Investigation on Hyperuricemia in Children with Obesity or Various Pediatric Disorders

The present study aims at investigating the frequency and characteristics of hyperuricemia in both obese and sick children. First, we established our own reference values for serum uric acid (UA), since UA values are highly dependent upon age. In the analysis of 328 samples consisting of six different age groups: <1, 1–3, 4–6, 7–9, 10–12, and 13–15 years, the mean values for UA were found to increase significantly with an increase of age. A significant sex difference was observed only in the age group of 13–15 years. Hyperuricemia was defined as the values over the mean value plus 2 standard deviations for each age group. Next, we examined the frequency of hyperuricemia in 1,687 obese children aged 6–15 years and its relation to metabolic syndrome (MetS). A total of 328 children (19.4%) were found to have hyperuricemia. Among them, 98 children (29.9%) had MetS, whereas 197 (14.5%) out of 1,359 children without hyperuricemia had MetS. Finally, the frequency of hyperuricemia in sick patients was investigated using 13,675 samples from 9,405 patients. Hyperuricemia was seen in 348 (3.7%) patients after excluding redundant samples. The number of patients with hyperuricemia was higher in males than in females. The most common disorder causing hyperuricemia was gastroenteritis, followed by respiratory tract infection and cardiac diseases. This first comprehensive study of childhood hyperuricemia is useful for considering its relationship with hyperuricemia and life-style-related disorders occurring in adulthood.     

Hyperuricemia in pediatric malignancies before treatment

The objective of this study was to clarify the prevalence and characteristics of hyperuricemia in various pediatric malignancies before the initiation of treatment. We conducted a retrospective analysis of 119 children with various newly diagnosed malignancies between April 2000 and March 2010. On the basis of the reference values previously established in our laboratory, hyperuricemia was defined as uric acid (UA) levels above 2 standard deviations (s.d.) over the mean values at each age. Thirty-six patients (30.3%) showed hyperuricemia. Hyperuricemia was more common in male patients (36.8%) than in female patients (21.6%). The prevalence of hyperuricemia was highest in patients with lymphoma followed by those with acute lymphoblastic leukemia (ALL). When the study population was divided into hyperuricemia-negative and -positive populations, blood urea nitrogen, creatinine, and lactate dehydrogenase levels, and white blood cell counts (only in leukemia) were found to be significantly higher in the latter group by a univariate analysis. This study highlights useful information for identifying patients with malignancies at risk for tumor lysis syndrome (TLS) before starting chemotherapy.     

Hyperuricemia in Pediatric Malignancies Before Treatment

The objective of this study was to clarify the prevalence and characteristics of hyperuricemia in various pediatric malignancies before the initiation of treatment. We conducted a retrospective analysis of 119 children with various newly diagnosed malignancies between April 2000 and March 2010. On the basis of the reference values previously established in our laboratory, hyperuricemia was defined as uric acid (UA) levels above 2 standard deviations (s.d.) over the mean values at each age. Thirty-six patients (30.3%) showed hyperuricemia. Hyperuricemia was more common in male patients (36.8%) than in female patients (21.6%). The prevalence of hyperuricemia was highest in patients with lymphoma followed by those with acute lymphoblastic leukemia (ALL). When the study population was divided into hyperuricemia-negative and -positive populations, blood urea nitrogen, creatinine, and lactate dehydrogenase levels, and white blood cell counts (only in leukemia) were found to be significantly higher in the latter group by a univariate analysis. This study highlights useful information for identifying patients with malignancies at risk for tumor lysis syndrome (TLS) before starting chemotherapy.     

