Evaluation of iron balance in healthy pregnant women and their newborns

Aim of the study: The aim of this study was to evaluate the iron status markers in normal healthy pregnancy, as well as the influence of maternal diet on iron concentration in their newborns. Material and methods: A longitudinal prospective study was conducted in a sample of 69 healthy, non-smoking pregnant women under prenatal care of The Institute of Mother and Child. Blood samples were collected in the first, second and third trimesters and from the umbilical vein. Concentrations of ferritin and transferrin were assessed using turbidimetric technique, the concentration of iron - with ferrozine colorimetric method. Pentra 120 analyzer was used to define hematological parameters. Maternal diet was assessed by means of a weekly questionnaire, processed with computer software Dietetyk 2. Results: Hematological parameters in the analyzed blood were normal. The average hematocrit values in the first trimester of pregnancy was 36.7%, in the second - 34.92%, in the third - 35.95%. The concentration of hemoglobin was 27.82g/dl, 28.55g/dl, 27.27g/dl in the respective trimesters of pregnancy. In the umbilical blood it was 25.84g/dl (5.2% less than in the maternal blood). The number of erythrocytes was the highest in the first (4.16mln/mm3), and the lowest in the second trimester (3.92mln/mm3). The average concentration of iron was the highest in the first trimester - 99.61μg/dl. In the second and third trimester it decreased by 25% and 2% respectively. The concentration was 76.34% higher in the umbilical blood than in maternal blood at the time of labor. The concentration of ferritin in the first trimester was 43.96μg/l, in the second and the third trimester it was lower by 46% and 29% respectively. It was 126.4μg/l in the umbilical blood (fourfold higher than in maternal blood). The concentration of transferrin was 321.01mg/dl in the first trimester and it increased in consecutive trimesters by 36.14% and 5.12%; it was 219.92mg/dl in the umbilical blood - 48% of the concentration of transferrin in the maternal blood at the time of labor. The analysis of an average daily food ration revealed that the supply of iron was 80% of the recommended dose in the first half and only 41% of the recommended dose in the second half of the pregnancy. Fat consumption was 99% and 95% of the recommended dose, respectively. There was a 30%-decrease in the protein and carbohydrates consumption in comparison with the recommended dose in the second half of the pregnancy. Conclusions: In spite of normal hematological parameters, we observed insufficient supply of iron in the diet of pregnant women, which was demonstrated by a decreased level of ferritin. It should be reason enough to issue dietary recommendations and guidelines for pregnant women in each stage of pregnancy

Influence of Oxidative Stress Generated by Smoking during Pregnancy on Glutathione Status in Mother-Newborn Pairs

Glutathione plays a key role in maintaining a physiological balance between prooxidants and antioxidants in the human body. Therefore, we examined the influence of maternal smoking as a source of oxidative stress measured by total oxidant capacity (TOC) on reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione peroxidase (GPx-3), and reductase (GR) amount in maternal and umbilical cord blood in 110 (45 smoking and 65 non-smoking) mother-newborn pairs. Concentrations of glutathione status markers and TOC were evaluated by competitive inhibition enzyme immunoassay technique. Plasma TOC levels were significantly higher and the GSH/GSSG ratio, which is considered an index of the cell’s redox status, were significantly lower in smoking women and their offspring than in non-smoking pairs. Decreased GR levels were found in smoking mothers and their newborns compared with similar non-smoking groups. Although plasma GPx-3 concentrations were similar in both maternal groups, in the cord blood of newborns exposed to tobacco smoke in utero they were reduced compared with the levels observed in children of tobacco abstinent mothers. Oxidative stress generated by tobacco smoke impairs glutathione homeostasis in both the mother and the newborn. The severity of oxidative processes in the mother co-existing with the reduced potential of antioxidant systems may have a negative effect on the oxidative-antioxidant balance in the newborn

Antioxidant status in erythrocytes of cystic fibrosis children.

Activities of superoxide dismutase, catalase and glutathione peroxidase in erythrocytes of cystic fibrosis children were studied in order to estimate the severity of their deficiency. Our results point to increased susceptibility of erythrocytes of cystic fibrosis subjects to oxidative injury and indicate that the antioxidant status of patients should be carefully monitored

Oxidative and Antioxidative Status Expressed as OSI Index and GSH/GSSG Ratio in Children with Bone Tumors after Anticancer Therapy Completion

