Magdalena Chełchowska

Institute of Mother and Child, Warszawa, Masovian Voivodeship, Poland

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Publications (71)19.24 Total impact

  • Joanna Gajewska, Jadwiga Ambroszkiewicz, Magdalena Chełchowska
    Pediatria polska 01/2014;
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    ABSTRACT: Adipokines may influence bone metabolism in children, but this phenomenon is not well understood. Therefore, we studied the relationships between bone markers and adipokines during weight loss in obese children.We determined serum leptin, soluble leptin receptor (sOB-R), adiponectin, BALP (bone alkaline phosphatase), CTX-I (C-terminal telopeptide of type I collagen), body composition and bone mineral density (by dual-energy X-ray absorptiometry) in 100 obese prepubertal children before and after 3 months of lifestyle intervention (low-energy diet, physical activity). The control group consisted of 70 non-obese children.Obese children had higher BALP activity by about 20% (p<0.001) and similar value of CTX-I compared with non-obese children. After weight loss (-0.96 BMI-SDS mean change), the BALP value in obese patients decreased (p<0.001), whereas CTX-I concentration was unchanged. Changes in BALP were positively correlated with changes in BMI (Body Mass Index) (r=0.352, p<0.001), but not associated with adipokine levels. Trend analysis using SDS-BMI subgroups showed that greater reduction of body mass was associated with a greater decrease of BALP (p=0.035) and leptin values (p<0.001), as well as a greater increase of sOB-R (p<0.003).Obesity during the prepubertal period is associated with an alteration in the adipokines profile and greater whole-body bone mass as a result of increased bone formation rather than reduced bone resorption. Changes in bone metabolism during lifestyle intervention seem to be related to weight loss but not to changes in adipokines. Further studies should elucidate the influence of long-term therapy on bone mass in childhood.
    Experimental and Clinical Endocrinology & Diabetes 06/2013; · 1.56 Impact Factor
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    ABSTRACT: The objective of this study was to evaluate the effect of cigarette smoking on concentration of selected angiogenic factors (vascular endothelial growth factor VEGF, placenta growth factor PIGF) and somatomedin C (insulin-like growth factor-I) in blood of mothers and umbilical cord blood. The correlations between studied biochemical parameters and markers of estimated intensity of cigarette smoking as well as birth weight were also determined. Fifty healthy pregnant women were divided into two groups: smoking and tobacco abstinent group according to serum cotinine concentration. The current smokers were defined as those who had smoked 5 cigarettes per day for 2 years before conception and continued smoking during pregnancy. In the group of smoking mothers the mean serum concentration of cotinine was 91.6 microg/L and correlated positively with number of cigarettes daily consumed (r = 0.58, p < 0.01) as well as with time of smoking before conception (r = 0.40, p < 0.05). The mean serum concentration of PIGF in III trimester of pregnancy was significantly higher in the group of smokers than in non-smoking ones (p < 0.0001) and correlated with serum cotinine concentration (r = 0.41, p < 0.05) and number of cigarettes daily consumed (r = 0.58, p < 0.01). The concentration of serum VEGF was similar in both studied group. The mean serum level of IGF-I was significantly lower in group of smokers than in non-smokers in the I and III trimester of gestation (p < 0.01). Also in umbilical cord blood of smoking newborn the concentration of IGF-I was lower by 20% than in nonsmoking group (p < 0.05). We observed negative correlation between number of cigarettes daily consumed and serum level of IGF-I in blood of mothers as well as in blood of their children (I trimester: r = -0.43, p < 0.05; III trimester: r = -0.70, p < 0.001; umbilical cord blood: r = -0.45, p < 0.05). In both studied groups there were a positive correlation between birth weight and concentrations of IGF-I in blood of mothers and umbilical cord blood (group of smokers: mothers r = 0.43, p < 0.05, cord blood r = 0.50, p < 0.01; group of tobacco abstinent: mothers r = 0.51, p < 0.01, cord blood r = 0.41, p < 0.05). The birth weight of the smoking mothers' infants was lower by about 400 g (p < 0.01) and their birth body length by 1.5 cm (p < 0.05) and negatively correlated with number of cigarettes smoked per day (r = -0.55; p < 0.005). Our results indicate, that tobacco smoking during pregnancy increased serum PIGF levels in the final stages of gestation and has no effect on the concentration of VEGF, which may lead to an increase of trophoblast proliferation and uteroplacental dysfunction. Lower than in tobacco abstinent levels of IGF-I in serum of smoking mothers and in umbilical cord blood and their close relationship with birth weight, may suggests a direct effect of this factor on birth anthropometric parameters.