患儿体外循环直视心脏术后高尿酸血症分析

目的：探讨体外循环心脏术后24h患儿高尿酸血症发生的原因、影响因素和预后。方法：以2006年9～12月我院心脏外科收治的106例体外循环心脏手术患儿为研究对象,收集其年龄、体外循环时间、尿量、预后资料和心脏术后24h血尿酸、尿素氮、肌酐、胱抑素、血糖、总胆红素、直接胆红素等生化指标数据;以空腹血尿酸为标准,将患儿分为无高尿酸血症组和高尿酸血症组,用SPSS11．0软件分析两组之间临床资料的差异、高尿酸血症组血尿酸与其他指标的相关性及影响患者预后的因素。结果：患儿术后高尿酸血症组患者53例（50％）,与无高尿酸血症组相比P〈0．01,除年龄因素外,其他临床指标均有统计学意义;高尿酸血症组的血尿酸与血糖、总胆红素无相关性,与年龄、尿量呈显著负相关,与转流时间、尿素氮、肌酐、胱抑素、直接胆红素含量呈极显著正相关;在预后良好组与死亡组的比较中,转流时间、血尿酸、尿素氮、肌酐含量有统计学意义。结论：患儿体外循环心脏术后高尿酸血症的发生较常见,血尿酸水平对患者术后肾功能状态及预后具有重要临床意义,连续监测术后血尿酸、尿素氮、肌酐水平是及时判断患者临床状况以采取相应措施改善预后的重要方法;低心排血量综合征是引起患者死亡的危险因素之一,通过提高体外循环心脏手术水平,尽量缩短转流时间,加强围手术期监护,可有效减少术后并发症,降低死亡率。     

Uric acid best predicts metabolically unhealthy obesity with increased cardiovascular risk in youth and adults

Objective:

The obesity prevalence is growing worldwide and largely responsible for cardiovascular disease, the most common cause of death in the western world. The rationale of this study was to distinguish metabolically healthy from unhealthy overweight/obese young and adult patients as compared to healthy normal weight age matched controls by an extensive anthropometric, laboratory, and sonographic vascular assessment.

Design and Methods:

Three hundred fifty five young [8 to < 18 years, 299 overweight/obese(ow/ob), 56 normal weight (nw)] and 354 adult [>18‐60 years, 175 (ow/ob), 179 nw)] participants of the STYJOBS/EDECTA (STYrian Juvenile Obesity Study/Early DEteCTion of Atherosclerosis) cohort were analyzed. STYJOBS/EDECTA (NCT00482924) is a crossectional study to investigate metabolic/cardiovascular risk profiles in normal and ow/ob people free of disease except metabolic syndrome (MetS).

Results:

From 299 young ow/ob subjects (8‐< 18 years), 108 (36%), and from 175 adult ow/ob subjects (>18‐60 years), 79 (45%) had positive criteria for MetS. In both age groups, prevalence of MetS was greater among males. Overweight/obese subjects were divided into “healthy” (no MetS criterion except anthropometry fulfilled) and “unhealthy” (MetS positive). Although percentage body fat did not differ between “healthy” and “unhealthy” ow/ob, nuchal and visceral fat were significantly greater in the “unhealthy” group which had also significantly higher values of carotid intima media thickness (IMT). With MetS as the dependent variable, two logistic regressions including juveniles < 18 years or adults >18 years were performed. The potential predictor variables selected with the exception of age and gender by t test comparisons included IMT, ultrasensitive c‐reactive protein (US‐CRP), IL‐6, malondialdehyde (MDA), oxidized LDL, leptin, adiponectin, uric acid (UA), aldosterone, cortisol, transaminases, fibrinogen. In both groups, uric acid and in adults only, leptin and adiponectin, turned out as the best predictor.

Conclusion:

Serum levels of UA are a significant predictor of unhealthy obesity in juveniles and adults.     