Aims. There are no data on the redox status of children with bone tumors in complete disease remission. Therefore, the presented study examined the reduced/oxidized glutathione (GSH/GSSG) ratio, total oxidant capacity (TOC) and total antioxidant capacity (TAC) values as well as the oxidative stress index (OSI) for assessing alterations in the oxidant/antioxidant balance in 35 children with osteosarcoma or Ewing’s sarcoma after anticancer therapy completion (median 14 months) compared with a control group. Methods. GSH, GSSG, TOC, TAC concentrations and bone alkaline phosphatase (BALP) activity were evaluated by immunoenzymatic (ELISA) and enzymatic methods. Results. We found no differences in serum BALP activity between all survivors with bone tumors and the control group. Patients with osteosarcoma after anticancer therapy completion had significantly higher values of TAC, GSH and the GSH/GSSG ratio as well as GSSG than healthy subjects. In patients with Ewing’s sarcoma, we found significantly higher values of TOC concentration compared with healthy children. In addition, survivors with Ewing’s sarcoma had higher TOC concentrations and OSI index values (p < 0.01), but a lower GSH/GSSG ratio (p < 0.05) than survivors with osteosarcoma. A positive correlation between TOC and the post-therapy period was observed in survivors. Conclusions. We found that in survivors with bone tumors, a disturbed balance between prooxidants and antioxidants persists after the completion of anticancer treatment. Moreover, an increased TOC value together with the post-therapy period may suggest increasing oxidative processes in survivors with bone tumors after treatment. Further observations will allow assessment of the relationship between the oxidant/antioxidant status and the predisposition of survivors to bone neoplastic disease recurrence

Assessment of Inflammatory Markers in Children with Cow’s Milk Allergy Treated with a Milk-Free Diet

Background: The aim of the study was to establish whether the use of a strict milk-free diet in children with cow’s milk allergy, resulting in the resolution of clinical symptoms of the disease, also extinguishes the inflammatory reaction induced by the allergy. Methods: We examined 64 children (aged 3–6 years) with a diagnosed cow’s milk allergy who had been treated with an elimination diet for at least six months and showed remission of the disease’s clinical symptoms as a result of the treatment. The control group consisted of 30 healthy children of the same age following an unrestricted age-appropriate diet. Concentrations of cytokines, calprotectin, and adipokines (leptin, resistin, chemerin, neutrophilic lipocalin associated with gelatinase—NGAL) were determined in the serum samples obtained from the studied children by immunoenzymatic assays. Results: Patients with CMA had significantly higher median values of serum IL-6, TNF-α, resistin, chemerin and NGAL in comparison to the healthy children (p < 0.05, p < 0.001, p < 0.05, p < 0.01, p < 0.001, respectively). Serum concentrations of IL-10, leptin, calprotectin and CRP as well as in WBC count were in the same range in both studied groups. We observed direct statistically significant correlations between levels of IL-10 and CRP (p = 0.005), IL-10 and WBC (p = 0.045), TNF-α and WBC (p = 0.038), calprotectin and WBC (p < 0.001), chemerin and CRP (p < 0.001) as well as between NGAL and WBC (p = 0.002) in children with CMA. Conclusion: The use of a strict milk-free diet by children with CMA, resulting in the resolution of clinical symptoms of the disease, does not seem to extinguish the inflammation induced by the allergy. The findings of this study—elevated IL-6, TNF-α, resistin, chemerin and NGAL levels in patients with CMA—suggest that these parameters seem to be involved in the generation of a low-grade proinflammatory environment observed in cow‘s milk allergy and could be used to monitor the effectiveness of treatment

Relationships between Body Weight Status and Serum Levels of Adipokine, Myokine and Bone Metabolism Parameters in Healthy Normal Weight and Thin Children

Optimal body weight and body composition for age are relevant to child development and healthy life. Changes in lean mass and fat mass as well as its distribution are associated with alterations in the secretion of myokines and adipokines by muscle and adipose tissues. These factors are very important for bone health. The aim of the study was to assess serum leptin, adiponectin, resistin, visfatin and omentin as adipokines and myostatin and irisin as myokines with regard to their associations with bone parameters in healthy normal weight and thin children. We studied 81 healthy prepubertal children (aged 5 to 9 years) divided into three groups: group A—35 children with a BMI z-score between +1 and −1 SD; group B—36 children with a BMI z-score between −1 and −2 SD; and group C—10 thin children with a BMI z-score of p p < 0.05) lower concentrations of 25-hydroxyvitamin D, resistin and high-molecular-weight (HMW) adiponectin but higher levels of myostatin as the BMI z-score deceased. We found that BMI and leptin levels were directly correlated with fat mass, lean mass, bone mineral content (BMC) and BMD. Resistin levels were negatively associated with lean mass, while visfatin concentrations were positively related to total BMD. In healthy prepubertal children there were differences in body composition and in bone mineral density across decreasing BMI status. We suggest that changes in serum myostatin and 25-hydroxyvitamin D levels may play a role in bone status of thin children. Moreover, significant relations between adipokines and bone parameters may confirm crosstalk between fat tissue and bone in these children

