Vitamin D Effect on Ultrasonography and Laboratory Indices and Biochemical Indicators in the Blood: an Interventional Study on 12 to 18-Year-Old Children with Fatty Liver.

PURPOSE: The rising prevalence of childhood obesity in the past decades has caused non-alcoholic fatty liver disease (NAFLD) to become the most common cause of pediatric chronic liver disease worldwide. This study was aimed at determining the effect of vitamin D (Vit D) on ultrasonography and laboratory indices of NAFLD and some blood biochemical indicators in children. METHODS: In this interventional study liver ultrasonography was performed in 200 children with overweight and obesity. A 108 had fatty liver among which 101 were randomly divided into two groups of study (n=51) and control (n=50). The study group was treated with Vit D, 50000 U once a week whereas the control group received placebo with the same dose and package, both for 12 weeks. At the end of the intervention lab tests and ultrasound study was performed once again to evaluate the response to treatment. RESULTS: It was found out that Vit D supplementation improved the fatty liver grade in the study group. The mean changes in hemoglobin (Hb), uric acid, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, albumin and alanine aminotransferase (ALT) was significantly higher in the study group compared to controls (p<0.05). After the intervention and means adjustment, a significant difference was obtained in HDL-C, insulin, LDL-C and homeostasis model assessment of insulin resistance (HOMA-IR) between the two groups. CONCLUSION: Vit D supplementation in addition to improving the fatty liver grade in ultrasonography and increasing the blood Vit D level, increases the HDL and Hb level besides decreasing uric acid, LDL, HOMA-IR, insulin and ALT levels.

Vitamin D Supplementation and High-Density Lipoprotein Cholesterol: A Study in Healthy School Children.

BACKGROUND: The high-density lipoprotein cholesterol (HDL-C) level has been shown to have a significant role in the prevention of cardiovascular diseases and atherosclerosis. Low vitamin D levels have been shown to be correlated with dyslipidemia, but limited data exist on indigenous children. OBJECTIVES: We aimed to investigate the effect of vitamin D supplementation on HDL-C levels in school-aged Iranian children. METHODS: In this prospective controlled clinical trial, 47 healthy children (23 boys) aged 10 - 14 years, students of Birjand (Iran) elementary schools, were selected and randomly divided into two groups. The study group received a vitamin D supplement (1000 mg capsule) daily for one month, and placebo tablets were prescribed to the controls. Before and after the treatment course, the serum HDL-C and 25-hydroxy vitamin D levels of both groups were measured. The data were analyzed by SPSS, ver. 16, and Chi-square tests, Fisher's exact test, paired-sample t-tests, and Pearson's correlation were used, wherever appropriate. The significance level was set at P < 0.05. RESULTS: Forty children completed the study; their mean age was 11.5 ± 1.175 years. The mean serum levels of both HDL-C and vitamin D showed a significant rise following the treatment in the study group (P = 0.007 and P < 0.001, respectively), whereas both variables decreased slightly in the control group (P = 0.27). There was no statistically significant difference in the mean serum levels of HDL-C and vitamin D between the two groups after the intervention (P = 0.11 and P = 0.20, respectively). CONCLUSIONS: Vitamin D supplements seem to have a positive impact on serum HDL-C levels and may be effective in reducing the risk of cardiovascular diseases in the long term.

Assessment of antibacterial effect of garlic in patients infected with Helicobacter pylori using urease breath test.

OBJECTIVE: Helicobacter pylori (H. pylori) is the most common pathogenic bacteria in the stomach. The aim of the current study was to explore the effect of oral garlic administration on bacterial urease activity inside the stomach and its contribution to the treatment of H. pylori infection. MATERIALS AND METHODS: In this clinical trial, 15 patients were studied quantitatively with Urease Breath Test (UBT). The patients with gastrointestinal symptoms and a positive serum H. pylori IgG were enrolled. UBT was performed for each patient in three sessions as follows: at the beginning of the study, an initial UBT was performed based on which, the positive cases entered the study and the negative ones were excluded. Second UBT was done three days later in patients who were not receiving any treatment and were considered as the control, whereas the third UBT was performed three days after prescribing two medium-sized cloves of garlic (3 g) with their meal, twice a day (at noon and in the evening). The collected data were analyzed using ANOVA and Bonferroni tests and the significance level was set at p<0.05. RESULTS: the mean UBT significantly differed before and after treatment with garlic cloves, being significantly lower after garlic consumption. No meaningful difference was observed in the mean UBT without garlic consumption between the first and second steps. CONCLUSION: Raw garlic has anti-bacterial effects against H. pylori residing in the stomach and may be prescribed along with routine drugs for the treatment of gastric H. pylori infection.