Association between Childhood Obesity and Metabolic Syndrome: Evidence from a Large Sample of Chinese Children and Adolescents

Data about metabolic syndrome (MetS) in children is limited in China. We aimed to assess the prevalence of MetS related components, and their association with obesity. Data were collected as part of a representative study on MetS among 19593 children, aged 6–18 years old in Beijing. General obesity was assessed by body mass index (BMI) and central obesity by waist circumference. Finger capillary blood tests were used to assess triglyceride (TG), total cholesterol (TC) and impaired fasting glucose (IFG). Vein blood samples were collected from a subsample of 3814 children aged 10–18 years to classify MetS. MetS was defined according to the International Diabetes Federation 2007 definition. The associations between MetS related components and the degree and type of obesity were tested using logistic regression models. The prevalence of overweight, obesity, high blood pressure, elevated TG, TC and IFG were13.6%, 5.8%, 8.5%, 8.8%, 1.2% and 2.5%, respectively. Compared with normal weight children, overweight and obese children were more likely to have other MetS related components. In the subsample of 3814 children aged 10–18 years, the prevalence of MetS was much higher in obese subjects than in their normal weight counterparts (27.6% vs. 0.2%). Children with both general and central obesity had the highest prevalence of MetS. Compared with normal weight children, overweight and obese children were more likely to have MetS (overweight: OR = 67.33, 95%CI = 21.32–212.61; obesity: OR = 249.99, 95% CI = 79.51–785.98). Prevalence of MetS related components has reached high level among Beijing children who were overweight or obese. The association between metabolic disorders and obesity was strong.     

Uric Acid Is Associated with Metabolic Syndrome in Children and Adults in a Community: The Bogalusa Heart Study

Background

Elevated serum uric acid (UA) is commonly found in subjects with metabolic syndrome (MetS). This study examined the association of UA with levels of individual MetS components and the degree of their clustering patterns in both children and adults.

Methods

The study sample consisted of 2614 children aged 4–18 years and 2447 adults aged 19–54 years. MetS components included body mass index (BMI), mean arterial pressure (MAP), triglycerides to high-density lipoprotein cholesterol ratio (TG/HDLC), and homeostasis model assessment of insulin resistance (HOMA). Observed/expected (O/E) ratio and intra-class correlation coefficient (ICC) were used as a measure of the degree of clustering of categorical and continuous MetS variables, respectively.

Results

UA was positively and significantly associated only with BMI in children but with all four components in adults. The odds ratio for MetS associated with 1 mg/dL increase of UA was 1.74 (p<0.001) in children and 1.92 (p<0.001) in adults. O/E ratios showed a significant, increasing trend with increasing UA quartiles in both children and adults for 3- and 4-variable clusters with p-values for trend <0.001, except for BMI-MAP-TG/HDLC and MAP-TG/HDLC-HOMA clusters in children and MAP-TG/HDLC-HOMA cluster in adults. ICCs of 3 and 4 components increased with increasing UA quartiles in children and adults.

Conclusions

These results indicate that UA may play a role in the development of MetS in both pediatric and adult populations alike, which may aid in the identification and treatment of high risk individuals for MetS and related clinical disorders in early life.     

Metabolic syndrome and endothelial fibrinolytic capacity in obese adults

The metabolic syndrome (MetS) often accompanies obesity and contributes to the increased risk of atherothrombotic events with increased body fatness. Indeed, the risks for coronary artery disease and acute vascular events are greater with obesity combined with MetS compared with obesity alone. Endothelial release of tissue-type plasminogen activator (t-PA) is a key defense mechanism against thrombosis and has been shown to be impaired with obesity. The aim of the present study was to determine whether the presence of MetS exacerbates endothelial fibrinolytic dysfunction in obese adults. Net endothelial release of t-PA was determined in vivo in response to intrabrachial infusions of bradykinin and sodium nitroprusside in 47 sedentary adults: 15 normal weight (age 57 +/- 2 yr; body mass index 22.9 +/- 0.5 kg/m(2)), 14 obese but otherwise healthy (55 +/- 1 yr; 29.4 +/- 0.3 kg/m(2)), and 18 obese with MetS (55 +/- 2 yr; 32.3 +/- 1 kg/m(2)). MetS was established according to National Cholesterol Education Program ATP III criteria. Net release of t-PA antigen to bradykinin was approximately 50% lower (P < 0.01) in the obese (from 2.5 +/- 1.9 to 37.1 +/- 5.3 ng.100 ml tissue(-1).min(-1)) and obese with MetS (from 0.4 +/- 0.8 to 32.5 +/- 3.8 ng.100 ml tissue(-1).min(-1)) compared with normal-weight (from 0.9 +/- 1.0 to 74.3 +/- 8.1 ng.100 ml tissue(-1).min(-1)) subjects. However, there were no significant differences in the capacity of the endothelium to release t-PA in the obese and obese with MetS adults. These results indicate that the presence of the MetS does not worsen the obesity-related endothelial fibrinolytic dysfunction.     

