EFFECTS OF DIABETIC KETOACIDOSIS ON VITAMIN D LEVELS

R. Danciulescu Miulescu (1), J. Cristescu (1), S. Danoiu (2)

1 Institute Prof. N. Paulescu Bucharest, Romania

2 UMF Craiova, Romania

Background and Aims: Clinical and experimental evidence suggests that chronic metabolic acidosis alters vitamin D metabolism. The aim of the present study was to investigate the levels of vitamin D in patients with acute metabolic acidosis.

Materials and Methods: 17 patients with type 1 diabetes and moderate or severe metabolic acidosis (according American Diabetes Association statement, moderate acidosis: pH between 7.00–7.25 and bicarbonate between 10–15 mmol/l, severe acidosis: pH below 7.00, bicarbonate below 10 mmol/l) were recruited for this study. Plasma 25-hydroxyvitamine D was assessed with a radioimmunoassay kit.

These results were compared those of the control group consisting of 12 patients with type 1 diabetes, but without metabolic acidosis.

Results: The subjects of the study group: 8 women (47.05%) and 9 men (52.94%) were between 26 and 38 years old, with mean age 30.20 ± 3.22 years. 13 patients (76.47%) present moderate metabolic acidosis and 4 patients (23.52%) present severe ketoacidosis. The prevalence of vitamin D insufficiency in patients with moderate or severe metabolic acidosis was 41.17% (7 patients-3 women and 4 men). 2 patients with severe metabolic acidosis (11.76 %- 2 men) present vitamin D deficiency. The prevalence of vitamin D insufficiency in patients with type 1 diabetes but without metabolic acidosis is 25% (3 patients -1 woman and 2 men).

Conclusion: There is considerable evidence supporting the role of vitamin D deficiency in the pathogenesis of type 1 diabetes mellitus.  Acute metabolic acidosis may alter vitamin D metabolism.

PREVALENCE OF OBESITY AMONG ADOLESCENTS (10 TO 14 YEARS) IN KUWAIT

I.F. El Bayoumy (1)

1 Ports and Borders Health Division, MOH, Kuwait

The purpose of this cross-sectional study was to find out the prevalence of obesity and overweight among intermediate school adolescents aged 10 to 14 years. The study comprised a multistage stratified random sample that included 5402 children (2657 males and 2745 females). They represent 12.7% of the total number of children between 10 and 14 years during the educational year 2005-2006. The weights and heights of adolescents were measured, from which the body mass index (BMI) was calculated, which is the weight in kilograms divided by the height in meters squared (kg/m2). BMI values higher than 95 percentile were accepted as being obese and those in between 85 and 94 percentile were accepted as overweight. Dietary intake was assessed by the investigators using food exchange lists designed by American Diabetic Association and physical fitness was measured by modified Harvard step test. Data regarding monthly income of the chosen sample were collected from parents of those children. The overall prevalence of overweight and obesity in adolescent Kuwaiti children aged 10 to 14 years was 30.7% and 14.6%, respectively. The overall prevalence of overweight and obesity among males was 29.3% and 14.9%, respectively (P < .001) and the prevalence of overweight and obesity among females was 32.1% and 14.2%, respectively (P < .001). High daily caloric intake by the obese and overweight children and physical inactivity was reported among the majority of them. Health education programs should be conducted to control this syndrome in order to prevent future risk of obesity-related disease, and physical activity programs should be incorporated in the schools. Any management plan for overweight and obese children should include 3 major components: diets, exercise, and family-based behavior and they should not be placed on restrictive diets because adequate calories are needed for proper growth.

HIGH SERUM IgA CONCENTRATIONS AND RISKS OF IMPAIRED FASTING GLUCOSE, HYPERTENSION, AND HYPERCHOLESTEROL AMONG CHILDREN

C.C. Liao (1), F.C. Sung (2), T.C. Su (3), K.L. Chien (3), Y.T. Lee (4)

1 Department of Anesthesiology, Taipei Medical University Hospital

2 College of Public Health, China Medical University

3 Division of Cardiology, Departments of Internal Medicine, National Taiwan University Hospital

4 Division of Cardiology, Departments of Internal Medicine, China Medical University Hospital

OBJECTIVE: We evaluated the relationship between levels of immunoglobulin A (IgA) and impaired fasting glucose, hypertension and hypercholesterol among children.

