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Laura Bozomitu

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

OSTEOPENIA LA COPIII CU SINDROAME DE MALABSORBTIE

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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OSTEOPENIA LA COPIII CU SINDROAME DE MALABSORBTIE

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REZUMAT

Introducere. Sindroamele de malabsorbţie au drept consecinţă perturbarea dezvoltării şi funcţiei normale a sistemului osos.
Obiective. Aprecierea densităţii osoase la copiii cu sindroame de malabsorbţie. Analiza factorilor de risc pentru osteopenie. Evaluarea corelaţiilor între osteopenie, markerii nutriţionali şi markerii metabolismului osos.
Material şi metodă. 118 copii cu sindrom de malabsorbţie de diverse etiologii, în principal boală celiacă (41 cazuri) şi fibroză chistică (14 cazuri). Densitatea osoasă a fost evaluată prin Ultrasonografie cantitativă (QUS) utilizând un Osteodensitometru Sunlight Omnisense Ultrasonometer 7000P. QUS a fost efectuată la radius (86 de cazuri) şi tibie (78 de cazuri). 25 hidroxivitamina D a fost evaluată la 10 cazuri prin metoda RIA. Analiza statistică a fost realizată utilizând SPSS for Windows.
Rezultate. Osteopenia a fost prezentă la 32% dintre cazuri. Scăderea densităţii osoase la radius a fost asociată cu sindromul celiachiform. Osteopenia la tibie s-a asociat cu fibroza chistică. Osteopenia a fost mai frecventă la fete. Osteopenia s-a asociat cu durata bolii. Osteopenia nu s-a corelat cu BMI. Scorul Z la radius s-a corelat pozitiv cu nivelele fosfatazei alcaline, iar scorul Z la tibie cu colesterolemia. Scorul Z la tibie şi radius s-a corelat negativ cu valorile markerilor inflamatori. La copiii cu boală celiacă, valoarea anticorpilor anti-transglutaminază s-a corelat negativ cu scorul Z la radius şi tibie. Nivelele 25(OH) vitaminei D au fost deficiente la 8 copii şi insuficiente la 2, dar valorile sale nu s-au corelat cu scorul Z la radius şi tibie. Semne clinice, biologice şi radiologice de rahitism au fost prezente la 35% dintre bolnavii cu osteopenie.
Concluzii. Osteopenia a fost prezentă la 1/3 din bolnavii cu sindrom de malabsorbţie din lotul studiat. 30% dintre bolnavi au avut semne clinice, biologice şi radiologice de rahitism. Valorile 25(OH) vitaminei D nu s-au corelat cu scorul Z. S-a observat o corelaţie negativă între parametrii osoşi şi markerii inflamaţiei şi anticorpii anti-transglutaminază.

Cuvinte cheie: osteopenie, sindroame de malabsorbţie, boală celiacă

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OSTEOPENIA IN CHILDREN WITH MALABSORPTION SYNDROM

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Promoting Global Health

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OSTEOPENIA IN CHILDREN WITH MALABSORPTION SYNDROM

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ABSTRACT

Introduction. Malabsorption syndromes result in the disturbance of bone normal development and function.
Objective. The assessment of bone density in children with malabsorption syndromes. The analysis of risk factors for osteopenia. The correlation between osteopenia, nutritional markers and bone metabolism markers.
Material and method. 118 children with malabsorbtion syndromes of different etiologies, mainly Celiac disease (41 cases) and Cystic fibrosis (14 cases). Bone density was assessed by Quantitative Ultrasonography (QUS) with a Sunlight Omnisense Ultrasonometer 7000P. QUS was performed at two sites – radius (86 cases) and tibia (78 cases). 25hydroxivitamin D was measured in 10 cases by RIA method. Statistical analysis was made using SPSS for Windows.
Results. Osteopenia was present in 32% cases. Decreased bone density at the radius was associated with the celiac syndrome. Osteopenia at the tibia was associated with cystic fibrosis. Osteopenia was more frequent in girls. Osteopenia was related to the duration of the disease. Osteopenia wasn’t related to BMI. Radius Z-score positively correlated to alkaline phosphatase levels and tibia Z-score to serum cholesterol levels. Radius and tibia Z-score negatively correlated with inflammatory marker levels. In children with celiac disease, the value of anti-transglutaminase antibodies was negatively correlated to radius and tibia Z-score values. 25(OH) vitamin D values were deficient in 8 patient and insufficient in 2, but its values didn’t correlate to radius/tibia Z-score. Clinical, biological and radiological signs of rickets were found in 35% of patients with osteopenia.
Conclusions. Osteopenia was found in 1/3 of patients with malabsorption syndromes of the studied group. In 30% of patients, clinical, biological and radiologic rickets signs were present. 25(OH) vitamin D values didn’t correlate with the Z-score. A negative correlation between bone parameters and inflammation markers and anti-transglutaminase antibodies values was observed.