Development of metabolic syndrome components in adults with a healthy obese phenotype: A 3‐year follow‐up

Objective:

There is a lack of data on the progression from a healthy obese phenotype toward an unhealthy obese phenotype and the development of metabolic syndrome (MetS). Our aim was to assess the development of MetS 3 years after screening in centrally obese individuals with a healthy obese phenotype and to evaluate the usefulness of repeated screening.

Design and Methods:

Eighty‐eight individuals (mean age 47 years, 88% female) with central obesity as their only MetS component (ATP III criteria) at baseline screening were re‐evaluated for MetS status after 3 years.

Results:

At follow‐up, the cardiometabolic risk profile in centrally obese individuals with a healthy phenotype showed a tendency toward deterioration. Thirty‐two percent developed at least one additional MetS component, 7% had developed MetS. Nobody had developed type 2 diabetes. An increased triglyceride level (n = 16) and an increased blood pressure (n = 18) were the components most often present at follow‐up. The people developing additional MetS components had a lower education level compared with the group that preserved the healthy centrally obese phenotype (80 vs. 71% lower educated, P = 0.35). They also had slightly worse baseline levels of the risk factors.

Conclusion:

The number of centrally obese individuals developing an unhealthy phenotype in this relatively short follow‐up period emphasizes the need for a regular surveillance of cardiometabolic parameters in centrally obese individuals. However, it is questionable whether a repeated screening for type 2 diabetes every 3 years, as recommended by the American Diabetes Association, in this category of patients is appropriate.     

Intestinal parasites in Kampuchea, Takeo Province

Fresh stool samples obtained from 1407 adult patients who sought treatment in Takeo province hospital and 332 Takeo preschool and school-age children from 3 to 18 years of age were examined for the presence of intestinal parasites using the technique of native preparation and the flotation method of Faust with subsequent staining with Lugol solution to demonstrate cysts. In hospital patients, a total of 13 protozoan and 9 helminth species were diagnosed. The prevalence of Entamoeba histolytica (cysts and trophozoites) was highest in the age group 15-18 years (18.3%), the peak prevalence of Gairdia lamblia (27.6%) occurred in children of the age group 6-9 years. The highest frequency distribution of Pentatrichomonas hominis (20.1%) was recorded in 3 to 5 years old, that of Enteromonas hominis (12.8%) in 6 to 9 years old. The predominant helminth was Ancylostoma duodenale, with the peak prevalence (65.2%) in patients older than 18 years, followed by Ascaris lumbricoides and Strongyloides stercoralis. Almost half of children patients under 6 was infected with at least two species of parasites, patients over 6 were infected simultaneously with two or more intestinal parasites in an absolute majority of cases. In Takeo preschool and school children the spectrum of diagnosed protozoan and helminth species was somewhat narrower than seen in hospital patients, but their prevalence rates were higher, except for the flagellate Pentatrichomonas hominis. The highest prevalence rates recorded were for E. histolytica 29.5% (age category 10-14 years), for G. lamblia 34.8% (age category 6-9 years), for P. hominis 19.3% (age category 3-5 years), for E. hominis 10.5% (age category 3-5 years), for A. duodenale 85.9% (age category 15-18 years), for A. lumbricoides 26.1% (age category 6-9 years), and for S. stercoralis 18.8% (age category 6-9 years). As many as 70% of children at the age between 6 and 15 years were simultaneously infected with two or three species of intestinal parasites.     

