Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

BACKGROUND: Environmental enteric dysfunction (EED) is a chronic subclinical condition, contributed to limited sources and poor countries. EED pathology is concerned with small intestine structure and function, which affect the macronutrients and micronutrients absorption with consequent growth faltering. AIM: This study aimed to evaluate some serum biomarkers involved in EED and determine their association with stunting and faltering growth in children; zonulin, endotoxin core antibody (EndoCAb), high-sensitive C-reactive protein (hsCRP), alpha-1-acid glycoprotein (AGP), and tumor necrosis factor (TNF), serum iron, and Vitamins A and D. PATIENTS AND METHODS: This case–control study enrolled 105 children aged from 1 to 10 years old, having weight-for-age z-scores and height-for-age z-scores (WAZ or HAZ) ranging from −1.5 to −2. They were compared with control group consisted of 100 children having WAZ or HAZ > −1 of matched age and sex. Assessment of serum markers levels of enteric dysfunction (zonulin and EndoCAb), markers of systemic inflammation (Hs CRP and AGP), along with serum micronutrients (vitamin A, vitamin D and iron) in children with malnutrition in comparison to controls. RESULTS: There was a highly significant decrease as regarding the anthropometric measurements; weight, height, BMI, and arm circumference. Moreover, significant increase in serum zonulin, EndoCAb, HsCRP, and AGP and highly significant decrease of serum Vitamin D and iron in cases group as compared to control group. Height Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D. Weight Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D and Vitamin A. Regression analysis noted increase of zonulin and α1AGP as high associative markers with height Z score affection, however, increase of zonulin was high associative markers with weight Z score affection. CONCLUSION: Faltering growth is associated with elevated serum systemic markers of intestinal inflammation (HsCRP and α1AGP). EED may be a cause of faltering growth.

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Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7023 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1625-1632

Author(s):

Maged A. El Wakeel ◽

Ghada M. El-Kassas ◽

Shaimaa A. Hashem ◽

Hasanin M. Hasanin ◽

Walaa H. Ali ◽

...

Keyword(s):

Vitamin D ◽

Vitamin A ◽

Negative Correlation ◽

Serum Biomarkers ◽

Control Group ◽

Z Score ◽

Positive Correlation ◽

Egyptian Children ◽

Environmental Enteric Dysfunction ◽

Z Scores

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SAT-395 Correlations Between Biochemical Parameters and Trabecular Bone Score (TBS) in Primary Hyperparathyroidism (PHP) Patients

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1960 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Lívia Marcela Santos ◽

Monique Nakayama Ohe ◽

Sthefanie Giovanna Pallone ◽

Ilda Sizue Kunii ◽

Renata Elen Costa Silva ◽

...

Keyword(s):

Vitamin D ◽

Trabecular Bone ◽

Vitamin D Deficiency ◽

Negative Correlation ◽

Bone Structure ◽

Trabecular Bone Score ◽

Control Group ◽

Total Calcium ◽

Mineral Density ◽

Positive Correlation

Abstract Background: Vitamin D deficiency is common among PHP patients. While data are limited, some studies suggest that vitamin D deficiency may exacerbates skeletal disease in PHP. TBS is a software-based method for assessment of trabecular bone structure of the spine, based on analysis of pixels obtained in dual energy x-ray absorptiometry (DXA) images. The aim of this study was to evaluate TBS, vitamin D status, clinical and laboratorial measurements in a PHP group of patients in a search for a more accurate bone fragility test for risk assessment in this group of patients. Methods: From June/2017 to January/2019, patients who met the criteria for PHP diagnosis were included in this study. Control group was composed by age and sex-matched healthy individuals. Overall, 64 PHP and 63 controls were enrolled. Bone mineral density (BMD) measured by DXA (Hologic QDR 4500) at the lumbar spine, total hip, femoral neck, and TBS values (InSight™) were determined in both groups. Total and ionized calcium, PTH, 25-hydroxyvitamin D (25(OH)D), creatinine, alkaline phosphatase, P1NP and CTX were measured. None were in use of Vitamin D supplementation. Results: As expected, PHP patients had lower BMD values than controls in all sites (p<0.0001). TBS measurements were also reduced in PHP patients compared to controls (1233 vs 1280, p=0.0444). TBS values were inversely correlated with total calcium (CaT) and phosphorus measurements were positively correlated in the PHP patients. 25(OH)D measurements didn’t differ between groups (PHP 22.5 vs. controls 19.8 ng/mL, p=0.1699). There was a positive correlation between 25(OH)D and TBS in both PHP and controls (r= 0,3088, p= 0,0138 and r= 0,3708, p= 0,003 respectively). Considering individuals with vitamin D deficiency (25(OH)D levels <=20 ng/mL), a negative correlation between TBS and CaT measurements among PHP patients (r= -0,4391, p=0,0172) was observeed, while in controls there was a positive correlation between TBS and 25(OH)D (r= 0,3504, p= 0,0362). Conclusion: Serum total calcium presents negative correlation and phosphorus a positive one with TBS in PHP patients. We also found a correlation between TBS and 25(OH)D, both in PHP and in controls. 25(OH)D <=20 ng/mL is an independent risk factor determining degraded TBS among PHP patients and controls.

