesity

    Metabolic Bone Disease of Prematurity: Diagnosis and Management

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    Metabolic Bone Disease (MBD) of prematurity is a multifactorial disorder commonly observed in very low birth weight (VLBW, <1,500 g) newborns, with a greater incidence in those extremely low birth weight (ELBW, <1,000 g). MBD is characterized by biochemical and radiological findings related to bone demineralization. Several antenatal and postnatal risk factors have been associated to MBD of prematurity, although the main pathogenetic mechanism is represented by the reduced placental transfer of calcium and phosphate related to preterm birth. The diagnosis of MBD of prematurity requires the assessment of several biochemical markers, radiological, and ultrasonographic findings. However, the best approach is the prevention of the symptomatic disease, based on the screening of subjects exposed to the risks of developing MBD. Regarding the subjects who need to be screened, there is a substantial agreement on the potential risk factors for MBD. On the contrary, different recommendations exist on the diagnosis, management and treatment of this disorder of bone metabolism. This review was aimed at: (1) identifying the subjects at risk for MBD of prematurity; (2) indicating the biochemical findings to take in consideration for the prevention of MBD of prematurity; (3) suggesting practical recommendations on nutritional intake and supplementation in these subjects. We searched for papers which report the current recommendations for biochemical assessment of MBD of prematurity and for its prevention and treatment. The majority of the authors suggest that MBD of prematurity is a disease which tends to normalize overtime, thus it is not mandatory to mimic the rate of mineral fetal accretion through parenteral or enteral supplementation. The optimization of total parenteral nutrition (TPN) and the early achievement of a full enteral feeding are important goals for the prevention and management of MBD of prematurity

    High Sclerostin and Dickkopf-1 (DKK-1) serum levels in children and adolescents with type 1 diabetes mellitus

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    CONTEXT: Childhood type 1 diabetes (T1DM) is associated with decreased bone mass. Sclerostin and dickkopf-1 (DKK-1) are Wnt inhibitors which regulate bone formation. OBJECTIVE: To evaluate sclerostin and DKK-1 levels in TD1M children and to analyze the influence of the glycaemic control on bone health. DESIGN AND SETTING: Cross-sectional study conducted at a clinical research center. Partecipants: One hundred and six T1DM subjects (12.2 ± 4 years), 66 on multiple daily injections (MDI) and 40 on continuous subcutaneous infusion of insulin (CSII), and 80 controls. RESULTS: The average of bone transmission time (BTT) and amplitude-dependent speed of sound (Ad-Sos) Z-scores was lower in diabetics than controls. Significant increased DKK-1 (3593 ± 1172 vs 2652 ± 689 pg/ml, p<0.006) and sclerostin (29.45 ± 12.32 vs 22.53 ± 8.29, p<0.001) levels were found in diabetics respect to controls, particularly in patients on MDI than ones on CSII. Glycaemic control was improved in CSII patients compared to MDI ones (p<0.001) and was also associated to a significant higher BMI-SDS (p<0.002) and BTT-Z-score (p<0.02). With adjustment for age multiple linear regression analysis for DKK-1 and sclerostin as dependent variables showed that levels of HbA1c%, glucose, 25(OH)-Vitamin D, osteocalcin, PTH, years of diabetes, BMI-SDS and AD-SoS-Z-score are the most important predictors (p<0.0001). CONCLUSIONS: Our study highlighted: 1. the high serum levels of DKK-1 and sclerostin in T1DM children, and their relationship with the altered glycaemic control; 2. the effect of CSII on the improvement of glycaemic control and bone health in T1DM children

    Cardiovascular dysfunction and vitamin D status in childhood acute lymphoblastic leukemia survivors

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    Vitamin D (25-OHD) has a role in bone health after treatment for cancer. 25-OHD deficiency has been associated with risk factors for cardiovascular disease, but no data focusing on this topic in childhood cancer survivors have been published. We investigated the 25-OHD status in children treated for acute lymphoblastic leukemia (ALL), and evaluated its influence on vascular function

    Extra Virgin Olive Oil Extracts Modulate the Inflammatory Ability of Murine Dendritic Cells Based on Their Polyphenols Pattern: Correlation between Chemical Composition and Biological Function

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    Extra virgin olive oil (EVOO) represents one of the most important health-promoting foods whose antioxidant and anti-inflammatory activities are mainly associated to its polyphenols content. To date, studies exploring the effect of EVOO polyphenols on dendritic cells (DCs), acting as a crosstalk between the innate and the adaptive immune response, are scanty. Therefore, we studied the ability of three EVOO extracts (cv. Coratina, Cima di Mola/Coratina, and Casaliva), characterized by different polyphenols amount, to regulate DCs maturation in resting conditions or after an inflammatory stimulus. Cima di Mola/Coratina and Casaliva extracts were demonstrated to be the most effective in modulating DCs toward an anti-inflammatory profile by reduction of TNF and IL-6 secretion and CD86 expression, along with a down-modulation of Il-1β and iNOS expression. From factorial analysis results, 9 polyphenols were tentatively established to play a synergistic role in modulating DCs inflammatory ability, thus reducing the risk of chronic inflammation
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