IgA肾病合并高尿酸血症的临床分析

目的：探讨血清尿酸对IgA肾病临床,病理及预后的影响,为临床治疗和预后评估提供依据。方法：分析我院2011年1月-2012年1月149例经肾穿活检确诊为原发性IgA肾病患者的临床和病理资料。采用t检验和X2检验进行统计学处理。结果：（1）伴高尿酸血症IgA肾病的发病率为30.2%,男性偏多,男女发病率无统计学差异（P〉0.05）。（2）女性高尿酸血症组BUN、Cys-C、Scr水平显著高于尿酸正常组（P〈0.05）,男性两组间无显著差异（P〉0.05）,而血清UA水平无论男女高尿酸血症组均显著高于尿酸正常组（P〈0.05）;尿酸正常组血清BUN、UA、Cys-C、Scr水平男性显著高于女性（P〈0.05）,高尿酸血症组血清UA水平男性显著高于女性（P〈0.05）;血清IgA、C3、IgA/C3比值无论男女,高尿酸血症组与尿酸正常组均无显著差异（P〉0.05）。（3）高尿酸血症组病理改变以Ⅳ-Ⅴ多见（57.8%）,而正常尿酸组则以Ⅰ-Ⅱ为主（46.2%）,血尿酸正常组与高尿酸血症组Lee＇s分级构成比差异具有统计学意义（P〈0.05）。结论：伴有高尿酸血症的IgA肾病患者男性血尿酸水平高于女性,但血尿酸水平升高对女性肾功能影响更大;高尿酸血症对血清IgA,C3水平的变化影响不大;伴高尿酸血症IgA肾病病理改变程度较尿酸正常组更加严重。     

Epidemiology of hyperuricemia in the elderly

BACKGROUND: Our study used data collected in Chung-Hsing Village to evaluate the relationship between hyperuricemia and the cardiovascular risk factors and the socio-demographic factors in the elderly in May 1998. METHODS: All individuals aged 65 and over were studied. A total of 1093 subjects, out of 1774 registered residents, were contacted by face-to-face interview. The response rate was 61.6 percent. However only 586 respondents had blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. To study the significant correlates of hyperuricemia, t- test, two-way ANOVA, chi-square test and multivariate logistic regression were used. RESULTS: Our results showed that 66 percent were men and 34 percent were women. The mean age was 73.1+/-5.3 years. The proportions of hyperuricemia were 57.3 percent in men and 40.9 percent in women (p < .01). In chi-square test, hypercholesterolemia, hypertriglyceridemia, renal function impairment, retirement status and marital status were related to hyperuricemia. After controlling the other covariates, the multivariate logistic regression analysis showed that the significant related factors of hyperuricemia were hypercholesterolemia, hypertriglyceridemia, and renal function impairment. CONCLUSIONS: Hyperuricemia is often found in the elderly. Hyperuricemia is more common in elderly men than in elderly women. A large-scale investigation will be suggested in the future to address causal-effect issues between hyperuricemia and hypercholesterolemia, hypertriglyceridemia, or renalfunction impairment.     