    Przegla̧d lekarski 01/2013; 70(10):800-4.
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    ABSTRACT: Tobacco smoking creates health problems which apply not only to individuals and the family but also to different ages and social groups, as well as the national economy. Epidemiologic studies conducted at the Institute of Mother and Child indicated that in Poland 25-30% women smoke during pregnancy. Lead exposure from cigarette smoke may have a negative effect on the transplacental flow of micronutrients and have an adverse influence on the growth and development of the fetus, and then on children. The aim of this study was to estimate the effect of smoking cigarettes on plasma and whole blood lead levels in pregnant women. Material and methods: Eighty healthy pregnant women, patients of the Clinical Department of the Obstetrics and Gynecology Institute of Mother and Child and Warsaw Medical University, were divided into two groups: group I - tobacco smokers and group II- tobacco abstainers according to questionnaire declaration and serum cotinine concentration. Current smokers were defined as those who had smoked 5 cigarettes per day for 2 years before conception and continued smoking during pregnancy. The women exposed to environmental tobacco smoke (smoking spouse or other family members, co-workers) were excluded from the non-smoking group. All pregnant volunteers signed a written, informed consent form, approved by the Institute's Ethical Committee. The concentrations of lead in plasma and whole blood were analyzed using inductively coupled plasma mass spectrometry on spectrometer analyzer ICP MS Elan 6100 (Perking Elmer, Germany). Levels of cotinine in serum were determined by Cotinine Direct ELISA test (Calbiotech Inc. Canada). Results: In the group of smoking mothers the mean serum cotinine concentration was 69.1 μg/L, whereas in the group of tobacco abstainers it was present only in trace amount. In group I we observed a significant positive correlation between serum cotinine and the number of cigarettes smoked daily (r=0.74; p<0.001), as well as the period of smoking before conception (r=0.60; p<0.001). The concentrations of lead in the plasma of smoking women were significantly higher than in the group of tobacco abstainers in each trimester of pregnancy (I trimester: 0.22 μg/dL vs 0.12 μg/dL p<0.01; II trimester: 0.19 μg/L vs 0.10 μg/L p<0.001; III trimester 0.28 μg/ dL vs 0.13 μg/dL p<0.0001). Tobacco smoking mothers also had a higher concentration of lead in whole blood as compared to pregnant non-smoking women. These differences were statistically significant and amounted to 2.15 μg/dL vs 1.28 μg/L in the first, 1.99 μg/dL vs 1.19 μg/dL in the second and 2.11 μg/dL vs 1.58 μg/dL in the third trimester of pregnancy. We observed that the level of lead was correlated with cotinine in blood, as well as with the number of cigarettes and the length of time women smoked before conception. Such an effect was observed in every trimester of gestation. A strong correlation between the number of cigarettes/day and lead concentration in plasma (r=0.57; p<0.001) and whole blood (r=0.54; p<0.001) was found in the third trimester of pregnancy. Conclusions: Tobacco smoking during pregnancy increased the concentrations in maternal blood lead. The level of lead in plasma and whole blood correlated with the degree of intensity of cigarette smoking in the pregnant women studied. It may be a result of influencing the mobilization of calcium from the bone with simultaneous release of lead deposited in the bone. Further studies are required to characterize the effect of higher lead level in the blood of mothers on the risk of premature labor, low birth weight of newborns and their inferior development.
    Medycyna wieku rozwojowego 01/2012; 16(3):196-204.
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    ABSTRACT: Phenylketonuria, galactosemia and celiac disease are disorders in which elimination diets are the only known therapy, which reverses many clinical manifestations of acute phase in the patients. Unfortunately, most of them develop long-term complications, including bone turnover impairment and low bone mineral density. These disturbances are not only observed in adulthood but also in childhood and adolescence. Insufficient accumulation of peak bone mass in these periods is a risk factor for osteoporosis and fractures in later life. The pathological mechanisms leading to a diminished bone mineral content in these disorders are not well known. The patients might be at risk for a decreased bone mineral content because of either dietary deficiencies secondary to the elimination diets and/or unknown intrinsic factors. This article overviews bone metabolism disturbances in phenylketonuria, galactosemia and celiac disease during childhood and adolescence, when growth and bone turnover are most intensive. The available data and own results concerning bone markers in children with these disorders and proposal for the prevention of osteoporosis in pediatric patients treated with elimination diets are discussed.