Prevalence of Dyslipidemia among Elementary School Children in Birjand, East of Iran, 2012.

BACKGROUND: Various studies have indicated that dyslipidemia starts in childhood. There is a relationship between the concentration of blood lipids and atherosclerosis. In this study, we assessed the prevalence of dyslipidemia in elementary school children. METHODS: This cross-sectional study was performed on 1,626 (882 girls and 744 boys) elementary school children aged between 6 and 11 years in Birjand in 2012. Samples were selected through multistage random sampling. The lipid profiles (i.e., cholesterol, triglyceride, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C]) of the subjects were measured after 12 hours' fasting. The definition of dyslipidemia was based on the criteria of The American Children Academia in 2011. RESULTS: Dyslipidemia (at least one abnormal level of a serum lipid) was detected in 31% of the children (31.3% of the girls vs. 30.6% of the boys). Total cholesterol was ≥ 200 mg/dL in 13.4% of the children, LDL-C was ≥ 130 mg/dL in 8.5%, HDL-C was < 40 mg/dL in 11.3%, and triglyceride was ≥ 130 mg/dL in 15.3%. The prevalence of hypertriglyceridemia was significantly higher in the females than in the males (16.3% in the girls vs. 13.8% in the boys; p value = 0.01) - while hypercholesterolemia (12.2% in the girls vs. 14.9% in the boys; p value = 0.16), high LDL-C (8.5% in the girls vs. 8.5% in the boys; p value = 0.05), and low HDL-C (12.7% in the girls vs. 9.5% in the boys; p value = 0.1) were not significantly different between the two sexes. CONCLUSION: The prevalence of dyslipidemia was high in the school children in Birjand and, thus, requires preventive measures.

SerumTrace Elements in Febrile Seizure: A Case-Control Study.

OBJECTIVE: Febrile seizure (FS) is one of the most common neurological problems during childhood.Pathogenesis of febrile convulsion is unknown. This study investigated some trace elements among children admitted with FS compared with thoseof febrile without seizure attacks. MATERIALS & METHODS: This case-control study was conducted on48 children (6 months to 5 yrold) diagnosed with febrile seizure as the cases and 48 age-matched febrile children as the control group. Serum levels of magnesium, calcium, sodium, potassium, and serum zinc were measured. Statistical analysis was performed with SPSS (version 15) using Student t-test. RESULTS: There were no significant differences between the cases and controls in terms of gender or age. The means of serum level of zinc, sodium, calcium and magnesium in the case group was lower than those of the control group. There was no significant difference onserum potassium mean level between the case and control groups. CONCLUSION: Deficiency of trace elements was correlated significantly with febrile convulsion, while further investigations on trace elements are required.

Prevalence of Metabolic Syndrome in Elementary School Children in East of Iran.

INTRODUCTION: Metabolic Syndrome (MS) in children and adolescents is becoming a global public health concern. MS tracks into adulthood increasing the risk for type 2 diabetes mellitus and cardiovascular diseases. This study was designed to verify the rate of MS in elementary school students of Birjand, as a representative sample of Iranian children to verify the best preventive measures in this age group. METHODS: This descriptive-analytical, cross-sectional study was performed on 1425 elementary school children through multiple-cluster sampling in 2013. Height, weight, waist circumference and blood pressure of children were measured by standard methods. Blood glucose, triglycerides, cholesterol, High-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) levels were also measured after 12 hours fasting. MS was defined according to the Adult Treatment Panel III (ATP-III) based on the National Cholesterol Education Program. Data were analyzed by SPSS using t test and chi-square test. Significance level was set at P < 0.05. RESULTS: The prevalence of MS was 5.3% which increased with age. 43.5% of the studied cases had one or more components of the MS. The most common components were hypertension, abdominal obesity, hypertriglyceridemia, low HDL-cholesterol and impaired fasting glucose, respectively. MS prevalence was 0.9% in normal weight, 11.3% in overweight and 36.2% in obese children. CONCLUSION: Regarding the high prevalence of MS in elementary school children in our region, screening for obesity is recommended to prevent adulthood complications. Therapeutic lifestyle changes and maintenance of regular physical activity are the most important strategies for preventing childhood obesity.

Prevalence of high normal FBS and prediabetes among adolescents in Birjand, East of Iran, 2012.