高尿酸血症与肾脏疾病关系的研究进展

高尿酸血症(HUA)是血尿酸(UA)增高的一种疾病,也是常见的机体代谢紊乱,临床上大多数HUA患者无明显的症状。由于经济水平提高和生活方式的改变,其发病率有增高趋势,且男性高于女性。HUA多发于中老年人群,严重影响其生活质量,因此中老年人群HUA已经成为普遍关注的健康问题。近年来研究发现HUA是痛风的主要病因之一,并且血尿酸(UA)水平可导致肾功能减退。已有多项研究表明HUA与肾脏疾病的发生发展密切相关,HUA是Ig A肾病、糖尿病肾病、急性肾损伤等肾脏疾病的独立危险因素,本文主要从HUA的流行病学、危险因素、发病机制及其与肾脏疾病关系这几个方面展开综述。     

Increased Serum Cholesteryl Ester Transfer Protein in Obese Children

Objective: To determine whether serum cholesteryl ester transfer protein (CETP), which is one of the physiologically active gene products secreted from adipose tissue, is increased and associated with atherogenic lipoprotein profile in obese children. Research Methods and Procedures: Subjects were 42 consecutive outpatient Japanese obese children, 29 boys and 13 girls, ranging in age from 5 to 14 years, and 25 age‐matched non‐obese children, 13 boys and 12 girls, as the control group for measuring CETP mass. Blood was drawn after an overnight fast and, at the same time, and anthropometric measurements including height, body weight, waist girth, hip girth, and triceps and subscapular skinfold thicknesses were taken. Paired samples were obtained from 15 obese children who underwent psychoeducational therapy. Serum CETP mass was assayed by an enzyme‐linked immunosorbent assay. Results: The serum levels of triglyceride, total cholesterol (TC), low‐density lipoprotein cholesterol, TC/high‐density lipoprotein cholesterol (HDLC), apolipoproteins (apo) B, apo B/apo A₁, and insulin in obese children were significantly higher than the respective reference values. Serum CETP level was ～2‐fold higher (98.7 ± 3.6 vs. 50.9 ± 4.0 nM, means ± SEM, p < 0.001) in the obese children than in the controls. In 15 obese children, whose percentage of overweight declined during therapy, CETP levels decreased significantly. CETP level was correlated with HDLC, TC/HDLC, and insulin, and with percentage of overweight when the data of the obese and non‐obese children were combined. Discussion: CETP is increased and associated with the atherogenic lipoprotein profile in obese children.     

Elevated Serum Triglyceride and Retinol-Binding Protein 4 Levels Associated with Fructose-Sweetened Beverages in Adolescents

Background

The metabolic effect of fructose in sugar-sweetened beverages (SSB) has been linked to de novo lipogenesis and uric acid (UA) production.

Objectives

This study investigated the biological effects of SSB consumption on serum lipid profiles and retinol-binding protein 4 (RBP4) among Taiwanese adolescents.

Methods

We evaluated the anthropometric parameters and biochemical outcomes of 200 representative adolescents (98 boys and 102 girls) who were randomly selected from a large-scale cross-sectional study. Data were analyzed using multiple regression models adjusted for covariates.

Results

Increased SSB consumption was associated with increased waist and hip circumferences, body mass index (BMI) values and serum UA, triglyceride (TG) and RBP4 levels. Adolescents who consumed >500 ml/day of beverages half-to-heavily sweetened with high-fructose corn syrup (HFCS) exhibited TG and RBP4 levels 22.7 mg/dl and 13.92 ng/ml higher than non-drinkers, respectively. HFCS drinkers with hyperuricemia had higher TG levels than HFCS drinkers with normal UA levels (98.6 vs. 81.6 mg/dl). The intake of HFCS-rich SSBs and high value of BMI (≥24) interactively reinforced RBP4 levels among overweight/obese adolescents. Circulating RBP4 levels were significantly correlated with weight-related outcomes and TG and UA concentration among HFCS drinkers (r = 0.253 to 0.404), but not among non-drinkers.

Conclusions

High-quantity HFCS-rich beverage consumption is associated with higher TG and RBP4 levels. Hyperuricemia is likely to intensify the influence of HFCS-rich SSB intake on elevated TG levels, and in overweight and obese adolescents, high BMI may modify the action of fructose on higher circulating levels of RBP4.     