    Medycyna wieku rozwojowego 01/2012; 16(1):61-9.
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    ABSTRACT: Aim: The aim of this study was to assess bone formation and resorption processes and bone metabolism regulators, such as osteoprotegerin and fetuin-A in children with cystic fibrosis. Material and methods: We examined 45 children with cystic fibrosis aged 5-13 years treated at the Institute of Mother and Child in Warsaw. The control group consisted of 35 healthy children in the same synage range without any diseases which may influence bone metabolism. We determined serum calcium and phosphate levels by colorimetric methods, vitamin D3 by the chemiluminiscence method and bone metabolism markers (osteocalcin, 5b isoenzyme of tartrate-resistant acid phosphatase, osteoprotegerin, fetuin-A) by immunoenzymatic methods. Results: Mean serum concentrations of calcium and phosphate in the studied children were within the reference ranges. However, the level of 25-hydroxyvitamin D3 was significantly lower in patients with cystic fibrosis compared to the controls (19.3±7.6 vs 25.2±8.9 ng/ml, p<0.01). In cystic fibrosis children we observed a statistically significant lower concentration of osteocalcin (81.9±28.9 vs 97.9±28.6 ng/ ml, p<0.01) and similar activity of 5b isoenzyme of tartrate-resistant acid phosphatase (12.5±2.9 vs 13.4±3.5 U/L) as compared to healthy peers. Mean serum concentration of osteoprotegerin in patients with CF was significantly lower than in the control children (4.1±0.98 vs 4.59±0.86 pmol/l, p<0.05). Serum concentration of fetuin-A was comparable in both groups of children. Conclusions: In children with cystic fibrosis changes in the profile of bone metabolism markers were observed. Even patients with CF who are clinically stable and supplemented with vitamins are at risk of osteopenia and osteoporosis in their later life. Therefore, they should be under a comprehensive medical and nutritional care in order to achieve their optimal peak bone mass.
    Medycyna wieku rozwojowego 01/2012; 16(2):117-123.
  • Bone 01/2011; 48. · 3.82 Impact Factor
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    ABSTRACT: It is widely recognized that lifestyle intervention with modification of dietary habits and physical activity is effective in weight reduction and may improve the biochemical parameters in obese children and adolescents. However, the levels of adiponectin multimeric complexes during lifestyle intervention have not been extensively studied in obese children. The aim of this study was to investigate the effect of the 3-months weight-reduction programme on serum adiponectin multimeric complexes in obese prepubertal children. Changes in clinical, anthropometric and metabolic parameters including total adiponectin and its multimeric forms were assessed in 30 obese children aged 4-10 years, after a 3-months lifestyle intervention programme. This programme consisted of dietary and physical activity modifications and behaviour therapy including individual psychological care for the child and its family. The recommended daily intake from low-energy diet was 1200-1400 kcal/day. The reference group consisted of 35 healthy normal-weight children. Concentration of serum total adiponectin (Total-A) and its multimeric complexes: low molecular weight (LMW) adiponectin, medium molecular weight (MMW) adiponectin and high molecular weight (HMW) adiponectin were measured by ELISA kit. We observed that the concentrations of total adiponectin and HMW adiponectin were 25% (p<0.01) and 45% (p<0.0001) lower respectively, in obese children compared to controls. HMW/ Total-A ratio was lower in the obese children than in the controls (p<0.001), whereas LMW/Total-A ratio was higher in the obese as compared to the normal-weight children (p<0.001). After 3-months therapy the increases of total adiponectin concentration (by 20%, p<0.001), HMW (by 25%, p<0.001) and MMW adiponectin (by 30%, p<0.05) were recorded in these patients in comparison to baseline values. The increase of HMW/Total-A ratio (p<0.05) and the decrease of LMW/Total-A ratio (p<0.05) were also found in obese patients after weight-reduction programme as compared to the level before therapy. After modification of the diet and physical activity, the BMI of the obese children declined by 10% (p<0.01). Our results indicate that the weight loss in children after 3-months therapy is associated with the increase of total and HMW, MMW adiponectin concentration. This suggests that the intervention programme is sufficient to detect significant changes in adiponectin multimeric profile, which confirms the efficacy of this therapy in prepubertal obese children.
