Lipoprotein (a) levels in children before and after antibiotic treatment

High lipoprotein (a), Lp(a), levels are closely related to thrombosis damage. Aim: The aim of this study was the evaluation of serum Lp(a) levels before and after 10 days treatment with certain antibiotic drugs. Patients and Methods: Before the beginning of this study, 3298 Lp(a) values were analyzed according to age percentiles (6-14 yrs) in order to establish control values. 110 children 6-14 yrs old, mean age 10±4 yrs were enrolled in this study. The children were admitted to the outpatient department of a pediatric Hospital in Athens because of fever (>380 C) during the last 3 days. Blood was obtained before and ten days after treatment for common laboratory tests (complete blood counts SG0T, SGPT etc.) as well as for Lp(a) estimation with an immunoassay. Children were divided into groups according to their antibiotic treatment. - Group A (n=24) received 40mg/kg BW/24h of amoxicillin/ clavulanic acid - Group B (n=25) received 40mg/kg BW/24h of cefaclor - Group C (n=22) received 30mg/kg BW/24h of loracarbef - Group D (n=19) received 06mg/kg BW/24h of trimethoprim/sulfamethoxazole and - Group E (n=20) received 15mg/kg BW/24h of clarithromycin Results: Remarkable increase in Lp(a) levels was observed in all groups ten days after treatment with one of the above mentioned antibiotics, except Group B, whereas the other biochemical parameters did not show any significant difference. In addition, Lp(a) levels pre vs. post therapy are presented in detail: Group A pre 105.5±15 vs 174±10 (p<0.001) Group C pre 102±10 vs 143±12 (p<0.01) Group D pre 105±12 vs 823±20 (p<0.00001) Group E pre 36±12 vs 83±10 (p<0.01) In contrast, Lp(a) levels in Group B were significantly reduced (135±12 vs. 117±10 mg/L, p<0.05) after treatment. Conclusions: Administration of the above mentioned antibiotics for 10 days resulted in a significant elevation of Lp(a) levels except those who underwent cefaclor treatment. The latter seemed to reduce Lp(a) levels when administrated for the same time. Much attention must be paid on patients on chronic administration of the above mentioned antibiotics. In contrast, cefaclor administration may be used as an Lp(a) reducing drug.Τα αυξημένα επίπεδα της λιποπρωτεΐνης (a), Lp(a), στενά συσχετίζονται με την εμφάνιση θρομβοτικών βλαβών. Σκοπός της εργασίας ήταν η μέτρηση των επιπέδων της Lp(a) πριν και μετά την χορήγηση συγκεκριμένων αντιβιοτικών. Ασθενείς - Μέθοδοι: Ένεκα της πολυμορφίας των τιμών της Lp(a) προηγήθηκε η ανάλυση των τιμών της σε ένα μεγάλο αριθμό (n=3298) ελληνοπαίδων, των οποίων τα επίπεδα της Lp(a) χρησίμευσαν ως μάρτυρες. Μελετήθηκαν συνολικά 110 παιδιά ηλικίας 6-14 ετών, μέσης ηλικίας 10±4 χρόνια, τα οποία επισκέφθηκαν τα εξωτερικά ιατρεία παιδιατρικού Νοσοκομείου Αθηνών για διάγνωση και θεραπευτική αντιμετώπιση οξέως εμπύρετου νοσήματος. Οι μικροί ασθενείς χωρίστηκαν σε 5 περίπου ισάριθμες ομάδες ανάλογα με το είδος του αντιβιοτικού που εκρίθη απαραίτητο για την θεραπευτική τους αντιμετώπιση. Ο γενικός εργαστηριακός έλεγχος που περιελάμβανε γενική αίματος, ηπατικό έλεγχο κτλ. όπως επίσης την μέτρηση των επίπεδων Lp(a) εγένετο πριν και μετά 10 ήμερη χορήγηση ενός συγκεκριμένου αντιβιοτικού ως εξής: - Ομάδα Α (n=24) χορήγηση αμοξικιλλίνης κλαβουλανικού οξέος σε δόση 40mg/kg BΣ/24h - Ομάδα Β (n=25) χορήγηση κεφακλόρης σε δόση: 40mg/kg BΣ/24h - Ομάδα Γ (n=22) χορήγηση λορακαρμπέφης σε δόση: 30mg/kg BΣ/24h - Ομάδα Δ (n=19) χορήγηση τριμεθοπρίμης/σουλφαμεθοξαζόλης σε δόση: 6 mg/kgBΣ/24h και - Ομάδα Ε (n=20) χορήγηση κλαριθρομυκίνης σε δόση: 15 mg/kg BΣ/24h Ο γενικός έλεγχος έγινε με μεθόδους ρουτίνας και τα επίπεδα της Lp(a) με ανοσοενζυμική μέθοδο. Αποτελέσματα: Σημαντική αύξηση των επιπέδων της Lp(a) παρατηρήθηκε μετά την χορήγηση των αντιβιοτικών. Ομάδα Α: Lp(a) προ 105.5±15 vs 174±10 (p<0.001) Ομάδα Γ: Lp(a) προ 102±10 vs 143±12 (p<0.01) Ομάδα Δ: Lp(a) προ 105±12 vs 823±20 (p<0.00001) Ομάδα Ε: Lp(a) προ 36±12 vs 83±10 (p<0.01) Αντίθετα μείωση παρατηρήθηκε στα επίπεδα της Lp(a) στην ομάδα Β προ 135±10 vs 117±12 mg/L (p<0.05) μετά την χορήγηση κεφακλόρης. Συμπεράσματα: Η χορήγηση των προαναφερόμενων αντιβιοτικών σε θεραπευτικές δόσεις προκαλεί αύξηση των επίπεδων της Lp(a) έστω και μετά 10ημερη χορήγηση πλην της κεφακλόρης η χορήγηση της οποίας μειώνει αρκετά τα επίπεδα της Lp(a). Η χορήγηση, λοιπόν, των ανωτέρω αντιβιοτικών και κυρίως η μακροχρόνια χρήση τους (π.χ. χημειοπροφύλαξη) θα πρέπει να γίνεται με προσοχή και με την σύγχρονη μέτρηση της Lp(a). Θα πρέπει να εξετασθεί, όμως, εάν η χορήγηση της κεφακλόρης θα μπορούσε να χρησιμοποιηθεί ως παράγων που μειώνει τα επίπεδα της Lp(a) σε άτομα που πάσχουν από θρομβώσεις και συγχρόνως τα επίπεδα της είναι υψηλά

