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

Inflammatory markers, tbars and vitamin E in class II and III obese patients before undergoing bariatric surgery

Background: Obesity and its comorbidities such as insulin resistance, endothelial dysfunction, hypertension, type 2 diabetes and atherosclerosis have been associated with chronic inflammation and oxidative stress. Weight loss with maintenance is not always possible. Bariatric surgery has been proved to be the only efficient method for weight reduction in patients with clinically severe obesity. It leads to significant weight loss and improvement and/or remission of comorbidities. On the other hand, considering that surgical intervention per se induces oxidative stress and inflammatory response, the objective of the present study was to verify if some inflammatory marker, TBARS and/or Vitamin E could be evaluated before gastric surgery. Methods: a quantitative cross-sectional study was carried out at Clinica Ana Rosa (Santo André, SP, Brazil). 100 obese patients (BMI ≥ 35-40 kg/m2) awaiting bariatric surgery were selected for this study. The control group included 29 individuals, BMI &lt; 35 kg/m2, with or without associated comorbidities. The patients completed a structured interview. Weight, height, waist and hip circumferences were also collected. Blood was collected. Glucose (G), total cholesterol (TC), HDL cholesterol (HDLc), LDL cholesterol (LDLc), VLDL cholesterol (VLDLc), triglycerides (TG), high-sensitivity C-reactive protein (hs-CRP), vitamin E (VIT E), fibrinogen (FIB), IL-6 (human interleukin-6), TNF-alpha and thiobarbituric acid reactive substances (TBARS) were measured. Results: patients have shown increased serum levels of hs-CRP and FIB. In this study, class II and III obese patients awaiting bariatric surgery and the control group had lower than normal VIT E levels and no significant changes in TBARS levels were observed. Conclusions: excess weight and accumulated fat in subjects with severe obesity seem to be related to increased inflammatory response, therefore, our results reinforce the importance of evaluating inflammatory markers and VIT E in obese patients before bariatric surgery.Â

Retinol, beta-carotene, oxidative stress, and metabolic syndrome components in obese asthmatic children

Universidade Federal de São Paulo, Escola Paulista Med, Dept Paediat, EPM UNIFESP, São Paulo, BrazilFac Med ABC, Dept Pediat, Santo Andre, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Paediat, EPM UNIFESP, São Paulo, BrazilWeb of Scienc

Avaliação antropométrica, fatores de risco para desnutrição e medidas de apoio nutricional em crianças internadas em hospitais de ensino no Brasil Anthropometric evaluation, risk factors for malnutrition, and nutritional therapy for children in teaching hospitals in Brazil

OBJETIVO: Avaliar os fatores de risco para desnutrição, estado nutricional e medidas de apoio nutricional em crianças hospitalizadas. MÉTODOS: Por meio de estudo longitudinal, prospectivo, avaliou-se por 3 meses consecutivos todas as crianças hospitalizadas (< 5 anos) em enfermarias de pediatria geral de 10 hospitais universitários brasileiros. Para coleta de dados, utilizou-se questionário padrão e avaliação da condição nutricional, obtida na internação e alta: escore z peso/estatura, peso/idade e estatura/idade. RESULTADOS: Somente 56,7% das crianças tinham classificação do estado nutricional registrada no prontuário. Observou-se, na admissão, 16,3 e 30% de crianças com desnutrição moderada/grave e baixa estatura, respectivamente. O risco de desnutrição associou-se com o baixo peso ao nascer e com a baixa idade das crianças. Houve alto percentual de agravos nutricionais nas crianças avaliadas, não sendo verificada a anotação da condição nutricional no prontuário e nem adoção de medidas de terapia nutricional apropriadas para crianças desnutridas. CONCLUSÕES: Salienta-se a importância da capacitação das unidades hospitalares quanto ao diagnóstico e abordagem terapêutica da desnutrição baseado nos guias de conduta já disponíveis em nosso país.<br>OBJECTIVE: To evaluate risk factors for malnutrition, nutritional status and nutritional support provided in hospitalized children. METHODS: This longitudinal study prospectively followed, for 3 consecutive months, all children under 5 years of age (n = 907) hospitalized in general pediatric medical wards of 10 Brazilian university-based hospitals. For data collection, a standard questionnaire was used and nutritional condition was evaluated at hospital admission and discharge: weight-for-height, weight-for-age and height-for-age z score. RESULTS: Only 56.7% of the children had their nutritional classification documented in the medical record. At hospital admission, 16.3 and 30.0% of the children had moderate/severe malnutrition and low stature, respectively. Risk of malnutrition was associated with low birth weight and younger age. A high percentage of nutritional deficiencies was observed in the children analyzed, although child's nutritional condition and the adoption of appropriate nutritional therapy were not documented in the medical records of the malnourished children. CONCLUSION: These data underscore the importance of developing qualified hospital medical wards regarding diagnosis and therapeutic approach to malnutrition, based on the conduct guidelines already available in Brazil