    Medycyna wieku rozwojowego 01/2011; 15(3):298-305.
  • Bone 01/2011; 48. · 3.82 Impact Factor
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    ABSTRACT: Vegetarian diets are considered to promote health and reduce the risk of some chronic diseases. It is also known that restriction or exclusion of animal foods may result in low intake of essential nutrients. The aim of the presented study was to assess the intake and serum status of vitamin B12, folate, vitamins A, E and D, as well as concentrations of homocysteine, total antioxidant status and iron balance in Polish vegetarian children. The study included 50 children, aged 5-11 who had been referred to the Institute of Mother and Child for dietary consultation. From those, 32 were vegetarians (aged 6.5±4.2 years) and 18 omnivores (aged 7.9±2.7 years). Dietary constituents were analyzed using the nutritional programme Dietetyk2®. Folate and vitamin B12 were determined with a chemiluminescence immunoassay, total homocysteine with a fluorescence polarization immunoassay and TAS (total antioxidant status) by colorimetric method. Vitamin A and E in serum were determined by the high-pressure liquid chromatography method (HPLC) and vitamin D by immunoenzymatic assay (ELISA). Concentrations of iron, ferritin, transferrin and total iron-binding capacity (TIBC) in serum were determined by commercially available kits. In vegetarian children daily intake of vitamin B12 (1.6 ěg) was in the recommended range, that of folate (195 ěg) and vitamin A (1245 ěg) higher, but vitamin E slightly lower (6.6 ěg) and three-fold lower vitamin D (1.1 ěg) than references allowance. Serum concentrations of vitamin B12 (548 pg/ml), folate (12.8 ng/ml), vitamin A (1.2 ěmol/L), vitamin E (15.6 ěmol/l) were within physiological range, but that of vitamin D (13.7 ěg/L) was only half of the lowest limit of the reference value. In vegetarian children in comparison to omnivorous similar levels of homocysteine (6.13 ěmol/L vs 5.45 ěmol/L) and vitamin A (1,17 ěmol/L vs 1.32 ěmol/L) were observed. Lower (p<0.05) values of vitamin E (15.6 ěmol/L vs 18.4 ěmol/L) and TAS (1.21 mmol/L vs 1.30 mmol/L; p<0.0001) were found. Concentrations of iron markers were in physiological range. Obtained results indicated that intakes of vitamin B12 and folic acid from vegetarian diets are sufficient to maintain serum concentrations of both homocysteine and iron in the range observed in omnivorous children. High consumption of vitamin A and low vitamin E only slightly affected their serum values. Significantly lower concentration of serum vitamin E in vegetarian children in comparison to nonvegetarians may be reflected with statistically significant lowering of total antioxidant status. Insufficient intake of vitamin D and its low serum concentration should be under close monitoring in vegetarian children. In order to prevent vitamin D deficiency appropriate age-dependent supplementation should be considered.
    Medycyna wieku rozwojowego 01/2011; 15(3):318-25.
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    ABSTRACT: THE AIM of our study was to investigate associations between serum adipocytokines status and anthropometric parameters as well as total energy and macronutrient intake in vegetarian, normal-weight omnivorous and obese omnivorous children. We examined 90 healthy prepubertal children aged 4-10 years who had been referred to the Department of Nutrition at the Institute of Mother and Child in Warsaw for dietary consultation. Patients with endocrine disorders or genetic syndromes, as well as those who were taking medications that could affect growth, pubertal development or nutritional status were excluded. Children were divided into groups: vegetarians (n=30), normal-weight omnivores (n=30) and obese omnivores (n=30). Anthropometric measurement (weight, height) was performed in all children and body mass index (BMI) was calculated. A whole body dual-energy X-ray absorptiometry (DXA) scan was performed to determine fat mass, the percentage of body fat and lean body mass using a Lunar Prodigy (GE, USA). Dietary constituents were assessed by questionnaire (nutrient intake from a 3-day period: 2 weekdays and 1 weekend day) and calculated using the nutritional computer program Dietetyk2®. Serum total cholesterol, high-density