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The Effect of Phosphate Supplementation on Linear Growth in Children with X-Linked Hypophosphatemia

PEDIATRICS ◽

10.1542/peds.94.4.478 ◽

1994 ◽

Vol 94 (4) ◽

pp. 478-481

Author(s):

Mouin G. Seikaly ◽

Richard H. Browne ◽

Michel Baum

Keyword(s):

Vitamin D ◽

Standard Deviation ◽

Linear Growth ◽

Standard Deviation Score ◽

Initial Therapy ◽

Current Therapy ◽

Height Standard Deviation Score ◽

Z Score ◽

Z Scores ◽

Phosphate Supplementation

Background. X-linked hypophosphatemia is the most common inherited cause of rickets. Current therapy for this disorder includes vitamin D and phosphate supplementation; however, phosphate therapy has been associated with nephrocalcinosis. The purpose of this study is to evaluate the effect of oral phosphate therapy on growth in patients with X-linked hypophosphatemia treated with either calcitriol or dihydrotachysterol (vitamin D). Methods. We retrospectively evaluated the prepubertal growth of 36 children with X-linked hypophosphatemia. The height standard deviation score (Z-score) of patients initially treated with vitamin D alone and the Z-scores of patients treated with vitamin D and phosphate therapy were compared. In addition, the growth of patients treated with vitamin D was compared with that of patients treated with vitamin D and phosphate from the outset of therapy. Results. Patients treated with vitamin D alone for 5.36 ± 2.18 years had an improvement in Z-score from -3.18 ± 1.10 to -2.49 ± 0.66 SDS, ,P < .05. Adding phosphate therapy for patients initially treated with vitamin D alone for 4.83 ± 2.99 years did not further improve Z-score (-2.49 ±0.66 vs -2.35 ± 0.83). Initial therapy with vitamin D and phosphate for 4.33 ± 2.19 years also improved Z-score, (-2.84 ± 1.02 vs -1.98 ± 0.82, P < .05). The change in Z-score was similar to the group treated with vitamin D alone compared with the group treated initially with vitamin D and phosphate (0.65 ± 0.54 vs 0.85 ± 0.65, respectively). Conclusion. These data demonstrate that both vitamin D alone and in combination with phosphate improved linear growth. Adding oral phosphate for children initially treated with vitamin D alone did not improve Z-score. Initial therapy with vitamin D and vitamin D plus phosphate produced similar changes in linear growth.

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Assessment of 25 Hydroxy Cholecalceferol Level in Autistic Children; is there a role for it in Treatment of Autism Spectrum Disorder?

QJM ◽

10.1093/qjmed/hcab113.039 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Martina Alfred Youssef Nakhla ◽

Eman Ahmed Zaky ◽

Enas Samir Nabeh ◽

Asmaa Wafeeq Abd El Aziz

Keyword(s):

Vitamin D ◽

Serum Vitamin ◽

Autism Spectrum ◽

Laboratory Evaluation ◽

Control Group ◽

Autistic Children ◽

Serum Vitamin D ◽

Group I ◽

Egyptian Children ◽

Therapeutic Doses

Abstract Background Autism is a group of neurodevelopmental disabilities with various genetic and environmental risk factors. Vitamin D is an important neurosteroid hormone which can affect brain development and function, but research on its use in treating autism has been limited. Objectives The current study aimed at assessing the level of 25 OH vit D3level in a group of autistic infants and children compared to controls and correlating it with the severity of autistic manifestations and evaluation of the role of therapeutic doses of vitamin D on the severity of autistic manifestations. Methodology Thirty autistic Egyptian children (group I) and 30 clinically healthy age and sex matched controls were enrolled (group II). Therapeutic doses of vitamin D were given for autistic children who showed insufficient levels of 25 OH cholecalceferol for a period of 4-6 weeks followed by maintenance doses for another 6 weeks. Psychometric and laboratory evaluation for this group was done thrice: at the onset of study, at 6 week after enrollment in the study, and at 12 weeks after that enrollment. Results Serum vitamin D level was substantially reduced in patients with ASD in comparison to control group, and on the other hand, 25 (OH) vitamin D level was significantly negatively correlated with ATEC score and Total CARS score. Autistic children who received vitamin D3 treatment had significant improvement of CARS and ATEC scores. Conclusion vitamin D supplementation significantly improved the outcome of enrolled autistic children. It is recommended to follow up our studied sample to check the consolidation of improvement for how long it will be needed.