The effect of nutritional habits on maternal-neonatal lipid and lipoprotein serum levels in three different ethnic groups

Aim: To investigate the effect of nutritional habits on lipid profiles in mothers of three different ethnic groups and in their newborns. Subjects and Methods: Lipids and lipoproteins were determined in 7-day dietetic diaries of 9,134 mothers (Greeks n = 3,118, Albanians n = 3,050, Muslim Asians n = 2,966), in their sera and in the cord blood of their newborns with routine methods. Results: Monounsaturated fat intake (35 12 g/day) was similar among the groups. Total fat, saturated fat and cholesterol intakes were significantly lower in Asians than those in Albanians and Greeks. Significantly lower lipid and lipoprotein concentrations (cholesterol 5.09 +/- 0.85 mmol/l, triglyceride, TG, 2.38 +/- 0.58 mmol/l, low-density lipoprotein cholesterol, LDL-C, 2.90 +/- 0.78 mmol/l, very-low-density lipoprotein cholesterol, VLDL-C, 0.32 +/- 0.11 mmol/l) were measured in the Muslim Asian mothers and in their newborns (cholesterol 1.06 +/- 0.26 mmol/l, TG 0.52 +/- 0.16 mmol/l, LDL-C 0.49 +/- 0.10 mmol/l and VLDL-CO.10 +/- 0.02 mmol/l; p &lt; 0.001). Higher levels of the mentioned biochemical parameters were found in Greek mothers versus their newborns (cholesterol 5.20 +/- 0.98 mmol/l, TG 2.37 +/- 0.62 mmol/l, LDL-C 3.40 +/- 0.85 mmol/l and VLDL-C 0.48 +/- 0.13 mmol/l vs. cholesterol 1.55 +/- 0.31 mmol/l, TG 0.56 +/- 0.20 mmol/l, LDL-C 0.65 +/- 0.15 mmol/l and VLDL-C 0.12 +/- 0.01 mmol/l; p &lt; 0.001) and Albanian mothers versus their newborns (cholesterol 7.1 +/- 0.78 mmol/l, TG 2.55 +/- 0.60 mmol/l, LDL-C 4.1 +/- 0.88 mmol/l and VLDL-C 0.52 +/- 0.13 mmol/l vs. cholesterol 1.6 +/- 0.40 mmol/l, TG 0.59 +/- 0.15 mmol/l, LDL-C 0.70 +/- 0.21 mmol/l and VLDL-C 0.12 0.01 mmol/l; p &lt; 0.001). The highest HDL-C levels were observed in the Asian mothers (1.60 +/- 0.31 mmol/l vs. 1.4 +/- 0.39 mmol/l in Greeks and 1.31 +/- 0.39 mmol/l in Albanians; p &lt; 0.001). Conclusion: The normal lipid profile in Greeks, the high one in Albanians and the low profile in Muslim Asians may be due to their nutritional habits and their socioeconomic status affecting those of their newborns