and low-density lipoproteins, and triglycerides concentrations were assessed by standard enzymatic methods. Serum levels of leptin, soluble leptin receptor and adiponectin were determined by immunoenzymatic assays. There were no significant differences in body weight, height, BMI and lean mass values between vegetarians and normal-weight children on traditional mixed diet. Children on vegetarian diet had lower fat mass (p<0.05) and fat mass/lean mass ratio (p<0.05) than normal-weight omnivores. However, omnivorous children with simple obesity had significantly higher body weight, height, BMI, fat and lean mass in comparison to vegetarian as well to normal-weight omnivorous children. The fat mass/lean mass ratio in obese children was about 2.5-fold higher than in normal-weight subjects on traditional diet. Total energy and percentage of energy from macronutrients in diets of all children were within the recommended daily intake. Children on vegetarian diet was related with lower fat and higher carbohydrates intake in comparison to their omnivorous peers. Vegetarian children had significantly lower mean total cholesterol (151.5±18.0 mg/dL), low-density lipoprotein (81.0±13.6 mg/dL) and triglycerides (61.6±20.5 mg/dL) than omnivores, especially the obese ones (165.0±22.3 mg/dL, 94.7±19.2 mg/dL, 82.4±32.3 mg/dL, respectively). These differences were statistically significant (p<0.05). Serum concentration of leptin was significantly lower in vegetarian children (3.0±2.1 ng/ml) compared with omnivores (6.8±3.4 ng/ml in normal weight versus 37.8±12.7 ng/ml in obese) (p<0.0001). However, serum soluble leptin receptor as well as adiponectin were at higher levels in vegetarians than in omnivores (p<0.001 and p<0.05, respectively). We observed that serum leptin levels positively and soluble leptin receptor negatively correlated with body mass index and fat mass in prepubertal children. Moreover, leptin levels negatively correlated with its soluble receptor and with adiponectin. In children different kinds of diet might modify not only body mass and lipid profile but also serum concentration of adipocytokines. Determination of leptin and its soluble receptor, as well as adiponectin levels may be clinically useful in the medical and nutritional care of obese as well as vegetarian prepubertal children.
    Medycyna wieku rozwojowego 01/2011; 15(3):326-34.
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    ABSTRACT: Biochemical markers of bone turnover reflecting the intensity of all bone remodeling processes in skeleton are important for fast and non-invasive assessment of bone formation and resorption processes. They can be used in terms of both physiological and pathological states. The aim of this study was to investigate if bone metabolism markers can be clinically useful for monitoring of treatment in children and adolescents with osteosarcoma. The study consisted of 55 patients (median age 15 years) with osteosarcoma and 60 healthy age matched counterparts. Serum bone turnover markers (bone alkaline phosphatase - BALP, osteocalcin - OC and C-terminal telopeptide of type I collagen - CTX) were analyzed by immunoenzymatic methods in patients at time of diagnosis, during treatment and after therapy. We observed that before treatment the concentration of OC in patients with osteosarcoma was significantly lower (p<0.05) compared to that obtained in healthy children, however, BALP and CTX were at a similar level. During chemotherapy the values of bone formation and resorption markers significantly decreased by about 20-30%. After therapy we observed different concentrations of all bone turnover markers in patients with favorable and unfavorable prognosis. Median values of OC and BALP were over twofold higher in patients with progression as compared to patients with remission of disease (p<0.01 and p<0.001, respectively). Patients with poor prognosis had also higher serum concentration of bone resorption marker in comparison to patients with remission (p<0.01). Presented results suggest that bone turnover markers identify changes in bone metabolism in patients with osteosarcoma during anticancer therapy. These markers due to the non-invasive methods and their specificity might be useful in monitoring of clinical treatment of osteosarcoma patients.
