Vaspin, a Compensatory Mechanism Against High Glucose Levels Since Birth?

Objective: Hormones produced by fat tissue, adipokines, produced during intrauterine life have recently been implicated in fetal growth. Vaspin is an adipokine expressed in visceral adipose tissue and has insulin-sensitizing effects. Elevated serum vaspin concentrations are associated with alterations in insulin sensitivity. We aimed to determine if vaspin concentrations in cord blood from healthy, term newborns differ among those born small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). A secondary objective was to determine whether an association existed between vaspin and anthropometric measurements, glucose and insulin levels in the newborn. Methods: The study population included healthy term newborns, 30 subjects in the SGA, 12 in the AGA, and 34 in the LGA group. Anthropometry was documented in all subjects. Blood was taken from the umbilical cord vein from each child for later analysis for vaspin, insulin and glucose concentrations. Results: Cord blood vaspin, insulin and glucose concentrations were not different between the three study groups. A negative correlation between vaspin and glucose concentrations was demonstrated in the whole cohort (r=-0.364, p=0.001). This correlation was also observed in the LGA group (r=-0.482, p=0.004). Glucose concentrations significantly predicted vaspin concentrations (r2=0.132, p=0.001). Conclusion: We found a negative association between glucose and vaspin concentrations in umbilical cord blood. In addition there was a predictive association between blood glucose and resulting vaspin concentration, suggesting that vaspin can be used as a predictor of alterations in the insulin-glucose metabolism from birth.

Comparación del incremento del perímetro abdominal con la prueba de hidrógeno espirado como predictor clínico de intolerancia a la lactosa / Comparison of an increased waist circumference with a positive hydrogen breath test as a clinical predictor of lactose intolerance

Introducción. La intolerancia a la lactosa es una afección frecuente en pediatría, cuyo diagnóstico erróneo conlleva morbilidad. El objetivo primario del estudio fue evaluar la utilidad del incremento del perímetro abdominal durante la prueba de hidrógeno espirado como predictor de intolerancia a la lactosa. El objetivo secundario fue analizar la influencia del índice de masa corporal, de la medida de la cintura y de la edad en la distensión abdominal de pacientes intolerantes a la lactosa. Población y métodos. Se incluyó a 138 sujetos de entre 3 y 15 años de edad a los cuales se les realizaron mediciones seriadas del perímetro abdominal y determinaciones de hidrógeno espirado cada 30 minutos por 3 horas, durante la prueba de hidrógeno espirado. Resultados. Del total de la muestra, 35 (25,4%) resultaron intolerantes a la lactosa. El incremento de 0,85 cm en el perímetro abdominal comparado con el perímetro abdominal basal tiene sensibilidad del 88% y especificidad del 85% para predecir intolerancia a la lactosa (OR 42,14; IC 95%: 13,08-135,75; p <0,001). El índice de masa corporal y la medida de la cintura no afectaron la distensibilidad del abdomen (p= NS); sin embargo, la edad modificó el momento de la distensión. Conclusiones. El incremento del perímetro abdominal de 0,85 cm en relación con el perímetro abdominal basal durante la prueba de hidrógeno espirado es un parámetro útil para diagnosticar la intolerancia a la lactosa en pediatría. Las variaciones en relación con el índice de masa corporal y la cintura no modificaron la utilidad del incremento del perímetro abdominal a diferencia de la edad.

Introduction. Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. Population and methods. A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. Results. Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p < 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. Conclusions. A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.

Comparison of an increased waist circumference with a positive hydrogen breath test as a clinical predictor of lactose intolerance. / Comparación del incremento del perímetro abdominal con la prueba de hidrógeno espirado como predictor clínico de intolerancia a la lactosa.

INTRODUCTION: Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. POPULATION AND METHODS: A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. RESULTS: Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p ≤ 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. CONCLUSIONS: A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age.

La intolerancia a la lactosa es una afección frecuente en pediatría, cuyo diagnóstico erróneo conlleva morbilidad. El objetivo primario del estudio fue evaluar la utilidad del incremento del perímetro abdominal durante la prueba de hidrógeno espirado como predictor de intolerancia a la lactosa. El objetivo secundario fue analizar la influencia del índice de masa corporal, de la medida de la cintura y de la edad en la distensión abdominal de pacientes intolerantes a la lactosa.