Serum Levels In Children Research Articles

Effect of potassium infusion on serum levels in children during treatment of diabetic ketoacidosis

Purpose: Profound total body potassium deficits occur in children admitted with diabetic ketoacidosis (DKA). However, amount required to maintain normal serum concentration during treatment of DKA is largely unknown. At our institution 40 mEq/L and 60 mEq/L is administered during treatment of DKA, based on initial serum potassium. We aimed to determine the effect of these infusions on potassium levels in children during treatment of DKA. Methods: A retrospective chart review was conducted, after …

Vitamin D serum levels in children with vernal keratoconjunctivitis and disease control.

The aim of this study was to evaluate whether the control of ocular symptoms with cyclosporine or with tacrolimus in eye drops allows to improve sun exposure and therefore serum level of vitamin D (VD; 25OHD), in the more severe forms of vernal keratoconjunctivitis (VKC). Out of 242 children followed for active VKC, 94 were treated with 1% cyclosporine or 0.1% tacrolimus eye drops, while the other 148 with mild VKC did not need to be treated with immunomodulators. VD serum levels were measured in spring and autumn in 71 children. In total, 60 of them were treated with cyclosporine eye drops (first group) and 11 (not responding to cyclosporine therapy previously) with 0.1% tacrolimus eye drops (second group) between March and November 2016. Pre-treatment median values of VD were 23.7 ng/mL in the first group and 23.8 in the second group, and post-treatment values increased up to 32.8 and 32.9 ng/mL, respectively. Before treatment, 33% presented a deficiency (25OHD < 20 ng/mL), and at the end of summer, only 4% were deficient. The overweight children had lower improvement in VD serum levels than children with a body mass index (BMI) lower than 85th percentile. Children in therapy with cyclosporine, but requiring the administration of local steroid therapy during the summer for control of the symptoms, showed a greater improvement in 25OHD serum levels in ng/mL (23–37 ng/mL) than children who did not require steroid therapy (24–35 ng/mL). Furthermore, there was a significant difference in change of 25OHD in children presenting limbal VKC (21–41 ng/mL) versus tarsal VKC (24–35 ng/mL) (P = 0.04). Our study suggests that ocular treatment carried out with immunomodulator eye drops could allow for an improvement in 25OHD serum levels. In children with active VKC and at risk of 25OHD deficiency, likely due to avoidance of sun exposure, the role of other risk factors (BMI, phototype and treatment) on 25OHD serum levels should be considered.

Comparison of Aquatic Exercise Program and Vitamin D Supplementation on Vitamin D and hs-CRP Serum Levels in Children with Autism Spectrum Disorders

Comparison of Aquatic Exercise Program and Vitamin D Supplementation on Vitamin D and hs-CRP Serum Levels in Children with Autism Spectrum Disorders

Assessment of some micronutrients serum levels in children with severe acute malnutrition with and without cerebral palsy- A follow up case control study

Summary Objective Zinc, copper and selenium are essential for normal development and function of the central nervous system. This study aimed at assessment of serum levels of zinc, copper and selenium in children with severe acute malnutrition (SAM) with & without cerebral palsy both before and after nutritional rehabilitation. Methods A prospective case control study involved 2 groups (Group I); included160 children with SAM of both sex, aged 6–59 months, this group was subdivided into 2equal subgroups; subgroup A: SAM without cerebral palsy, subgroup B: SAM with cerebral palsy. Group II (control group) included 96 apparently healthy children matching age and sex with the first group. Both groups were subjected to a detailed history including nutritional history. Anthropometric measurements were recorded and laboratory assessment for serum levels of (copper, zinc, & selenium) before and after nutritional rehabilitation were performed for all children. Results Group I (A&B) showed a significant decrease in anthropometric measurements, serum zinc, serum selenium but normal copper level before nutritional rehabilitation in comparison to control. After nutritional rehabilitation, all cases of the group I showed a significant improvement of the three parameters except for (45%) of cerebral palsy cases, experienced a resistant low selenium. Conclusion Nutritional rehabilitation significantly improved micronutrients' serum level in SAM children with and without cerebral palsy. Selenium supplementation is advised for children with cerebral palsy in order to reach normal values with observation of effect on neurological state.

New pediatric percentiles of liver enzyme serum levels (alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase): Effects of age, sex, body mass index, and pubertal stage.

Current reference values of ALT, AST, and GGT serum levels were calculated for children between 11 months and 16.0 years, using modern analytical and statistical methods. This study extends the current knowledge about transaminases by revealing influences of age, sex, BMI, and puberty on serum concentrations of all three parameters and has for these parameters one of the largest sample sizes published so far. (Hepatology 2017).