METHODS: From 1992 to 2000, a nationwide mass urine screening was conducted to identify proteinuria, glucosuria, and/or hematuria for all school graders in Taiwan Province. Students with urine screening positive twice received health check-up for anthropometric measures and selected blood tests including fasting glucose, total cholesterol, albumin, blood urea nitrogen, and creatinine. We stratified IgA concentration into deciles levels for measuring the associations with impaired fasting glucose and interaction with obesity.

RESULTS: Among 92514 students with screening positive, the median IgA level increased from 94 mg/dL in the lowest decile to 348 mg/dL in the highest decile with a median of 190 mg/dL. Mean age, body mass index, fasting glucose, blood pressure, and total cholesterol increased as IgA increased, with impaired fasting glucose increased from 11.0% in the lowest decile to 19.0% in the highest (p<0.0001). The corresponding prevalence of hypertension increased from 7.5% to 10.8%, respectively (p<0.0001). School children with an IgA in the highest decile had an adjusted odds ratios of 1.77 (95% confidence interval [CI] = 1.62-1.93) for impaired fasting glucose; the odds ratio increased to 2.93 (95% CI = 1.93-4.44) for obese children.

CONCLUSIONS: Our findings showed that children with higher IgA are at higher risk of impaired fasting glucose, particularly for obese children with high IgA.

THE RATIO OF LEG-LENGTH OVER STANDING HEIGHT AS A PREDICTOR OF CHILHOOD OBESITY: RESULTS FROM A LONGITUDINAL COHORT STUDY

J. Liu (1), N. Akseer (1), B. Faught (1), J. Hay (1), J. Cairney (2)

1 Brock University, St. Catharines, Canada

2 McMaster University, Hamilton, Canada

Using data from a longitudinal cohort, we examined if leg-length to height ratio (LLHR) measured at Grade Five was associated with obesity risk at Grade Eight. A total of 1167 children (575 girls and 594 boys) from South Ontario, Canada who had no missing information on body compositions in Grade Five and Grade Eight were included in this analysis. Based on LLHR gender specific quartile cutoffs in Grade Five, children were categorized into four groups (Q1–Q4). Body mass index (BMI) was derived from weight (kg) and height (cm) measured at Grade Eight; the gender and age specific BMI cutoffs were used to categorize children as overweight/obese or normal weight. Logistic regression models were used to examine the obesity risk association with LLHR. After adjusting for age, total physical activity score and waist circumference measured at Grade Five, in comparing to those in Q1 of LLHR, the odds ratios (OR, 95%CI) of overweight/obese for those in the Q2–Q4 were 0.60 (0.29, 1.21), 0.43 (0.21, 0.89), and 0.32 (0.15, 0.70) for boys, and 0.77 (0.36, 1.64), 0.60 (0.28, 1.29), and 0.27 (0.12, 0.62) for girls, respectively. The P-values for trends were statistically significant in both genders (P<0.0001). When further adjusting early life experience variables among a subsample (n=566), the risk association pattern did not change. The obesity risk association with LLHR remains even after removing those who were considered as overweight/obese at Grade Five. This suggests that LLHR can be considered as a potential screening tool to estimate obesity risk among children.

PREVALENCE OF BMI AND ITS RELATED FACTORS AMONG PRIMARY SCHOOL STUDENTS IN SANANDAJ, IRAN

K. Moradi (1)

1 Islamic Azad University, Sanandaj, Kurdistan

Introduction and Objectives: Over the past 3-2 decades, the prevalence of obesity among children has been increased significantly. The aim if this study was to assess the prevalence of BMI and its related factors among primary school students in Sanandaj, Iran in 1389.

Methods: This research was a descriptive - analytical study. The population included the primary school students in Sanandaj, who selected by random cluster sampling (800 samples -400 girls and 400 boys). At first, their height and weight measured and secondly their BMI calculated. Moreover, a questionnaire about BMI related factors were completed by the respondents. After calculating BMI and determining the values of the top percentile and the values between 85 and 95 percentiles in proportion to the respective age and gender, obese, overweight and low weight students were determined. Data analyzed by SPSS software using of CHISQURE and Man-Whitney U Test.

Results: Prevalence of overweight and obesity in this study were 1.6% and 16.3%, respectively. Only, 23% of the students had normal weight. There was a significant difference in obesity by students' age, duration of walking to school, and students' appearance. Also, significant differences were found in obesity by the number of hours watching television per day, entertainment type, place of living, parents' education and job.