BACKGROUND AND OBJECTIVES: To determine the prevalence of impaired fasting glucose in adolescents in Birjand city in eastern Iran. MATERIALS AND METHODS: This cross-sectional study was done on 2653 students aged 11-18 years selected through multi-stage stratified and random sampling. Fasting blood glucose (FBS) of these students was measured applying the enzymatic process. The obtained data were analyzed by means of SPSS software (V: 15) and statistical tests T and X2. RESULTS: The mean age of individual was 14.5 ± 2 years. Mean FBS of the whole population was 89.8 ± 9.8 mg/dl, but it was significantly higher among boys than girls (P < 0.001). Out of the whole subjects (92.4%), 1,328 (95.1%) of the girls and 1,122 (89.3%) of the boys, FBS was less than 100 mg/dl among whom 64.4% had FBS above 86 mg/dl. In 200 subjects (7.5%) of whole population, FBS was 100-125 mg/dl; with that of the boys was 2.3 times than the girls revealing a prediabetes condition: OR = 2.3(CI: 1.7-3.2). Among the students, 3 (0.1%) had an FBS > 126 mg/dl. Mean blood glucose was significant regarding age and sex. CONCLUSIONS: High prevalence of high FBS (within normal range) among adolescents is warning and requires special attention of health officials. Screening of children and adolescents in order to identify those at risk and plan for intervening is urgent to prevent type-2 diabetes epidemic and following cardiovascular complications in the Society.

Lipid Profiles and Prevalence of Dyslipidemia in Eastern Iranian Adolescents, Birjand, 2012.

BACKGROUND: Cardiovascular risk factors begin in childhood and adolescence. This study aimed at assessing serum lipids and prevalence of Dyslipidemia in 11-18 year old students of Birjand. METHODS: The present cross-sectional, descriptive, and analytical study was done on 2,643 middle and high school students of Birjand aged 11-18 years (1,396 girls and 1,247 boys). Blood samples were collected for the measurement of blood lipids, including Cholesterol, Triglyceride, HDL, and LDL after a 12-hour fasting period. The defined borderline and abnormal values stated in 2011 by the American Academy of Child, was used. RESULTS: According to our results, it is concluded that: (i) 34.3% (31.3% girls and 37.6% boys) of adolescents had at least one dyslipidemia. (ii) 24.7% of the individuals had HDL lower than 40, where 14% of them TG≥130, 6.1% of cases TC≥200, and 3.5% of cases LDL≥130. Lipid disorder within low HDL type and hypertriglyceridemia were significantly higher in boys (P<0.05) than girls. Hypercholesterolemia and hypertriglyceridemia in the age group of 11-14 years and low HDL in the age group of 15-18 years showed the highest values (P<0.05). CONCLUSION: Adolescents of Birjand have high prevalence of dyslipidemia. Preventive measures are recommended to improve lifestyle, including healthy nutrition, encouraging adolescents to exercise, and more mobility.

The relationship between serum lipids and obesity among elementary school in Birjand: a case control study.

BACKGROUND: Childhood obesity could induce some risk factors for cardiovascular disease (CVD) including serum lipid abnormalities, hypertension, and atherosclerosis. The present study aimed to comparison the lipid profile in normal children with cases having overweight, obesity and central obesity. METHODS: In this case control study, which was conducted 2013, serum lipids for three groups of children including cases with overweight (Body mass index (BMI): 85-95th percentiles to age and sex and waist circumference (WC) <90th percentile to age and sex = Case group1), central obesity without general obesity (BMI <85th percentiles and WC ≥ percentile 90 = Case group 2) and central obesity with general obesity (BMI ≥95th percentile and WC ≥ percentile 90 = Case group 3) were compared with control group (BMI < 85th percentiles WC <90th percentile). Data were analyzed using software SPSS-16 by chi-square and ANOVA tests at significance level α=0.05. RESULTS: Each group consisted of 100 individuals. The highest mean of serum lipids and the highest extent of dyslipidemia existed in the children having central obesity along with general obesity. So that 49%, 28%, and 38% students of this group show hypertriglyceridemia, hypercholesterolemia, and low high-density lipoprotein cholesterol (HDL-C). Odd ratio of hypertriglyceridemia, hypercholesterolemia and low HDL-c, in children with at least one abnormal index (BMI and /or WC) compared with control group were 3.73 (95% CI: 1.98, 6.99), 1.37 (95% CI: 1.71, 2.65) and 2.98 (95% CI: 1.51, 5.87), respectively. CONCLUSIONS: With regard to the relationship between central obesity and adverse changes in lipid profiles, the screening children for central obesity to prevention of cardiovascular disease are recommended.

Prevalence of abdominal obesity in adolescents 2012, birjand, East of iran.