Weight loss and sleep-disordered breathing in childhood obesity: effects on inflammation and uric acid

Sleep-disordered breathing (SDB) is prevalent in childhood obesity. It may be an independent risk factor for the metabolic syndrome. Possible mechanisms are inflammation and oxidative stress. Adenotonsillectomy in childhood obesity is associated with a high recurrence rate and risk of postoperative weight gain. Therefore, this study assessed the effects of SDB on inflammation and oxidative stress in childhood obesity before and after weight loss. We included 132 obese subjects between 10 and 18 years consecutively. Median age was 15.4 years (10.1-18.0). Mean BMI z-score was 2.72 ± 0.42. Leukocytes and differentiation, high sensitivity C-reactive protein (hs-CRP), and uric acid (UA) were determined at baseline and subjects underwent a sleep assessment. SDB was diagnosed in 39%. Linear regression analysis showed an association between UA(log) and oxygen desaturation index(log) (ODI(log)) (r = 0.20; P = 0.03), between leukocytes(log) and respiratory disturbance index(log) (RDI(log)) (r = 0.23; P = 0.01), and between lymphocytes(log) and RDI(log) (r = 0.19; P = 0.04). Follow-up was organized after 4-6 months of treatment. Median decrease in BMI z-score was 32%. Laboratory measurements were repeated. Subjects with SDB at baseline underwent a second sleep study. Of these 49 subjects, 12 showed residual SDB. This corresponds with a treatment success rate of 71%. Unlike changes in inflammatory markers, improvements in UA were associated with improvements in RDI and ODI (respectively: r = 0.44; P = 0.007, r = 0.41; P = 0.01). In conclusion, weight loss is effective in treating obese children with SDB. At baseline, a link exists between inflammation and SDB. Oxidative stress is reflected by UA at baseline and the concentration decreases after treatment according to improvements in SDB.     

Prevalence of enterotoxigenic Bacteroides fragilis in patients with diarrhea: a controlled study

In this age matched controlled study performed in Malatya, a city in east region of Turkey, enterotoxigenic Bacteroides fragilis (ETBF) was investigated in stool specimens obtained from children and adults with and without diarrhea. A nested polymerase chain reaction (PCR) method was used to detect the enterotoxin gene of B. fragilis in a total of 418 stool samples, including 221 samples from 117 children (aged 0-16 years) and 104 adults (aged >16 years) with diarrhea, and 197 samples from 102 children and 95 adults as control group that was the same age group with those having diarrhea. ETBF was detected in 13 of 117 diarrheal children (11.1%) and 8 of 102 control children (7.8%) (P>0.05). In children aged 1-5 years, the rate of ETBF was significantly higher in patients than in controls (25% versus 9.5%, respectively; P<0.05). On the other hand ETBF was detected similar rates (2.2% and 2.4%, respectively) in children younger than 1 year in both patients and controls. ETBF positivity was not significantly difference between patient and control groups who were older than 5 years of age and adults. The frequency of ETBF in the controls was slightly higher in older persons than in younger ones; however, it was not significant. The rate of ETBF as the only enteropathogen in the patients with ETBF was significantly higher than in controls with ETBF (88% versus 39%, respectively; P<0.02). We found that in east region of Turkey, the prevalence of ETBF was higher in the childhood diarrhea, particularly in aged 1-5. As the only enteropathogen, ETBF may play an important role in diarrheal diseases. Persons after 6 years old can be carrier for ETBF regardless diarrhea.     

