Abdominal subcutaneous and visceral fat thickness in newborns: correlation with anthropometric and metabolic profile

OBJECTIVE

To correlate abdominal subcutaneous and visceral fat thickness with anthropometric data and metabolic profile in newborns.

STUDY DESIGN

A cross-sectional study with 99 newborns was performed at Instituto de Medicina Integral Professor Fernando Figueira, Brazil. Abdominal subcutaneous and visceral thickness were measured by ultrasound. Glucose, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol and triglycerides were determined. Pearson correlation coefficients were calculated.

RESULT

Abdominal subcutaneous fat thickness was positively correlated with birth weight (r=0.31; P<0.001), height (r=0.27; P<0.001) and abdominal circumference (r=0.26; P<0.001), but not with metabolic profile. Abdominal visceral fat thickness was correlated with abdominal circumference (r=0.23; P=0.01), insulin (r=0.21; P=0.04) and HOMA (r=0.24; P=0.02). The results remained the same among males and females.

CONCLUSION

Abdominal fat distribution in newborns has a different correlation with anthropometric and metabolic profile. Abdominal subcutaneous fat thickness is positively correlated with anthropometric data whereas abdominal visceral fat thickness is correlated with insulin and HOMA-IR.

Factors associated with sickle cell disease mortality among hospitalized Angolan children and adolescents

BACKGROUND

Sickle cell disease complications are an important mortality cause in children mainly in Africa and India. Notwithstanding the magnitude of the problem on the African continent, studies identifying factors related to the adverse outcomes of sickle cell disease in the pediatric population are still scarce.

OBJECTIVE

To identify prognostic factors associated with mortality in children and adolescent aged under fifteen years with diagnosis of sickle cell disease.

METHODS

Patients meeting inclusion criteria were listed and randomly selected. Clinical and laboratory data collected at time of admission were collected from medical records through the use of standard forms. The association between mortality and explanatory variables was tested using univariable and multivariable analysis.

RESULTS

The overall mortality rate was 64 (12.9%), and bacterial infections 26 (40.1%) were the most common cause of death. Place of residence out of Luanda, lack of outpatient follow-up, symptoms onset more than three days, disease manifestation before age of eighth months and hemoglobin level of < 7 g/dl were independent risk factors related to death. In the study population, sickle cell related deaths were related to quality of health care and access to care.

CONCLUSION

The creation of regional sickle cell disease centers to support those afflicted by the disorder and their families would contribute to reduce the burden associated with the disease.

APOA1/C3/A4 gene cluster variability and lipid levels in Brazilian children

Genetic studies have suggested that polymorphisms of genes coding for apolipoproteins are significant determinants of serum lipoprotein and lipid levels in adults. However, only a few studies have investigated the association of these polymorphisms in children. Therefore, in the present investigation we studied the distribution of APOA1 -75 G>A, +83 C>T, APOC3 -482 C>T, -455 T>C and 3238 C>G, and APOA4 Q360H and T347S polymorphisms and their influence on plasma lipoprotein levels in children from a Brazilian northeastern admixed population. The seven polymorphic sites were genotyped in 414 children aged 5 to 15 years (mean 8.9 +/- 2.9). The genotypes of the seven polymorphic sites were assessed by PCR-RFLP methods. The frequencies of the less common alleles were, in general, intermediate among parental populations, as expected. Strong linkage disequilibrium was detected between polymorphisms at the APOA1, APOC3 and APOA4 loci in this admixed population sample. Overall the genotype effects seen in adults were weaker or absent in children. The APOC3/-455 and APOA4 T347S variants showed significant effects on HDL cholesterol in girls (P = 0.033 and P = 0.016, respectively). Significantly higher plasma total (P = 0.003) and LDL cholesterol (P = 0.004) levels were observed in boys who were carriers of the 3238G allele at the APOC3/3238 C>G site. These results disclosed an overall absence of associations between these polymorphisms and lipids in children. This finding is not unexpected because expression of the effect of these polymorphisms might depend on the interaction with environmental variables both internal and external to the individual.