BACKGROUND: Prevalence of obesity in children has been increased during recent decades all over the world. Obesity, particularly, abdominal obesity (AO) is associated with the risk of metabolic syndrome and cardiovascular disease. This study aimed to assess obesity and central obesity within students aged 11-18 of Birjand city. METHODS: This cross-sectional and descriptive- analytical study was conducted on 2458 secondary and high school students, including 1345 girls (54.8%) and 1113 boys (45.2%), who had been selected from Birjand Middle and high schools through multiple-cluster sampling in 2012. For determination of AO, waist circumference and the percentage 90 or more regarding age and sex were used. The obtained data were analyzed by using statistical t-tests and χ(2) at the significant level P < 0.05. RESULTS: Among the studied students, average 16.3% (20% of boys and 13.2% of girls) had AO. The obtained data about these two groups shows statistical significant difference of P < 0.001. Chance of AO in boys was 1.6 times greater than that of girls. Odds ratio (OR) = 1.6 (confidence interval [CI]: 1.3-2.1). It was 1.9 times more about under 15-year-old than over 15 aged subjects. OR = 1.9 (CI: 1.5-2.4). CONCLUSIONS: Regarding high prevalence of AO in Birjand adolescents, it is recommended that adolescents and their families should be warned for long-term outcomes of obesity on quality-of-life. Periodic studies are suggested for awareness of obesity trends in the coming years.

Comparison of the WHO Child Growth Standards with the NCHS for Estimation of Malnutrition in Birjand-Iran.

BACKGROUND: Anthropometric indices are widely used to assess the health and nutritional status of children The aim of the present study was determination of malnutrition and compare estimates of under nutrition among young children under 2 years of age from Birjand city of Iran using WHO growth standard and the National Center for Health Statistics (NCHS) references. METHODS: The cross-sectional descriptive study conducted on 822 children under 2 years of age mean z scores for weight-for-age and height-for-age and prevalence underweight, stunting and wasting were calculated using the new WHO growth standards and compared with NCHS references. RESULTS: Compared with NCHS reference, the mean height for age were lower and mean weight for age scores were almost similar using the WHO standards. Prevalence underweight, stunting, and wasting using WHO standards were 5.2-8.2% and 1.9%, respectively, compared to 6.5-37.3% and 1% based on the NCHS references. CONCLUSIONS: Using WHO standards resulted differences in mean z score for height for age and changes in prevalence of stunting compared with NCHS references in Birjand city children.

Prevalence of overweight, obesity and central obesity among elementary school children in Birjand, east of Iran, 2012.

BACKGROUND: Prevalence of obesity in children has been increasing during recent decades all over the world. Obesity, particularly central obesity, is associated with metabolic syndrome and cardiovascular diseases. The present study aimed to assess obesity and central obesity in 6-11 year old Birjand elementary school children, East of Iran. METHODS: This cross-sectional study was conducted on 1541 elementary school children, i.e. 851 girls and 690 boys, selected from Birjand elementary schools through multiple-cluster sampling in 2012. In order to determine overweight and obesity the percentile of CDC was used, so that, 85-95th percentile were taken as overweight and >95th percentile was defined as obese with respect to age and sex. For determination of central obesity, waist circumference and the ≥90th percentile were used regarding age and sex. The obtained data was analyzed by means of SPSS software (V: 15) using t and chi-square statistical tests at the 0.05 significant level. RESULTS: Out of the studied children, 9.6% (11% of boys and 8.3% of girls) were overweight and 9.2% of children (i.e. 10.9% of boys and 7.9% of girls) were obese. About 15.7% of children (i.e. 20.3% of boys and 12% of girls) had central obesity. CONCLUSIONS: Regarding high prevalence of obesity, central obesity, and overweight in Birjand elementary school children, it is recommended that families should be provided with necessary information with respect to correcting life-style and preventing obesity in children.

Intestinal Parasitic Infection among School Children in South Khorasan Province, Iran.

BACKGROUND: Intestinal parasitic infection is one of the major public health problems in developing countries. Children are more vulnerable to these infections. In addition, the prevalence of infection is different among various communities; hence, there is a need for the periodical prevalence evaluation. This study was performed to define the prevalence of intestinal parasitic infection among the students of South Khorasan Province, eastern Iran in 2007. METHODS: A cross-sectional study was performed on 2169 students aged 6-11 years in six cities of South Khorasan Province in 2007. Three stool specimens were collected from each student. Specimens were examined with direct wet and formalin ethyl acetate method. Data were analyzed with SPSS version 15 software. RESULTS: From a total 2169 students, 47.7% were infected with one or more intestinal parasites. Almost 33.4% were pathogen parasites. The most common parasite was Giardia (28.7%). The prevalence rate of infection was significantly higher in rural area than that of urban area (P=0.001). The prevalence of infection was also much more common in those students whose parents were less educated. CONCLUSION: Prevalence of intestinal parasitic infection in this region is remarkable. Public health education and using healthy water are recommended.