Growth velocity and weight gain in prepubertal asthmatic children

Objective: To evaluate the stature growth rate (GR) and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR) was calculated. Results: Excess weight (risk for overweight, overweight and obesity) was observed in 31.8% (27/85) of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2) was found in 13.9% (11/79) of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047). Use of steroids (dose, type and time of use) was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.National Counsel of Technological and Scientific Development (CNPq)Univ Fed Sao Paulo Unifesp, Escola Paulista Med EPM, Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilUnifesp, EPM, Dept Pediat, Santo Andre, SP, BrazilFMABC, Dept Pediat, Santo Andre, SP, BrazilUniv Fed Sao Paulo, EPM, Dept Pediat, Rua Otonis 725, BR-04025002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med EPM, Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilUnifesp, EPM, Dept Pediat, Santo Andre, SP, BrazilUniv Fed Sao Paulo, EPM, Dept Pediat, Rua Otonis 725, BR-04025002 Sao Paulo, SP, BrazilWeb of Scienc

Is age a risk factor for liver disease and metabolic alterations in ataxia Telangiectasia patients?

Background: Ataxia telangiectasia (A-T) is a neurodegenerative disease that leads to mitochondrial dysfunction and oxidative stress. Insulin resistance (IR), type 2 diabetes and the risk for development of cardiovascular disease was recently associated as an extended phenotype of the disease. We aimed to assess IRliver involvementcarotid intima-media thickness (cIMT) and metabolic alterations associated to cardiovascular risk in A-T patients, and relate them with age. Results: Glucose metabolism alterations were found in 54.6% of the patients. Hepatic steatosis was diagnosed in 11/17 (64.7%) A-T patients. AST/ALT ratio > 1 was observed in 10/17 (58.8%). A strong positive correlation was observed between insulin sum concentrations with ALT (r = 0.782, p < 0.004) and age (r = 0.818, p = 0.002). Dyslipidemia was observed in 55.5% of the patients. The apolipoprotein (Apo-B)/ApoA-I ratio (r = 0.619p < 0.01), LDL/HDL-c (r = 0.490p < 0.05) and the Apo-B levels (r = 0.545p < 0.05) were positively correlated to cIMT. Conclusions: Metabolic disorders implicated in cardiovascular and liver diseases are frequently observed in adolescent A-T patients and those tend to get worse as they become older. Therefore, nutritional intervention and the use of drugs may be necessary.CAPES Foundation, Ministry of Education of Brazil, Brasilia DF, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Pediat, Rua Otonis 725, BR-04025002 São Paulo, SP, BrazilABC Fdn FMABC, Fac Med ABC, Dept Morphol & Physiol, Santo Andre, SP, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Diagnost Imaging, São Paulo, SP, BrazilSanta Casa São Paulo Sch Med Sci FCMSCSP, São Paulo, SP, BrazilFed Univ Alfenas UNIFAL, Sch Nutr, Alfenas, MG, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Pediat, Rua Otonis 725, BR-04025002 São Paulo, SP, BrazilFed Univ São Paulo UNIFESP, Escola Paulista Med, Dept Diagnost Imaging, São Paulo, SP, BrazilWeb of Scienc

Avaliação da espessura do complexo médio-intimal da carótida em pacientes com ataxia telangiectasia: associação com biomarcadores relacionados ao metabolismo lipídico e da glicose

Introduction: Ataxia telangiectasia (A-T) is a neurodegenerative disease, which evolves immunodeficiency in varying degrees, mitochondrial dysfunction and oxidative stress. Recent discoveries include extended phenotype of the disease other changes such as insulin resistance and risk for developing diabetes and atherosclerotic diseases. Objective: Evaluate the carotid media-intima thickness and correlate it with the lipid and glucose metabolism biomarkers in A-T patients. Methods: Prospective and controlled cross-sectional study which evaluated 18 patients and 17 controls, matched by sex, age and pubertal staging, regarding nutritional status, lipid profile, apolipoproteins A-I and B (Apo A-I and Apo B ), glucose and insulin basal and after oral glucose overload and was measured the carotid media-intima thickness (IMT). Results: The median age of A-T group was 13.1 years; 6/18 (33%) were malnourished, 3/13 (23.1%) presented short height for age and 10/18 (55.5%) impairment of muscle mass. Dyslipidemia was observed in 10/18 (55.5%) of patients, however only for concentrations of high density lipoprotein cholesterol (HDL-c) was observed a statistically significant difference between the two groups (p= 0.020). A-T group 1/18 (5.5%) was diabetic, 2/11 (18.2%) presented glucose intolerance and 5/11 (41.2%) insulin resistance. In bivariate analysis, the body mass index (BMI) and blood glucose concentrations of fasting were lower, and the Apo B and the ration of Apo B/ApoA-I were highest in A-T group. However, in multivariate analysis only the BMI and the ratio of Apo B/Apo A-I were remained in the model. The median carotid IMT thickness presented correlation with ratios of Apo B/Apo A-I, LDL-c/HDL-c and with the concentrations of Apo B. The intake of energy, macronutrients and cholesterol did not differ between the groups. Conclusion: A-T patients present risk of atherosclerosis and diabetes that coupled with the commitment of nutritional status can complicate the evolution of the disease.Introdução: A ataxia telangiectasia (A-T) é uma doença neurodegenerativa, que cursa com imunodeficiência em graus variáveis, disfunção mitocondrial e estresse oxidativo. Descobertas recentes incluem como fenótipo estendido da doença outras alterações como a resistência à insulina e o risco para o desenvolvimento de diabetes e doenças ateroscleróticas. Objetivo: Avaliar a espessura médio-intimal da carótida e correlacioná-la com biomarcadores do metabolismo lipídico e da glicose em pacientes com A-T. Métodos: Estudo transversal prospectivo e controlado que avaliou 18 pacientes e 17 controles, pareados por sexo, idade e estadiamento puberal, quanto ao estado nutricional, perfil lipídico, apolipoproteínas A-I e B (Apo A-I e Apo B), glicemia e insulinemia basais e após sobrecarga oral de glicose e aferiu a medida da espessura do complexo médio-intimal (CMI) da carótida. Resultados: A mediana de idade do grupo A-T foi de 13,1 anos; 6/18 (33%) eram desnutridos, 3/13 (23,1%) apresentavam baixa estatura para idade e 10/18 (55,5%) comprometimento da massa muscular. Foi observado dislipidemia em 10/18 (55,5%) dos pacientes, no entanto, apenas para o HDL-c foi constatada diferença significante entre os dois grupos (p=0,020). No grupo A-T 1/18 (5,5%) era diabético, 2/11 (18,2%) apresentavam intolerância à glicose e 5/11 (41,2%) resistência à insulina. Na análise bivariada o índice de massa corporal (IMC) e as concentrações de glicemia de jejum foram menores, e as de Apo B e da relação Apo B/ApoA-I foram maiores no grupo A-T. No entanto, na análise multivariada somente o IMC e a relação Apo B/Apo A-I permaneceram no modelo. A mediana da espessura do CMI da carótida apresentou correlação com as relações Apo B/Apo A-I, LDL-c/HDL-c e com a Apo B. A ingestão de energia, macronutrientes e colesterol não diferiu entre os grupos. Conclusão: Pacientes com A-T apresentam risco de aterosclerose e de diabetes que aliado ao comprometimento do estado nutricional pode complicar a evolução da doença.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016