Keywords: osteopenia, malabsorption syndromes, celiac disease

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Ursodeoxycholic acid benefit in pediatric non-alcoholic fatty liver disease

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Ursodeoxycholic acid benefi t in pediatric non-alcoholic fatty liver disease

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REZUMAT

Introduction. Nonalcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in children, encompasses a range of disease from simple steatosis to steatohepatitis (NASH). Ursodeoxycholic acid (UDCA) has been used in adult pacients with NASH, demonstrating its efficacy in high doses.

Purpose. The aim of our study was to assess the effect of high-dose ursodeoxycholic acid therapy on liver functions in children with NASH.

Methods. We prospectively studied 18 children with NASH aged 2.5 to 17 years. NASH was operationally defined as diffusely hyperechogenic liver at ultrasonography with persistently elevated (> 35 UI/l) alanine aminotransferase (ALT) or aspartate aminotransferaze (AST) after exclusion of viral, alcohol-induced, druginduced, cholestatic and genetic causes of liver disease. Patients were treated with ursodeoxycolic acid (20 mg/ kg per day) for six month.

Results. Treatment with UDCA significantly decreased hepatic transaminases. ALT levels ranged from 68.5 (50-166) at baseline vs. 47 (29-104) after six month, p <0.001, AST from 43 (29-101) 34 (17-75), p < 0.001, and GGT between 41.5 (11-150) vs. 22 (8-55). At the end of treatment, ALT levels normalized in 4 patients. Moreover, cholesterol levels were significantly reduced after treatment.

Conclusions. Treatment with high-dose ursodeoxycholic acid improves liver function parameters in children with NASH.

Cuvinte cheie: steatoză hepatică, acid ursodeoxicolic, transaminaze hepatice

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BENEFICIUL ACIDULUI URSODEOXICOLIC IN STEATOZA HEPATICA NON-ALCOOLICA LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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DOI - Crossref
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DOAJ
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ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

BENEFICIUL ACIDULUI URSODEOXICOLIC IN STEATOZA HEPATICA NON-ALCOOLICA LA COPIL

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REZUMAT

Introducere. Boala ficatului gras non-alcoolic (NAFLD), cea mai frecventă cauză a bolii hepatice cronice la copii, cuprinde un spectru de afecţiuni variind de la steatoză simplă până la steatohepatită (NASH). Acidul ursodeoxicolic (UDCA) a fost utilizat la pacienţi adulţi cu NASH, demonstrându-şi eficacitatea în doze crescute.

Scop. De a evalua efectul tratamentului cu doze crescute de UDCA asupra parametrilor funcţiei hepatice la copii cu NASH.

Metode. Lotul de studiu a fost constituit din 18 copii cu NASH cu vârste cuprinse între 2,5 şi 17 ani. NASH a fost operaţional definit ca ficatul difuz hiperechogenic la ecografie cu valori persistent crescute (> 35 UI/l) ale alanin aminotransferazei (ALAT) sau aspartat aminotransferazei (AST), după excluderea cauzelor virale, drog sau alcool induse, colestatice sau genetice ale bolii hepatice. Pacienţii au fost trataţi cu acid ursodeoxicolic (20 mg/kg/zi), timp de şase luni.

Rezultate. Tratamentul cu UDCA a determinat scăderea semnificativă a valorilor transaminazelor hepatice. Nivelurile ALT au variat între 68,5 (50-166) iniţial vs 47 (29-104) după şase luni, p < 0,001, AST între 43 (29-101) vs 34 (17-75), p < 0,001, şi GGT între 41,5 (11-150) vs. 22 (8-55). La sfârşitul tratamentului, niveluri ALT s-au normalizat la 4 dintre pacienţi. De asemenea, concentraţiile de colesterol au fost semnificativ reduse după tratament.

Concluzii. Tratamentul cu doze crescute de acid ursodeoxicolic imbunătăţeşte parametrii funcţiei hepatice la copii cu NASH.

Cuvinte cheie: steatoză hepatică, acid ursodeoxicolic, transaminaze hepatice

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