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Longitudinal Maternal Vitamin D Status during Pregnancy Is Associated with Neonatal Anthropometric Measures

Nutrients ◽

10.3390/nu10111631 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1631 ◽

Cited By ~ 5

Author(s):

Ellen Francis ◽

Stefanie Hinkle ◽

Yiqing Song ◽

Shristi Rawal ◽

Sarah Donnelly ◽

...

Keyword(s):

Vitamin D ◽

Linear Models ◽

Z Score ◽

Anthropometric Measures ◽

Hydroxyvitamin D ◽

Prepregnancy Bmi ◽

Z Scores ◽

Gestational Week ◽

25 Hydroxyvitamin D ◽

Lower Birthweight

Findings on maternal 25-hydroxyvitamin D (25[OH]D) and neonatal anthropometry are inconsistent, and may at least be partly due to variations in gestational week (GW) of 25(OH)D measurement and the lack of longitudinal 25(OH)D measurements across gestation. The aim of the current study was to examine the associations of longitudinal measures of maternal 25(OH)D and neonatal anthropometry at birth. This study included 321 mother–offspring pairs enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies–Singletons. This study was a prospective cohort design without supplementation and without data on dietary supplementation. Nevertheless, measurement of plasma 25(OH)D reflects vitamin D from different sources, including supplementation. Maternal concentrations of total 25(OH)D were measured at 10–14, 15–26, 23–31, and 33–39 GW and categorized as <50 nmol/L, 50–75 nmol/L, and >75 nmol/L. Generalized linear models were used to examine associations of 25(OH)D at each time-point with neonate birthweight z-score, length, and sum of skinfolds at birth. At 10–14 GW, 16.8% and 49.2% of women had 25(OH)D <50 nmol/L and between 50–75 nmol/L, respectively. The association of maternal 25(OH)D with neonatal anthropometry differed by GW and women’s prepregnancy BMI (normal (<25.0 kg/m2), overweight/obese (25.0–44.9 kg/m2)). All analyses were stratified by prepregnancy BMI status. Among women with an overweight/obese BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower birthweight z-score (0.56; 95% CI: −0.99, −0.13) and length (−1.56 cm; 95% CI: −3.07, −0.06), and at 23–31 GW was associated with shorter length (−2.77 cm; 95% CI: −13.38, −4.98) and lower sum of skinfolds (−9.18 mm; 95% CI: −13.38, −4.98). Among women with a normal BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower sum of skinfolds (−2.64 mm; 95% CI: −5.03, −0.24), at 23–31 GW was associated with larger birthweight z-scores (0.64; 95% CI: 0.03, 1.25), and at 33-39 GW with both higher birthweight z-score (1.22; 95% CI: 0.71, 1.73) and longer length (1.94 cm; 95% CI: 0.37, 3.52). Maternal 25(OH)D status during pregnancy was associated with neonatal anthropometric measures, and the associations were specific to GW of 25(OH)D measurement and prepregnancy BMI.

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EVALUATION OF GLUTATHIONE-S-TRANSFERASE P1 POLYMORPHISM AND ITS RELATION TO BONE MINERAL DENSITY IN EGYPTIAN CHILDREN AND ADOLESCENTS WITH BETA- THALASSEMIA MAJOR

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2016.004 ◽

2016 ◽

Vol 8 ◽

pp. 2016004 ◽

Cited By ~ 3

Author(s):