    Advances in Medical Sciences 11/2010; 55(2):266-72. · 0.80 Impact Factor
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    ABSTRACT: The vegetarian diet may play a preventive role in the development of chronic diseases such as coronary heart and cardiovascular disease. However increase of homocysteine (Hcy) concentration in peoples avoiding animal products may contribute to an increased atherosclerotic risk in these subjects. Recent evidence has suggested that role of hyperhomocysteinemia in atherogenesis is associated with process of autooxidation, which can promote the production of hydroxyl radicals, resulting in oxidative modification of low density lipoprotein and endothelium injury. The oxidant-antioxidant imbalance depends not only on the amount of enhanced free oxygen species but also insufficiency of antioxidant defence system. Total antioxidant status (TAS) expresses capacity for scavenging of free radicals minimizes oxidative damage. The aim of this study was to asses concentrations of homocysteine and total antioxidant status in serum of children on vegetarian and omnivorous diet. We also studied levels of vitamin A (retinol) and vitamin E (alpha-tocopherol) particular components of TAS. The study included 35 children, aged 5-16 who had been referred to Institute of Mother and Child for dietary consultation. From those, 17 were lacto-ovo-vegetarians and 18 omnivores. Dietary constituents were analyzed using the nutritional programme Dietetyk2 and completed with supplementation data. Concentration of homocysteine was estimated in serum with fluorescence polarization immunoassay and TAS by colorimetric method. Levels of vitamin A and E were determined using high-pressure liquid chromatography (HPLC). The mean concentration of homocysteine was similar in both studied groups (vegetarians: 6.13 +/- 1.01 micromol/l vs. omnivores: 5.45 +/- 0.98 micromol/l). In vegetarian children serum level of TAS was significantly lower (1.21 +/- 0.06 mmol/I) as compared to those in non-vegetarian ones (1.30 +/- 0.05 mmol/l, p < 0.0001), but remained within the physiological range (1.16-1.40 mmol/l). The mean concentrations of vitamins A and E in serum of vegetarians were lower than observed in omnivores group, but only in case of alpha-tocopherol the difference was statistically significant (vegetarians: 15.58 +/- 4.12 vs. omnivores: 18.41 +/- 3.10; p < 0.05). In studied group of children on lacto-ovo-vegetarian diet, serum concentrations of homocysteine are normal and daily food intake of antioxidants and their level in blood are sufficient for preserving adequate total antioxidant status.
    Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 09/2010; 29(171):177-80.
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    ABSTRACT: Osteosarcoma is a primary malignant bone tumor, whose peak incidence occurs in the second decade of life during the adolescent growth spurt. Complex oncological treatment consisted of chemotherapy combined with surgery which substantially increased the cure rate of patients with osteosarcoma, but it is very important to identify patients with poor prognosis and to treat them with more aggressive therapy. To assess serum biochemical bone turnover markers as prognostic indicators in patients with osteosarcoma. We studied 55 patients from age 5 to 20 years with diagnosed osteosarcoma treated at the Institute of Mother and Child in Warsaw. The studied group was divided into 2 subgroups consisted of 27 patients with favorable (disease remission) and 28 patients with unfavorable (disease progression) prognosis. Venous blood was collected from patients in the morning hours at time of diagnosis, during anticancer treatment and after completion of treatment. Serum osteocalcin (OC), bone alkaline phosphatase (BALP) and C-terminal cross-linking telopeptide of type I collagen (CTX) were analyzed by immunoenzymatic methods. At time of diagnosis, in patients with unfavorable prognosis concentration of bone formation markers were higher (OC by 30% and BALP by 60%) than in those with good prognosis, however, CTX level was similar in both groups of patients. During chemotherapy in patients with poor prognosis we observed higher levels of bone turnover markers in comparison to subjects with favorable prognosis. After the completion of therapy, in patients with progression median values of bone formation markers were over twofold and bone resorption marker about 50% higher as compared to patients with remission of disease. These differences were statistically significant at p < 0.05 for OC, p < 0.001 for BALP and p < 0.01 for CTX. Our results suggest that bone turnover markers, especially bone alkaline phosphatise may be useful in the monitoring and in the assessment of the efficacy of therapy in children with osteosarcoma. Higher rates of bone formation and resorption during treatment and after its completion are associated with unfavorable prognosis and may indicate progression of disease.
    Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2010; 29(169):19-26.
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    ABSTRACT: Pro-hepcidin, mainly synthesized in hepatocytes is the pro-hormone of hepcidin which demonstrates antimicrobial activity and is the body's main regulator of iron homeostasis. The estimation of serum pro-hepcidin concentrations in uncomplicated pregnancy and complicated by premature rupture of membranes (PROM) and in pregnancy induced hypertension (PIH). The studies were performed in 24 women in pregnancy complicated by premature rupture of membranes, 31 women in pregnancy with induced hypertension and 35 healthy women in corresponding weeks of gestation (third trimester). Concentration of pro-hepcidin, C-reactive protein, white blood cell count, haemoglobin and haematocrit were studied using commercially available kits. Levels of serum pro-hepcidin in studied pregnant women were similar and amounted respectively to 99.6 microg/L, 93.7 microg/L and 98.2 microg/L in PIH, PROM and in the uncomplicated pregnancy group. In the group of patients with PROM and PIH, concentration of haemoglobin was significantly lower than in healthy pregnant women, but remains in the physiological range. In the studied groups values of C-reactive protein and leucocytes count were normal. We did not observe any correlation between the concentration of serum pro-hepcidin and iron status measurements. In pregnancies complicated by premature rupture of membranes and pregnancy induced hypertension with normal values of haemoglobin and haematocrit serum pro-hepcidin concentrations are similar to those observed in healthy pregnant women with normal course of pregnancy.