Metabolomics of breast milk: The importance of phenotypes

Breast milk is the gold standard of nutrition for newborns. Its composition is tailored to the nutritional needs of the infant and varies between mothers. In recent years, several bioactive molecules have been discovered in addition to the main nutrients, such as multipotent stem cells, hormones, immunoglobulins, and bacteria. Furthermore, the human milk oligosaccharides (HMOs) seem to exert several important protective biological functions. According to the HMOs’ composition, breast milk can be classified as a secretory or non-secretory phenotype. In our study, we investigated the metabolome of milk collected from 58 mothers that delivered neonates at term, that were appropriate, small or large for gestational age, by performing nuclear magnetic resonance spectroscopy (1 H-NMR). From the data analysis, two groups were distinguished based on their different types of oligosaccharides, and classified according the mother phenotype: secretory and non-secretory. This information is of major importance given the different biological function of the different HMOs, such as immune-modulation and protection against disease. This would allow us to predict whether the neonate would be, for instance, more prone to developing certain diseases, and to tailor her or his nutrition to fit their needs perfectly and pave the way to a personalized nutrition

Maternal-neonatal 8-hydroxy-deoxyguanosine serum concentrations as an index of DNA oxidation in association with the mode of labour and delivery

Aim. To investigate the effect of the mode of labour and delivery on the total antioxidant status (TAS), and the biomarker of DNA oxidation, 8-hydroxy-deoxyguanosine (8-OHdG) serum levels, in mothers and their newborns. Subjects and methods. Some 106 women with normal pregnancy and normal blood biochemical parameters were divided into 4 groups: Group A ( n = 28) with normal labour and vaginal delivery ( VG), Group B ( n = 25) with scheduled cesarean section ( CS), Group C ( n = 26) with ‘emergency’ CS, and Group D ( n = 27) with prolonged labour + VG. Blood was obtained fr? m the mothers at the beginning of labour, and immediately after delivery ( pre- and post-delivery), as well as from the umbilical cord ( CB). TAS, 8-OHdG and creatine kinase (CK) were measured in the sera with appropriate methodology. Results. TAS levels were almost similar in all the groups pre- delivery, and in CB irrespective of the mode of labour and delivery, and remarkably decreased in Groups C and D post-delivery. 8-OHdG levels in Group C ( 0.94 +/- 0.08 ng/ml) and Group D (0.98 +/- 0.08 ng/ml) were significantly higher than those in Group A (0.26 +/- 0.01 ng/ml, p &lt; 0.001) and Group B (0.28 +/- 0.07 ng/ml, p &lt; 0.001) post-delivery. 8-OHdG levels were low in CB, independent of the mode of labour. CK positively correlated with 8-OHdG ( r = 0.48, p &lt; 0.001), the latter negatively correlated with TAS ( r = - 0.53, p &lt; 0.01). Conclusions. The lowest TAS and the highest 8-OHdG levels were found in Groups C and D post-delivery, probably due to the long-term participation of the mothers’ skeletal and uterus muscles, whereas 8-OHdG levels were low in CB irrespective of the mode of delivery, possibly as a consequence of the antioxidant action of the placenta and/or the low lipid levels in the serum of the umbilical cord