Hair Mineral and Trace Element Contents as Reliable Markers of Nutritional Status Compared to Serum Levels of These Elements in Children Newly Diagnosed with Inflammatory Bowel Disease.

Patients with inflammatory bowel disease (IBD) are at high risk for nutritional deficiencies because of long-term inflammation in the gut mucosa and decreased oral intake. Because inflammation responses affect serum micronutrient concentrations, serum levels are limited in reflecting body nutrient status in acute and chronic illness. We investigated the usefulness of measuring trace elements in hair as reliable markers of nutritional status compared to serum levels in children with IBD. We retrospectively analyzed pediatric patients newly diagnosed with Crohn's disease (n = 49) and ulcerative colitis (n = 16) and controls (n = 29) from 2012 to 2016. Serum micronutrient levels, inflammatory markers, and hair trace element content were evaluated and compared at the time of diagnosis and before initiating treatment. Serum calcium (p < 0.001), iron (p < 0.001), zinc (p = 0.013), selenium (p = 0.008), albumin (p < 0.001), prealbumin (p < 0.001), hemoglobin and hematocrit (p < 0.001), and WBC (p = 0.001) and lymphocytes (p < 0.001) differed significantly between the groups. After adjustment for the erythrocyte sedimentation rate, serum zinc and selenium levels were no longer significantly different between the groups (p < 0.062 and p < 0.057, respectively). Following hair analysis for mineral and trace elements, iron (p = 0.033), selenium (p = 0.017), and manganese (p = 0.009) differed significantly between the groups. Serum micronutrient levels need cautious interpretation in conjunction with inflammatory markers. Hair mineral and trace element measurement may support understanding micronutrient status in children with IBD.

Zinc and copper serum levels in children and adolescents with neurodevelopmental disoders at the center for neuropsychopathology in Kinshasa: An exploratory study

Background: Zinc and copper are physiologically antagonists and abnormal levels of both of them are known associated with neurodevelopmental disorders. Data in this area are lacking in Congolese children.

Brain derived neurotrophic factor profile in children with ischemic stroke

Objective: Assessment of brain derived neurotrophic factor (BDNF) serum levels in children who have suffered an ischemic stroke (1 month after stroke) and establishment of the correlation between BDNF serum levels and imaging and neurophysiological changes. Methods: The study included a sample of 26 children, aged between 1 and 3 months, with ischemic stroke because of perinatal hypoxic-ischemic lesions of the central nervous system (CNS); 25 children, in the same age group, were included in the control group. Enzyme-linked Immunosorbent Assay (ELISA) was used to test the serum BDNF levels. Neurophysiological and neuroimaging exams were performed. Statistical analyses were obtained by the correlation coefficient (Pearson) and ANOVA test. Results: Preliminary study results showed that compared to control group, the children who have suffered ischemic stroke, showed significantly lower serum BDNF levels (p<0.01). In the study group, low BDNF levels correlated with the degree of neuroimaging modifications (rxy=−0.72, p<0.05) and neurophysiological changes (rxy=−0.74, p<0.05). During 3 years after stroke, children with low levels of BDNF developed cerebral palsy and epilepsy. Conclusion: Children that suffered an ischemic stroke because of perinatal hypoxic-ischemic lesions of the CNS had a significantly lower serum BDNF concentrations compared to the control group. Low BDNF levels correlate with the severity of neurophysiological and neuroimaging changes and play an important role in the development of cerebral palsy and epilepsy.

Bcl-2 and Caspase-9 serum levels in children and adolescents with idiopathic epilepsy and active seizures

In the present study we investigated the levels of proapoptotic caspase-9 and antiapoptotic Bcl-2 proteins in the sera of children and adolescents with idiopathic epilepsy and tried to relate the findings to the patients' clinical parameters. This retrospective study consisted of 118 children and adolescents with idiopathic epilepsy, categorized according to type and number of seizures, duration of the disease and the control of seizures and 30 age- and sex-matched controls. The relapse of seizures was taken into consideration. Mean serum level between Bcl-2 and caspase-9 was significantly higher only in Bcl-2 patients, compared to controls (P≤0.0001) and (P=0.987) respectively. Significant difference in Bcl-2 level was found among the different types of focal seizures. Caspase-9 level was statistically different in patients with two or more seizures per month compared to those with one seizure per month (P=0.048). No correlation was found between Bcl-2 and caspase-9 levels and age, gender, seizure frequency, total number of seizures and the duration of epilepsy. No significant difference was found in patients with and without drug treatment. Bcl-2 displays an association with apoptosis and highlights the potential of being a surrogate biomarker for active seizures and epilepsy. There is a significant difference in Bcl-2 serum level among the different types of focal seizures. Proapoptotic caspase-9 cannot act as a marker of active seizures and epilepsy. Caspase-9 serum level is increased acutely in controlled cases after a single relapse.