    Medycyna wieku rozwojowego 05/2010; 14(4):374-7.
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    ABSTRACT: The aim of this study was to evaluate the iron status markers in normal healthy pregnancy as well as the influence of maternal diet on iron concentration in their newborns. A longitudinal prospective study was conducted in a sample of 69 healthy non-smoking pregnant women under prenatal care of The Institute of Mother and Child. Blood samples were collected in the first, second and third trimesters and from the umbilical vein. Concentrations of ferritin and transferrin were assessed using turbidimetric technique, the concentration of iron--with ferrozine colorimetric method. Pentra 120 analyzer was used to define hematological parameters. Maternal diet was assessed by means of a weekly questionnaire, processed with computer software Dietetyk 2. Hematological parameters in the analyzed blood were normal. The average hematocrit values in the first trimester of pregnancy was 36.7%, in the second--34.92%, in the third--35.95%. The concentration of hemoglobin was 27.82 g/dl, 28.55 g/dl, 27.27 g/dl in the respective trimesters of pregnancy. In the umbilical blood it was 25.84 g/dl (5.2% less than in the maternal blood). The number of erythrocytes was the highest in the first (4.16 mln/mm3), and the lowest in the second trimester (3.92 mln/mm3). The average concentration of iron was the highest in the first trimester--99.61 microg/dl. In the second and third trimester it decreased by 25% and 2% respectively. The concentration was 76.34% higher in the umbilical blood than in maternal blood at the time of labor. The concentration of ferritin in the first trimester was 43.96 microg/l, in the second and the third trimester it was lower by 46% and 29% respectively. It was 126.4 microg/l in the umbilical blood (fourfold higher than in maternal blood). The concentration of transferrin was 321.01 mg/dl in the first trimester and it increased in consecutive trimesters by 36.14% and 5.12%; it was 219.92 mg/dl in the umbilical blood--48% of the concentration of transferrin in the maternal blood at the time of labor. The analysis of an average daily food ration revealed that the supply of iron was 80% of the recommended dose in the first half and only 41% of the recommended dose in the second half of the pregnancy. Fat consumption was 99% and 95% of the recommended dose, respectively. There was a 30%-decrease in the protein and carbohydrates consumption in comparison with the recommended dose in the second half of the pregnancy. In spite of normal hematological parameters, we observed insufficient supply of iron in the diet of pregnant women, which was demonstrated by a decreased level of ferritin. It should be reason enough to issue dietary recommendations and guidelines for pregnant women in each stage of pregnancy.
    Ginekologia polska 05/2010; 81(5):358-63. · 0.79 Impact Factor
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    ABSTRACT: This article presents a review of scientific literature concerning adverse effect of tobacco smoking on concentration of the pregnancy-associated plasma protein A (PAPP-A) in pregnant women. PAPP-A is produced in great amounts during pregnancy by the syncytiotrofoblast, but can be also detected in a variety of cell types such as fibroblasts, osteoblasts and vascular smooth muscle cells (VSMC). We describe the structure of PAPP-A and its function as an insulin-like growth factor binding proteins (IGFBPs) protease with a focus on data obtained in tobacco smoking pregnant women. We also discuss the results of studies indicating a correlation between smoking and deficit of PAPP-A in the first trimester of pregnancy. The review summarizes possible mechanisms relating tobacco smoking to the changes of PAPP-A concentration during pregnancy.
    Przegla̧d lekarski 01/2010; 67(10):1061-5.