Thyroid Function and Metabolic Syndrome: A Cross-Sectional Study in Obese and Overweight Patients

Objective: Metabolic syndrome (MetS) is associated with increased risks of developing cardiovascular disease and type 2 diabetes. Thyroid dysfunction is also a known cardiovascular risk factor. In obese patients, serum thyroid-stimulating hormone (TSH) levels tend to be higher than in lean controls. The objective of this study was to assess potential associations between serum TSH levels and MetS as well as individual components of MetS.Methods: This was a cross-sectional observational study of obese and overweight patients seen for initial evaluation at the Boston Medical Center weight-management clinic between February 1, 2013 and February 1, 2014. Demographic, anthropometric, and laboratory data including serum TSH, insulin, glucose, hemoglobin A_1c, and lipid levels were obtained from electronic medical records. Associations between serum TSH levels and presence of MetS and its components were assessed.Results: A total of 3,447 patients, 75.6% female and 38% African American, without known thyroid dysfunction, were included. Mean ± SD age was 46.74 ± 15.11 years, and mean ± SD body mass index was 36.06 ± 9.89 kg/m². Among 1,005 patients without missing data, the prevalence of MetS was 71.84%. In patients with MetS, the median serum TSH was 1.41 μIU/mL, compared with 1.36 μIU/mL in patients without MetS (P = .45). In multivariate models, there was no significant association between serum TSH levels and the presence of MetS, adjusting for age, sex, race, education, socioeconomic status, and smoking. There were also no significant associations between serum TSH and individual components of the MetS.Conclusion: Serum TSH level does not appear to be a potentially modifiable risk factor for MetS in obese and overweight individuals.Abbreviations: BMI = body mass index FT₄ = free thyroxine HDL-C = high-density-lipoprotein cholesterol HbA_1c = hemoglobin A_1c MetS = metabolic syndrome SE = standard error TSH = thyroid-stimulating hormone     

Determination of uric acid in human saliva by high-performance liquid chromatography with amperometric electrochemical detection

The aim of the present study is to establish a highly sensitive method for the determination of uric acid (UA) in human saliva. The monitoring of UA levels in less invasive biological samples such as saliva is suggested for the diagnosis and therapy of gout, hyperuricemia, and the Lesch-Nyhan syndrome, and for detecting such conditions as alcohol dependence, obesity, diabetes, high cholesterol, high blood pressure, kidney disease, and heart disease. Reversed-phase high-performance liquid chromatography with electrochemical detection (HPLC-ED) was employed for the determination of UA obtained by solid-phase extraction from saliva. To quantify UA, we compared the ED efficiencies of an amperometric ED (Ampero-ED) with a single electrode and a coulometric ED (Coulo-ED) with a multiple electrode array. The results showed that the detection limits (S/N=3) were 3 nM for Ampero-ED and 6 nM for Coulo-ED, and the linearity of the calibration curves of 60-6000 nM had correlation coefficients exceeding 0.999. In addition, the total analytical time was 10 min. In the sample preparation of UA in saliva, an Oasis MAX solid-phase cartridge was used. The recoveries of UA spiked at 0.6 and 3 microM in saliva were above 95% with a relative standard deviation (RSD) of less than 15%. Therefore, the present method may be used in the routine and diagnostic determination of UA in human saliva.     

Reference values for height, weight and body mass index of German born Turkish children

Turkish children and adolescents born in Northern Europe grow different from native Northern European children, but reference values for height, weight and BMI for these children do not exist. With this study, we intend to provide growth standards for German born Turkish children. Data were obtained from 797 Turkish children and adolescents born in Germany age 0-25.8 years (males), respectively 0-18.3 years (females). We generated synthetic reference values for height, weight, and BMI. The results show that Turkish children and adolescents are heavier after the age of 6 years, and that they remain short after puberty. Eighteen year old Turkish men, and 15-year-old Turkish women are shorter (males 175.2 cm vs. 180.4 cm, p < 0.05; females 159.3 cm vs. 165.0 cm, p < 0.05), and heavier than Germans. Six out of 53 young Turkish men and 9 out of 100 young Turkish women were obese. Twelve out of 53 young Turkish men (23%) and 18 out of 100 young Turkish women (18%) have fallen below the 3rd centile for height. It can be concluded that growth of Turkish children and adolescents born in Germany significantly differs from native children. Reference LMS values for body height, weight and BMI of German born Turkish boys and girls are presented.