Seham Ragab

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Thalassemia Major ◽

Beta Thalassemia ◽

Z Score ◽

Glutathione S Transferase ◽

Mineral Density ◽

Beta Thalassemia Major ◽

Egyptian Children ◽

Z Scores

Background:Osteoporosis is a major problem in beta thalassemia major (TM) patients. Increased oxidative stress and its controlling genes were linked to osteoporosis. Glutathione S-transferase P1 (GSTP1),Ile105 Val variant is a functional mutation with reduced ant-oxidative property .No data are available about this variant or its association with osteoporosis among thalassemia patients yet. Objectives: The aim of this study was to investigate Ile105Val polymorphism and its possible association with bone mineral density (BMD) values in a group of TM children. Methods:Thirty five TM patients and 30 age and sex matched healthy controls were included. Liver and renal functions, serum ferritin, calcium, phosphorous, alkaline phosphatase and osteocalcin were assayed. BMD was determined by DXA with calculation of Z-scores at lumbar spine (Ls) and femoral neck (Fn).Height for age z- score (HAZ) adjusted BMD Z-scores were considered . GSTP1 Ile105Val polymorphism was studied by polymerase chain reaction-restriction fragment length polymorphism. Results:The relative frequency of 105 Val allele was significantly higher in TM patients than the controls (P<0.0001). Significant association between genotype subgroups and BMD parameters was detected. Mutant homozygotes had significant lower BMD , Z –score and haz -adjusted BMD Z-score at both Ls and Fn compared to wild homozygotes ( Ps =0.029, 0.008, 0.011, 0.001,0.02, 0.001) with significant higher osteocalcin level compared to heterozygotes and wild homozygotes (P=0.012 and P=0.013,respectively). Conclusion: The results indicated that 105Val allele was frequent among TM patients and could increase their susceptibility to osteoporosis. Large sample studies are required to confirm these findings.

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The Effects of a Preconception Lifestyle Intervention on Childhood Cardiometabolic Health—Follow-Up of a Randomized Controlled Trial

Cells ◽

10.3390/cells11010041 ◽

2021 ◽

Vol 11 (1) ◽

pp. 41

Author(s):

Stijn Mintjens ◽

Mireille N. M. van Poppel ◽

Henk Groen ◽

Annemieke Hoek ◽

Ben Willem Mol ◽

...

Keyword(s):

Blood Pressure ◽

Lifestyle Intervention ◽

Maternal Obesity ◽

Controlled Trial ◽

Cardiometabolic Health ◽

Control Group ◽

Z Score ◽

Infertile Women ◽

Z Scores

Maternal obesity is associated with adverse metabolic outcomes in her offspring, from the earliest stages of development leading to obesity and poorer cardiometabolic health in her offspring. We investigated whether an effective preconception lifestyle intervention in obese women affected cardiometabolic health of their offspring. We randomly allocated 577 infertile women with obesity to a 6-month lifestyle intervention, or to prompt infertility management. Of the 305 eligible children, despite intensive efforts, 17 in the intervention and 29 in the control group were available for follow-up at age 3–6 years. We compared the child’s Body Mass Index (BMI) Z score, waist and hip circumference, body-fat percentage, blood pressure Z scores, pulse wave velocity and serum lipids, glucose and insulin concentrations. Between the intervention and control groups, the mean (±SD) offspring BMI Z score (0.69 (±1.17) vs. 0.62 (±1.04)) and systolic and diastolic blood pressure Z scores (0.45 (±0.65) vs. 0.54 (±0.57); 0.91 (±0.66) vs. 0.96 (±0.57)) were similar, although elevated compared to the norm population. We also did not detect any differences between the groups in the other outcomes. In this study, we could not detect effects of a preconception lifestyle intervention in obese infertile women on the cardiometabolic health of their offspring. Low follow-up rates, perhaps due to the children’s age or the subject matter, combined with selection bias abating contrast in periconceptional weight between participating mothers, hampered the detection of potential effects. Future studies that account for these factors are needed to confirm whether a preconception lifestyle intervention may improve the cardiometabolic health of children of obese mothers.

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Nutritional role of amniotic fluid: clues from infants with congenital obstruction of the digestive tract

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-314531 ◽

2018 ◽

Vol 104 (2) ◽

pp. F199-F201 ◽

Cited By ~ 2

Author(s):

Nigel J Hall ◽

Melanie Drewett ◽

David Burge

Keyword(s):

Amniotic Fluid ◽

Digestive Tract ◽

Gestational Age ◽

Significant Negative Correlation ◽

Control Group ◽

Z Score ◽

Term Infants ◽

Z Scores ◽

And Gender

AimsTo investigate the role played by amniotic fluid in late fetal nutrition by analysis of infants born with digestive tract atresia.MethodsBirth weight (BW), gestational age and gender of infants born with oesophageal (OA), duodenal (DA), jejunal (JA) and ileal atresia (IA) were recorded and BW Z-scores compared. Infants with incomplete obstruction (stenosis), chromosomal or syndromic conditions and multiple congenital malformations were excluded. Term infants admitted with suspected postnatal intestinal obstruction in whom no congenital malformation was found were used as a control group.ResultsA total of 584 infants were identified comprising 148 OA, 60 DA, 26 JA and 57 IA with 293 in the control group. Infants with OA and DA had statistically significantly lower BW Z-score than controls. However, BW Z-score for infants with more distal atresia (JA and IA) was similar to controls. When compared with infants with OA, BW Z-score for infants with more distal atresia was higher than that for OA. BW Z-score in infants with OA was significantly lower in those born at term compared with those born preterm (mean±SD −0.92±1.0 vs −0.48±0.87; p=0.01) with a significant negative correlation between BW Z-score and increasing gestational age (R2=0.12; p<0.0001). This effect of gestational age was not seen in other atresias.ConclusionThese observations support the concept that reduced enteral absorption of amniotic fluid due to high digestive tract obstruction in utero reduces fetal growth. The effect is greater when the obstruction is more proximal and with advancing gestation.