P237 Hair mineral and trace element contents as reliable markers of nutritional status compared to serum levels in children with inflammatory bowel disease

P237 Hair mineral and trace element contents as reliable markers of nutritional status compared to serum levels in children with inflammatory bowel disease

Adipokines and cytokines serum levels in children and adolescents and its relationship with obesity

Adipokines and cytokines serum levels in children and adolescents and its relationship with obesity

BDNF Val66Met polymorphism and peripheral protein levels in pediatric bipolar disorder and attention-deficit/hyperactivity disorder.

Frontiers between pediatric bipolar disorder (PBD) and attention-deficit/hyperactivity disorder (ADHD) are not well defined. Few studies have addressed potentially different neurobiological factors between the two disorders. Brain-derived neurotrophic factor (BDNF) has been increasingly recognized for its etiologic and prognostic role in adult bipolar disorder (BD) studies. This study aimed to examine the BDNF gene polymorphism and potential alterations in BDNF serum levels in the pediatric ADHD patients with or without comorbid BD illness. We assessed the non-synonymous single-nucleotide polymorphism in the BDNF gene (rs6265/Val66Met) and its serum levels in children and adolescents with BD comorbid with ADHD (BD + ADHD) and ADHD alone. Children and adolescents were assessed for psychiatric diagnoses using the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). Using Analysis of covariance (ancova) we detected a significant group effect (patients with BD + ADHD had higher serum levels than those with ADHD - F80,3 = 8.73, P = 0.005). Although the Val66Met polymorphism at the BDNF gene does not seem to play a significant role in children and adolescents with BD or ADHD, BDNF serum levels deserve further attention in future research on neurobiological aspects of BD and ADHD.

Mathematical Model for During Ghrelin and Growth Hormone Serum Levels in Children

Mathematical Model for During Ghrelin and Growth Hormone Serum Levels in Children

Vitamin D [25(OH)D] Serum Level on Headache Children

Background: Statistical signification between serum 25(OH)D levels and headache in pediatric population is still controversial. Purpose of study: To study vitamin D blood levels in primary headaches and to show the relationship with clinical parameters influencing clinical course of headache. Materials and method: 67 males (42%) and 92 females (58%), aged between 5-18 year, suffering from headache, divided into three diagnostic categories, according to ICHD-III classification: Migraine with Aura (MWA), Migraine without Aura (MWoA) and Tension-type headache (TTH). Level of Serum Vitamin D as determined by immune-histochemical methods of chemiluminescence, lower than 20 ng/ml, was considered pathological. Results: 91 patients (57%) received a diagnosis of MWoA, 32 (20%) of MWA and 36 (23%) of TTH. Hypovitaminosis D was found in 56% of children with MWoA, in 50% of patients with MWA and in 44.4% with TTH. 12% of all the sample showed severe Hypovitaminosis D (<10 ng/ml). There were not statistically significant differences comparing Vitamin D serum levels between male and females in each categories of headache (p=0.36), but in TTH there is statistically significance (p=0.05) in adolescents and pre-adolescent than children under 10 years and in 25(OH)D serum level in children with MWoA compared to patient with MWA and THH (p<0.05). Conclusion: Our study shows a high incidence of vitamin D deficiency in pediatric population whit headache (56%), overall in migraineurs without Aura. Probably this objet could be directly correlated with a higher frequency of migraine attacks in children with MwoA.