Analysis of the concentration of vitamin E in erythrocytes of patients with celiac disease

Abstract Introduction: Consumption of gluten proteins leads to an enteropathy characterised by lymphocytic infiltration of mucous membrane, crypts hypertrophy, and atrophy of villi. Enteropathy leads to disturbances in the immune system as well as secondary deficiency of vitamin E. Aim: Analysis of the concentration of vitamin E in erythrocytes of patients with celiac disease. Material and methods: Three experimental groups were distinguished among 77 patients with histologically confirmed celiac disease (mean age: 17 years): those who strictly respected gluten-free diet (group I, n = 48), patients breaking dietary recommendations (group II, n = 22), and those with newly diagnosed disease (group III, n = 7). Additionally, a control group consisting of healthy individuals with negative serological markers of celiac disease was formed (group IV, n = 20). Vitamin E concentration was determined by high performance liquid chromatography with ultraviolet detector. Results: Significantly lower average concentration of vitamin E was demonstrated in erythrocytes in all examined groups of patients with celiac disease compared to the control group. Among the patients with celiac disease, the highest average concentration of vitamin E in erythrocytes was observed in the group who respected the gluten-free diet, a little lower in patients who violated dietary recommendations, and lowest among patients with newly diagnosed disease. These relationships, however, were not statistically significant. Conclusions: Patients with celiac disease are at risk of vitamin E deficiency irrespective of their diet. Vitamin supplementation should be considered in their case, especially immediately after diagnosis of the disease and in case of breaking a gluten-free diet regime

Total Oxidant and Antioxidant Status in Prepubertal Children with Obesity

Aims. Obesity is accompanied by the formation of oxygen free radicals, whose intensified activity without effective defense mechanisms can lead to oxidative stress and related complications. We evaluated the presence of oxidative stress in obese prepubertal children. Methods. The study included 83 healthy children aged 2–10 years (62 with obesity and 21 nonobese controls). Total oxidant capacity (TOC), total antioxidant capacity (TAC), oxidized low-density lipoprotein (ox-LDL), lipid parameters, glucose, and C-reactive protein (CRP) were measured in serum. Oxidative stress index (OSI) was calculated. Results. Serum TOC concentration was significantly higher (p<0.05) and TAC concentration was lower (p<0.05) in obese children. OSI was higher (p<0.01) in obese subjects compared with controls. CRP levels were normal in all children, but median CRP value was higher (p<0.01) and HDL cholesterol levels were lower (p<0.05) in the obese group. We found a significant negative correlation between TAC and ox-LDL concentrations (r=−0.27, p<0.05) in obese children. Furthermore, obesity duration was positively correlated with TOC level (r=0.32, p<0.05) in this group. Conclusions. Obesity-related oxidative stress already occurs in prepubescence. Early obesity diagnosis and the necessary therapeutic activity implementation is a vital strategy for the prophylaxis of free radical damage and related multiorgan complications

Comparison of body composition and adipokine levels between thin and normal‐weight prepubertal children

Objective: Thinness can have substantial consequences for child development and health. Adipokines, including leptin and adiponectin, play a significant role in the regulation of important metabolic functions. The aim of this study was to investigate associations between body composition and serum leptin and adiponectin levels in thin and normal‐weight children. Methods: The authors examined 100 healthy prepubertal children, who were divided into two subgroups: thin (n = 50) and normal‐weight children (n = 50). Body composition was assessed by dual‐energy X‐ray absorptiometry. Serum concentrations of adipokines were determined by immunoenzymatic assays. Results: Thin children had a similar body height but significantly lower (p < 0.0001) body weight, body mass index, fat mass, lean mass, and bone mineral content compared with normal‐weight children. Serum concentrations of leptin were about 2‐fold lower (p < 0.0001) in thin vs. normal‐weight subjects. Serum levels of total adiponectin, adiponectin multimers, and soluble leptin receptor (sOB‐R) were similar in both groups. The leptin/soluble leptin receptor ratio and leptin/adiponectin ratios were lower (p < 0.0001) in thin vs. normal‐weight children. In both groups of children, it was found that body composition parameters were positively related with leptin but not with adiponectin levels. Additionally, bone mineral content was positively related with body mass index, fat mass, lean mass, and leptin level in thin and normal‐weight children. Conclusions: Prepubertal thin children have disturbances in body composition and adipokine profile. Early recognition of thinness and determination of body composition parameters and adipokine levels can be useful in medical and nutritional care of thin children for the optimization of bone mineral accrual