Incidence of Type 2 Diabetes in Children With Nonalcoholic Fatty Liver Disease

Background & aimsType 2 diabetes (T2D) is a growing problem in children. Children with NAFLD are at potentially high risk for developing T2D; however, the incidence of T2D in this population is unknown. This study aimed to determine the incidence of T2D in children with NAFLD and identify associated risk factors.MethodsChildren with NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network were followed longitudinally. Incidence of T2D was determined by using clinical history and fasting laboratory values. Cumulative incidence curves were developed for time to T2D. A Cox regression multivariable model was constructed using best subsets Akaike's Information Criteria selection.ResultsThis study included 892 children with NAFLD and with a mean age of 12.8 years (2.7) followed for 3.8 years (2.3) with a total 3234 person-years at risk. The incidence rate of T2D was 3000 new cases per 100,000 person-years at risk. At baseline, 63 children had T2D, and during follow-up, an additional 97 children developed incident T2D, resulting in a period prevalence of 16.8%. Incident T2D was significantly higher in females versus males (hazard ratio [HR], 1.8 [1.0-2.8]), associated with BMI z-score (HR, 1.8 [1.0-3.0]), and more severe liver histology including steatosis grade (HR, 1.3 [1.0-1.7]), and fibrosis stage (HR, 1.3 [1.0-1.5]).ConclusionsChildren with NAFLD are at high risk for existing and incident T2D. In addition to known risk factors for T2D (female and BMI z-score), severity of liver histology at the time of NAFLD diagnosis was independently associated with T2D development. Targeted strategies to prevent T2D in children with NAFLD are needed

Kinetics and Pathways of the Aqueous Photolysis of Pharmaceutical Pollutants: A Versatile Laboratory or Remote Learning Investigation

In this laboratory experiment, students explore the aquatic photochemical fate of ranitidine and cimetidine, two common wastewater-derived pharmaceutical pollutants. It provides an engaging environmental context for students to develop knowledge of reaction kinetics and photochemistry, as well as skill using analytical instrumentation. This versatile experiment consists of two basic modules, three optional advanced modules, and additional add-ons that may be performed in various combinations to meet the unique learning objectives of general, analytical, physical, and environmental chemistry courses and science outreach activities. It may be performed as a traditional lab experiment or as an entirely remote exercise with an increased focus on data analysis and interpretation using provided example data sets. All photolysis experiments are carried out by preparing solutions of ranitidine or cimetidine in various matrices, irradiating the samples, and periodically removing subsamples for HPLC analysis of the compound of interest. Pseudo-first-order kinetic plots are then generated to determine rate constants that are used to draw conclusions about photolysis pathways or to calculate additional kinetic parameters. In the two basic modules, cimetidine is found to degrade appreciably only when irradiated in the presence natural organic matter (NOM), indicating an indirect, photosensitized degradation pathway. In contrast, ranitidine degrades in pure buffer and in the presence of NOM with comparable rate constants, highlighting the predominant role of direct photolysis. In the advanced modules, students calculate ranitidine direct photolysis quantum yields and examine the significance of singlet oxygen as a photochemically produced reactive intermediate. The two basic modules may be completed in two three- to five-hour lab periods while the advanced modules require additional time. This experiment requires only a HPLC, inexpensive chemicals, and common glassware and lab equipment if performed in person, and a personal computer if performed remotely.</p

Kinetics and Pathways of the Aqueous Photolysis of Pharmaceutical Pollutants: A Versatile Laboratory or Remote Learning Investigation

In this laboratory experiment, students explore the aquatic photochemical fate of ranitidine and cimetidine, two common pharmaceutical pollutants found in wastewater. It provides an engaging environmental context for students to develop knowledge of reaction kinetics and photochemistry as well as skill in using analytical instrumentation. This versatile experiment consists of two basic modules, three optional advanced modules, and additional add-ons that may be performed in various combinations to meet the unique learning objectives of general, analytical, physical, and environmental chemistry courses and science outreach activities. It may be performed as a traditional lab experiment or as an entirely remote exercise with an increased focus on data analysis and interpretation using provided example data sets. All of the photolysis experiments are carried out by preparing solutions of ranitidine or cimetidine in various matrices, irradiating the samples, and periodically removing subsamples for HPLC analysis of the compound of interest. Pseudo-first order kinetic plots are then generated to determine rate constants that are used to draw conclusions about photolysis pathways or to calculate additional kinetic parameters. In the two basic modules, cimetidine is found to degrade appreciably only when irradiated in the presence natural organic matter (NOM), indicating an indirect, photosensitized degradation pathway. In contrast, ranitidine degrades in pure buffer and in the presence of NOM with comparable rate constants, highlighting the predominant role of direct photolysis. In the advanced modules, students calculate ranitidine direct photolysis quantum yields and examine the significance of singlet oxygen as a photochemically produced reactive intermediate. The two basic modules may be completed in two 3 hour lab periods, while the advanced modules require additional time. This experiment requires only an HPLC instrument, inexpensive chemicals, and common glassware and lab equipment if performed in person and a personal computer if performed remotely.ISSN:0021-9584ISSN:1938-132