Myeloperoxidase as cardiovascular risk marker in pre-pubertal preterm children?

BACKGROUND AND AIMS: To evaluate the biomarkers related to cardiovascular risk in pre-pubertal preterm children with a birth weight of less than 1,500 g and relate them to current nutritional status, insulin resistance, and inflammation. METHODS & RESULTS: This is a cross-sectional, controlled study with pre-pubertal preterm children aged 5-9 years with a birth weight of less than 1500 g (Preterm group, n = 44) compared to full term children of adequate weight for gestational age (Control group, n = 30). Clinical evaluation: anthropometry and pubertal staging. Laboratory tests: total cholesterol and fractions, triglycerides, paraoxonase 1, apolipoproteins A-I and B, myeloperoxidase (MPO), high sensitivity C-reactive protein (hs-CRP), glycemia and insulin (to calculate HOMA-IR). In the preterm group, 19 (43.2%) were male, with mean birth weight and gestational age of 1157 ± 242 g and 30.0 ± 2.3 weeks, respectively. The preterm group showed lower concentrations of HDL-c (60.1 ± 10.1 vs. 69.0 ± 10.0 mg/dL; p < 0.001); higher concentrations of hs-CRP [0.55 mg/dL (0.30; 39.4) vs. 0.30 mg/dL (0.30; 10.80); p = 0.043], of MPO [21.1 ng/mL (5.7; 120.0) vs. 8.1 ng/mL (2.6; 29.6); p < 0.001] and of MPO/HDL-c ratio [0.39 (0.09; 2.07) ng/mg vs. 0.11 (0.05; 0.58)]. The MPO/HDL-c ratio was the variable that showed the best discriminatory power between the groups (AUC = 0.878; 95% CI; 0.795-0.961). MPO concentrations in the preterm group were correlated with those of hs-CRP (r = 0.390; p = 0.009), insulin (r = 0.448; p = 0.002) and HOMA-IR (r = 0.462; p = 0.002). CONCLUSION: Prepubertal preterm children show high MPO concentrations and MPO/HDL-c ratio that are associated with inflammation and oxidative stress, which, in turn, may be associated with atherosclerosis.

[Vitamin A: blood level and dietetics intake in stunted children and adolescents without hormonal disease]. / Vitamina A: nível sérico e ingestão dietética em crianças e adolescentes com déficit estatural de causa não hormonal.

OBJECTIVES: To determine the vitamin A intake and the blood levels of carotenoids and retinol in stunted children and adolescents without hormonal disease, assisted in the Clinic of Pediatric Endocrinology of the Center for Nutrition and Child Development--Department of Health, State of São Paulo, Brazil. METHODS: We evaluated, in a prospective and randomized trial, 47 prepubertal patients between 4 and 14 years old. All patients were submitted to anthropometric evaluation, bone age, bioelectric impedance and serum retional and carotenoid levels. RESULTS: The average of the stature z score was -2.4; 20% of the patients were undernourished, 25.5% they had inadequacy of the fat mass as well as larger delay of the bone age. The more stunted the patients the lower were the carotenoid levels. There was no relationship between the levels of retinol and carotenoids and the growth velocity. In 82.9% of the recall record of food intake, the vitamin A intake was lower than 50% of the established one in the Food Guide Pyramid. CONCLUSION: There is a high prevalence of malnutrition, bone age delay and inadequacy of the levels of carotenoids and vitamin A intake in stunted children and adolescents.

Vitamina A: nível sérico e ingestäo dietética em crianças e adolecentes com déficit estatural de causa näo hormonal / Vitamin A: blood level and dietetics intake in stunted children and adolescents without hormonal disease

OBJETIVOS: Determinar a ingestäo dietética de vitamina A e os níveis séricos de carotenóides e retinol em crianças e adolescentes com déficit estatural sem causa hormonal, atendidos no Ambulatório de Endocrinopediatria do Núcleo de Nutriçäo (NUNADI) da Secretaria de Estado da Saúde de Säo Paulo. MÉTODOS: Foram avaliados de maneira prospectiva 47 pacientes pré-púberes, entre 4 e 14 anos, com relaçäo a: antropometria, idade óssea, inquérito alimentar, bioimpedanciometria e nível sérico de retinol e carotenóides. RESULTADOS: A média do escore Z da estatura foi de -2,4; 20 por cento dos pacientes eram desnutridos, 25,5 por cento tinham inadequaçäo da massa gorda e maior atraso da idade óssea. Os níveis séricos de retinol e carotenóides foram inadequados em 21 por cento dos pacientes, sendo que foi maior o percentual de inadequaçäo dos carotenóides nos pacientes que apresentavam déficit estatural mais acentuado. Näo houve relaçäo dos níveis séricos de retinol e carotenóides com a velocidade de crescimento. Em 82,9 por cento dos inquéritos alimentares realizados, houve ingestäo de vitamina A inferior a 50 por cento do estabelecido na Pirâmide de Alimentos. CONCLUSÄO: Baseados nestes resultados, concluímos que há uma elevada prevalência de desnutriçäo, comprometimento da idade óssea, inadequaçäo no nível sérico de carotenóides e ingestäo de vitamina A em crianças com comprometimento estatural