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Association of Vitamin D Status with Semen Parameters and Male Reproductive Hormones in Egyptian Infertile Men

Austin Andrology ◽

10.26420/austinandrology.2021.1028 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Doaa Abou-Taleb AE ◽

◽

Mahran AM ◽

Mahmoud MA ◽

Gaber MA ◽

...

Keyword(s):

Vitamin D ◽

Significant Positive Correlation ◽

Reproductive Hormones ◽

Male Reproduction ◽

Semen Parameters ◽

Unknown Etiology ◽

Control Group ◽

Positive Correlation ◽

Infertile Men

Background: Although vitamin D receptor (VDR) is expressed in human sperm, little is known about the role of vitamin D (Vit. D) in male reproduction. Our objective was to assess Vit. D levels both in serum and seminal fluid and to establish the relation between serum and seminal Vit. D levels, semen parameters, male sex hormones and serum calcium level in Egyptian infertile men. Patients and Methods: We conducted a prospective case control study including 30 healthy fertile males as a control group and 60 male patients with infertility of unknown etiology. Semen samples were collected and semen parameters were evaluated. Also, seminal Vit. D level was measured. Blood samples were taken as serum levels of Vit. D, calcium, testosterone, Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) were estimated. Results: There was significant decrease of both serum and seminal Vit. D level in groups of male infertility compared to control group. A significant positive correlation was found between serum and seminal Vit. D levels in different study groups. Also, significant positive correlation between serum Vit. D level and non-progressive sperm motility. Conclusion: Our results support the role of Vit. D in semen parameters and male fertility status.

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ROLE OF VITAMIN D IN ETIOPATHOGENESIS AND METABOLIC ABNORMALITIES SEEN IN POLYCYSTIC OVARIAN SYNDROME

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i9.33310 ◽

2019 ◽

pp. 215-219

Author(s):

SURANKITA SUKUL ◽

JYOTIRMAYEE BAHINIPATI ◽

ASHOK KUMAR DAS

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Negative Correlation ◽

Biochemical Parameters ◽

Polycystic Ovarian Syndrome ◽

Serum Insulin ◽

Control Group ◽

Insulin Metabolism ◽

Ovarian Syndrome

Objective: Polycystic ovarian syndrome (PCOS) is a common cause of ovarian dysfunction in women in reproductive age group. It is now the leading cause of infertility among premenopausal women. PCOS women usually suffer from metabolic disturbances and insulin resistance (IR). Vitamin D has shown a significant role in glucose and insulin metabolism. Correlation studies have been done to examine the role of vitamin D in PCOS. However, still, Vitamin D status in PCOS remains varied. This study is an attempt to find out the association of Vitamin D with etiopathogenesis and metabolic risk factors seen in PCOS. Methods: Hundred subjects (50 PCOS and 50 age-matched normal control) were recruited for the study. Difference in biochemical parameters in PCOS women and normal group was measured, and association of Vitamin D with etiological and biochemical parameters in PCOS was seen. Results: There was a significant (p<0.001) increase in body mass index, serum insulin, fasting blood sugar (FBS), serum cholesterol, triglyceride, and low-density lipoprotein in PCOS. IR was observed in PCOS cases (homeostatic model assessment for β-cell function and IR = 6.40±1.96) compared to the control group (2.43±0.53). Serum 25(OH) Vitamin D3 was significantly decreased in PCOS (9.04±2.60 ng/ml) compared to control group (20.06±3.28 ng/ml). Negative correlation of serum Vitamin D was found with FBS, serum insulin, IR, HI, and serum testosterone. Vitamin D with metabolic parameters also showed a statistically significant negative correlation. Conclusion: Vitamin D deficiency may be a common comorbid manifestation of PCOS. Hence, Vitamin D supplementation may decrease the potential risk of morbidity and mortality associated with PCOS. However, further studies are needed which should include assessment of Vitamin D in women at various stages of PCOS to enhance the temporal order of Vitamin D deficiency in relation to PCOS.

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