Fasting serum blood measures of bone and lipid metabolism in children with myelomeningocele for early detection of cardiovascular and bone fragility risk factors

Objective: This study examined serum levels in children with myelomeningocele to identify the prevalence of pre-clinical signs of disease.Design: A prospective, cross-sectional study.Setting: Patients were actively recruited from multidisciplinary care clinics at tertiary children's hospitals from 2010–2012. The control comparison group was recruited by word-of-mouth.Patients: Twenty-eight children with myelomeningocele (93% Hispanic; 17 males; 10.0 ± 2.1 years) and 58 controls (84% Hispanic; 30 males; 10.4 ± 2.4 years) provided ≥ 8-hour fasting blood samples with concomitant dual-energy x-ray absorptiometry measurements of body fat.Interventions: Not applicable.Main Outcome Measures: The serum analysis included a lipid panel (cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein), insulin, glucose, leptin, aspartate aminotransferase, alanine transaminase, alkaline phosphatase, albumin, creatinine, calcium, phosphatase, parathyroid hormone, and vitamin D.Results: Children with myelomeningocele had higher body fat (35.2% versus 29.9%, p=0.01) and altered lipid profiles (lower high-density lipoprotein levels, 43.9 mg/dL versus 51.6 mg/dL, P = 0.03) suggesting elevated risk of metabolic syndrome. They also had a higher prevalence of vitamin D deficiency (43% versus 17%, p=0.02) and significantly lower levels of calcium (9.4 mg/dL versus 9.7 mg/dL, P = 0.003) and alkaline phosphatase (187.0 U/L versus 237.0 U/L, P = 0.003). Unexpectedly children with myelomeningocele had lower parathyroid hormone levels (14.5 pg/mL versus 18.4 pg/mL, P = 0.02) than controls despite lower calcium, vitamin D and alkaline phosphatase levels. This suggests an alteration in the sensing mechanism or response of the parathyroid gland to normal physiological stimuli in patients with myelomeningocele.Conclusions: Children with myelomeningocele have abnormal biochemical markers for cardiovascular disease, insulin resistance and bone and mineral metabolism. Early recognition and monitoring of these risk factors in patients with myelomeningocele may help prevent later complications.

Vitamin D serum levels in children with allergic and vasomotor rhinitis

PurposeIn addition to regulating calcium and phosphorus homeostasis and bone metabolism, vitamin D is known as an immune modulator. Recently, there has been increased worldwide interest in the association between low levels of vitamin D and allergic diseases. The purpose of this study was to assess the relationship between serum vitamin D levels and allergic/vasomotor rhinitis (AR/VR) in children.MethodsThis study included 164 patients. The sample included 59 patients with AR, 42 patients with VR, and 63 controls. Their ages ranged from 0 to 16 years. We examined the levels of 25-hydroxyvitamin D, Immunoglobulin E, specific IgE, and eosinophil cationic protein; peripheral blood eosinophil count; and the results of a skin prick test.ResultsSerum 25-hydroxyvitamin D levels were 19.0±8.5 ng/mL in the AR group, 25.5±10.9 ng/mL in the VR group, and 26.9±10.7 ng/mL in the control group. After adjustment for body mass index and season at the time of blood sampling, vitamin D levels in the AR group were lower than those of the VR group (P=0.003) and control group (P<0.001). Vitamin D levels were inversely correlated with Immunoglobulin E levels (r=-0.317, P<0.001). AR patients with food allergy or atopic dermatitis did not have lower levels of 25-hydroxyvitamin D than AR patients without these diseases.ConclusionThis study demonstrates a possible relationship between vitamin D levels and allergic rhinitis in Korean children.

25-hydroxyvitamin D serum level in children of different ethnicity living in Italy.

Several factors including ethnicity are known to influence 25(OH)D levels. The purpose of our study was to assess 25(OH)D levels among 1374 pediatric subjects of different ethnicity and to determine the prevalence of vitamin D deficiency and insufficiency among different ethnic groups. The prevalence of 25(OH)D ≤ 20 ng/ml was 44.2, 65.2, 69.2, 54.0, and 44.8 % among Caucasians, Africans, North Africans, Indians, and others, respectively (P < 0.001). The median of 25(OH)D was 21.0 ng/ml (IQR = 14.0-29.6 ng/ml) for the cohort. Season of blood sampling, age, ethnicity, gestational age, birth weight, and z-score BMI were associated with 25(OH)D levels. Caucasians had higher median 25(OH)D levels than sub-Saharan Africans (P < 0.001), North Africans (P < 0.001), and Indians (P < 0.001). There were no significant differences in the median 25(OH)D levels between ethnic groups among infants, whereas for children older than 1 year we found significant differences in 25(OH)D levels in the different ethnic groups, compared to Caucasians. Ethnicity was correlated with 25(OH)D levels among children older than 1 year. We found a high prevalence of vitamin D deficiency and insufficiency after the first year of life, and this was more remarkable in non-Caucasian children.

Variability in PCB and OH-PCB serum levels in children and their mothers in urban and rural U.S. communities.