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    ABSTRACT: Vegetarian diets can be healthy when they are well balanced and if a variety of foods is consumed. However, elimination of animal products from the diet (vegan diets) decreases the intake of some essential nutrients and may influence the bone metabolism. This is especially important in childhood and adolescence, when growth and bone turnover are most intensive. The aim of the study was to assess the effect of vegan diet on bone density (BMD) density and serum concentrations of bone metabolism markers. We examined a family on vegan diet which consisted of parents and two children. Dietary constituents were analysed using a nutritional program. Total and regional BMD were measured by dual-energy X-ray absorptiometry. Concentrations of calcium and phosphate in serum obtained from fasting patients were determined by colorimetric methods, 25-hydroxyvitamin D by the chemiluminescence method and bone turnover markers by specific enzyme immunoassays. In studied vegans, the dietary intake of phosphate was adequate while calcium and vitamin D were below the recommended range. Concentrations of calcium, phosphate and bone turnover markers in the serum of all subjects were within the physiological range, but 25-hydroxyvitamin D level was low. Age-matched Z-score total BMD was between -0.6 and 0.3 in adults, however in children it was lower (-0.9 and -1.0). Z-score BMD lumbar spine (L2-L4) was between -0.9 to -1.9 in parents and -1.5 to -1.7 in children. Our results suggest that an inadequate dietary intake of calcium and vitamin D may impair the bone turnover rate and cause a decrease in bone mineral density in vegans. The parameters of bone density and bone metabolism should be monitored in vegans, especially children, in order to prevent bone abnormalities.
    Pediatric endocrinology, diabetes, and metabolism. 01/2010; 16(3):201-4.
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    ABSTRACT: However smoking during pregnancy has been show to result in growth restriction of the fetus but the mechanism by which this occurs has not been adequately clarified. Insulinlike growth factor (IGF) and its insulin-like growth factor binding protein (IGFBP) are the main mediators of intrauterine fetal growth. The aim of the study was to estimate the effect of tobacco smoking on serum concentrations of IGF-I, IGFBP-3 and IGFBP-4 in pregnant women. Forty five healthy pregnant women patients of Clinical Department of Obstetrics and Gynecology, Institute of Mother and Child, were divided into two groups: smoking and tobacco abstinent according to questionnaire declaration and serum cotinine concentration. The current smokers were defined as those who had smoked 5 cigarettes per day for 2 years before conception and continued smoking during pregnancy. Serum concentrations of cotinine, IGF-I, IGFBP-3 and IGFBP-4 were determined by immunoenzymatic method. We observed, that in group of smoking mothers the mean serum concentration of cotinine was 82.9 microg/l and correlated positively with number of cigarettes daily consumed (r = 0.47; p < 0.05). In group of tobacco abstinent cotinine in serum was present only in trace amount (range: 0-3.5 microg/l). The mean serum concentration of IGF-I was significantly lower in group of smokers than in non-smoking ones (222,4 microg/L vs 282,1 microg/L; p < 0.05). In tobacco abstinent group we observed positive correlation between gestational age and serum level of IGF-I (r = 0.40; p < 0.05). There was no association among this parameters in smoking pregnant women. In serum of cigarette users the mean concentration of IGFBP-3 was slightly higher as compared to those of tobacco abstinent (6798 microg/L vs 6427 microg/L). In this group level of IGFBP-4 was lower by 20% than in non-smoking ones, but the difference was not statistically significant. Our results indicate that tobacco smoking during pregnancy affect in maternal IGF-I and its binding proteins, which may correlate with smaller birth weight. Further studies will be continued in larger group of women in all trimesters of pregnancy and their children to confirm of this association.
    Przegla̧d lekarski 01/2010; 67(10):893-6.
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    ABSTRACT: It is commonly known, that tobacco smoking during pregnancy has negative influence on child birth mass. Also in polish population neonates of smoking mothers are frequently born with lower body mass and are smaller. Purpose of this study was to estimate the percentage of women smoking during pregnancy and its relation to body mass of newborns. Research was made on the basis of standardized survey questionnaire done in the group of 20320 mothers. Women were divided into non-smoking and smoking before conception and during pregnancy. Questions concerned also intensity of smoking and body mass of a child. Among of participants 41.5% were in smokers group with tendency to decrease in the course of pregnancy. However even in 3-rd trimester percentage of smoking mothers was high. Body mass of newborns of smokers was lower than in group of abstinent and was related to intensity of smoking. In the light of these results some more intensive prophylactic and education actions are needed.
    Przegla̧d lekarski 01/2010; 67(10):830-4.

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Institutions

  • 2001–2013
    • Institute of Mother and Child
      Warszawa, Masovian Voivodeship, Poland
  • 2002–2012
    • Instytut Matki i Dziecka
      Warszawa, Masovian Voivodeship, Poland