Vitamina A: nível sérico e ingestão dietética em crianças e adolecentes com déficit estatural de causa não hormonal Vitamin A: blood level and dietetics intake in stunted children and adolescents without hormonal disease

OBJETIVOS: Determinar a ingestão dietética de vitamina A e os níveis séricos de carotenóides e retinol em crianças e adolescentes com déficit estatural sem causa hormonal, atendidos no Ambulatório de Endocrinopediatria do Núcleo de Nutrição (NUNADI) da Secretaria de Estado da Saúde de São Paulo. MÉTODOS: Foram avaliados de maneira prospectiva 47 pacientes pré-púberes, entre 4 e 14 anos, com relação a: antropometria, idade óssea, inquérito alimentar, bioimpedanciometria e nível sérico de retinol e carotenóides. RESULTADOS: A média do escore Z da estatura foi de -2,4; 20% dos pacientes eram desnutridos, 25,5% tinham inadequação da massa gorda e maior atraso da idade óssea. Os níveis séricos de retinol e carotenóides foram inadequados em 21% dos pacientes, sendo que foi maior o percentual de inadequação dos carotenóides nos pacientes que apresentavam déficit estatural mais acentuado. Não houve relação dos níveis séricos de retinol e carotenóides com a velocidade de crescimento. Em 82,9% dos inquéritos alimentares realizados, houve ingestão de vitamina A inferior a 50% do estabelecido na Pirâmide de Alimentos. CONCLUSÃO: Baseados nestes resultados, concluímos que há uma elevada prevalência de desnutrição, comprometimento da idade óssea, inadequação no nível sérico de carotenóides e ingestão de vitamina A em crianças com comprometimento estatural.<br>OBJECTIVES: To determine the vitamin A intake and the blood levels of carotenoids and retinol in stunted children and adolescents without hormonal disease, assisted in the Clinic of Pediatric Endocrinology of the Center for Nutrition and Child Development - Department of Health, State of São Paulo, Brazil. METHODS: We evaluated, in a prospective and randomized trial, 47 prepubertal patients between 4 and 14 years old. All patients were submitted to anthropometric evaluation, bone age, bioelectric impedance and serum retinol and carotenoid levels. RESULTS: The average of the stature z score was -2.4; 20% of the patients were undernourished, 25.5% they had inadequacy of the fat mass as well as larger delay of the bone age. The more stunted the patients the lower were the carotenoid levels. There was no relationship between the levels of retinol and carotenoids and the growth velocity. In 82.9% of the recall record of food intake, the vitamin A intake was lower than 50% of the established one in the Food Guide Pyramid. CONCLUSION: There is a high prevalence of malnutrition, bone age delay and inadequacy of the levels of carotenoids and vitamin A intake in stunted children and adolescents

Assessment of Nutritional Status and Eating Disorders in Female Adolescents With Fibromyalgia

Purpose: To assess eating disorders, nutritional status, body composition, and food intake in adolescents presenting with fibromyalgia.Methods: in a cross-sectional study, we evaluated the nutritional status (z score of body mass index [ZBMI]), waist circumference, body fat percentage by bioelectrical impedance analysis, symptoms of disordered eating, and possible eating disorders (Kids' Eating Disorders Survey [KEDS]) of 23 female adolescents with fibromyalgia and 23 matched healthy control subjects.Results: Median age for both groups was 15 years. in the fibromyalgia group, the median time for diagnosis was 13.5 months. We did not observe a statistically significant difference between the control and fibromyalgia groups in relation to ZBMI, fat mass percentage, food intake, and symptoms of disordered eating (KEDS). in the fibromyalgia group, there was a significant correlation between fat mass percentage and the total KEDS score (r = .587, p = .003); the same correlation was observed for ZBMI (r = .0778, p < .001).Conclusions: This study verified an absence of nutritional and eating disorders in adolescents recently diagnosed with fibromyalgia that, in addition to the correlation between adiposity indexes and KEDS total score, emphasizes the importance of nutritional and body composition assessment, allowing an early and adequate nutritional intervention. (C) 2012 Society for Adolescent Health and Medicine. All rights reserved.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo UNIFESP, Dept Pediat, Pediat Rheumatol Unit, BR-04038002 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Pediat, Pediat Rheumatol Unit, BR-04038002 São Paulo, BrazilWeb of Scienc