Environmental exposures that affect accumulation of polychlorinated biphenyls (PCBs) in humans are complex and not fully understood. One challenge in linking environmental exposure to accumulation is determining variability of PCB concentrations in samples collected from the same person at different times. We hypothesized that PCBs in human blood serum are consistent from year to year in people who live in the same environment between sampling. We analyzed blood serum from children and their mothers from urban and rural U.S. communities (n = 200) for all 209 PCBs (median ∑PCBs = 45 ng/g lw) and 12 hydroxylated PCBs (median ∑OH-PCBs = 0.09 ng/g fw). A subset of these participants (n = 155) also had blood PCB and OH-PCB concentrations analyzed during the previous calendar year. Although many participants had similar levels of PCBs and OH-PCBs in their blood from one year to the next, some participants had surprisingly different levels. Year-to-year variability in ∑PCBs ranged from −87% to 567% and in ∑OH-PCBs ranged from −51 to 358% (5th–95th percentile). This is the first study to report variability of all PCBs and major metabolites in two generations of people and suggests short-term exposures to PCBs may be a significant component of what is measured in human serum.

ABSTRACT 385

Background and aims: Common inflamatory biomarkers are insufficient to evaluate the lung injury in bronchiolitis. The soluble form of the receptor for advanced glycation end-products (sRAGE) may be helpful as a marker of alveolar type I epithelial cell injury. Aims: To assess the sRAGE serum levels in children with acute bronchiolitis admitted to the a Pediatric Intensive Care Unit (PICU). To study the association between sRAGE levels and clinical evolution. Methods: The study was approved by the ethics committee of our hospital. Clinical data and biological samples of controls and cases were prospectively obtained fter signing the consent form by their caregivers (December 2011 to February 2012). The serum levels of sRAGE were measured at cases PICU admission. Results: Thirty seven patients were enrolled; their mean age was 162 days (95% CI 77 - 248). The control group included 43 children with a mean age of 3096 days (95% CI 2567 – 3624). The age was the unique epidemiological significant difference between groups (95%CI 2365 - 3501). sRAGE (pg/mL) mean values were statistically difference btween groups (p<0.001) 1) Study group 1215.7 pg/ml (95% CI 1037.3 – 1394.2) 2) Control group 849 pg/ml (95% CI 679.8 – 1027.2). Considering the rest of collected data a significant inverse correlation by bivariate analysis was found between sRAGE and the Wood-Downes score at PICU admission (p=0.02).Figure 1: Comparison between mean valeu of sRAGE in the study group and the control group.Figure 2: Correlation between sRAGE value and the Wood-Downes score.Conclusions: These findings suggest that serum sRAGE is elevated in children with severe bronchiolitis. Larger clinical studies are necessary.

Lipopolysaccharide-binding protein (LBP) serum levels in children with OSA and obesity

Obstructive sleep apnea (OSA) has been linked to obesity and the metabolic syndrome (MetS). All these conditions are further tightly linked to inflammation, the origin of the latter still being under debate. In recent years, the gut microbiota and/or gut permeability have emerged as important factors in the vicious cycle of obesity, MetS and inflammation. The gut microbiota, which serves as reservoir for bacterial lipopolysaccharides (LPS), could be altered by OSA and trigger inflammation. Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute-phase protein derived from the liver which has been viewed as a surrogate marker of underlying low level endotoxemia brought about by LPS from the gut. We hypothesized that systemic LBP levels would be higher in obese children and in those with OSA. Consecutive snoring and non-snoring children (mean age: 6.8 ± 1.3 years) were included after they underwent overnight polysomnographic evaluation and a fasting blood sample was drawn the morning after the sleep study. Children were subidivided into 4 sub-groups based on the presence of obesity (BMI z score > 1.65) or OSA (obstructive AHI > 2/hrTST). Plasma LBP levels were assayed using commercial ELISA kits. Of the children studied to date ( n = 56), non-obese controls had lowest levels of LBP, and the presence of obesity without OSA was associated with significant increases in LBP levels ( p < 0.03). Non-obese children with OSA exhibited LBP leves that were similar to those of obese children without OSA ( p < 0.01 vs. non-obese without OSA), with obese children with OSA demonstrating the highest LBP levels of all 4 groups ( p < 0.02 vs. all 3 other groups). Systemic low level endotoxemia and resultant systemic inflammation is present in children who are either obese or suffer from OSA, and is particularly prominent when both conditions are present. We postulate that altered sleep and other factors facilitating obesity such as high fat diet may disrupt the gut microbiome, and lead to increased systemic LPS leaks with resultant inflammation. NIH HL65270.