Orientador: Iracema de Matos Paranhos Calderon / Banca: Maria Aparecida Mourão Brasil / Banca: Belmiro Gonçalves Pereira / Resumo: A hiperinsulinemia no ambiente intrauterino é o principal determinante do DM infantil. Avaliar a relação entre marcadores maternos e neonatais e DM em crianças de zero a 10 anos. Estudo de caso-controle, onde foram incluídas 1400 crianças, diabéticas (449 casos) e não diabéticas (951 controles). Os marcadores dos recém-nascidos [peso, comprimento e IP, no momento do parto, e tempo de aleitamento (meses)] e os maternos [Índice de massa corporal (IMC), classes de IMC, tipo de parto e presença de DMG e Hipertensão arterial na gestação] foram associados ao DM infantil. Para a análise estatística foram empregados o teste do Qui-quadrado ou exato de Fisher e calculados os valores de Odds ratio [OR] e respectivos IC 95%, adotando-se p < 0,05. RESULTADOS  As crianças diabéticas tinham maior peso (27,282 Kg) e estatura (1,27 m), resultando em maior IMC nos casos (16,442 vs 15,735 Kg/m2) (p = 0,000). As mães do grupo de casos apresentaram sobrepeso e obesidade (66,8% vs 45,0%), maior ocorrência de cesárea (62,0% vs 43,0%) e associação com DMG (27,8% vs 10,2%) e hipertensão arterial (18,0% vs 8,2%). Os marcadores dos recém-nascidos não diferenciaram os casos dos controles (p ≥ 0,05). Na análise univariada foram resultados significativos IMC, cesárea, DMG e Hipertensão arterial, com valores de OR de, respectivamente, 1,98; 2,19; 3,39 e 2,46 (p ≤ 0,05). Na multivariada, sobrepeso e obesidade (OR = 1,53), cesárea (OR = 1,73) e DMG (OR = 2,00) favoreceram o desenvolvimento DM infantil (p < 0,05). Sobrepeso e obesidade, cesárea e DMG, presentes na gestação, confirmaram-se como fator de risco independente para o DM infantil / Abstract: Hyperinsulinemia in the intrauterine environment is the major determinant of DM (Diabetes Mellitus) in children. To evaluate the relationship between maternal and neonatal markers and DM in children up to 10 years. METHOD  case-control study, including 1400 diabetic (449 cases) and nondiabetic children (951 controls). Newborns markers [weight, length and ponderal index, at delivery, and duration of breastfeeding (months)] and maternal markers [Body Mass Index (BMI), BMI classes, type of delivery and the presence of GDM (Gestational Diabetes Mellitus) and Hypertension in pregnancy] were associated with childhood DM. For the statistical analysis, the chi-square or Fisher's exact test was used, and values of Odds Ratio [OR] and their several CI95% (Confidence Interval) were calculated by adopting p <0.05. RESULTS  The diabetic children had higher weight (27.282 kg) and height (1.27 m) resulting in higher BMI (16.442 vs. 15.735 kg/m2) (p = 0.000). Mothers in the case group were overweight or obese (66.8% vs 45.0%), had higher incidence of cesarean section (62.0% vs 43.0%) and association with GDM (27.8% vs 10.2 %) and hypertension (18.0% vs 8.2%). Newborns markers did not differed cases from controls (p ≥ 0.05). In the univariate analysis, significant results were BMI, cesarean section, GDM and hypertension, with OR values of, respectively, 1.98, 2.19, 3.39 and 2.46 (p ≤ 0.05). In multivariate analysis, overweight and obesity (OR = 1.53), cesarean section (OR = 1.73) and GDM (OR = 2.00) favored the development of DM in children (p <0.05). Overweight and obesity, cesarean section and GDM during pregnancy were confirmed as independent risk factor for DM in children / Mestre

Made available in DSpace on 2014-06-11T19:29:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-25Bitstream added on 2014-06-13T20:20:19Z : No. of bitstreams: 1 silva_tc_me_botfm.pdf: 241116 bytes, checksum: 23bc959299af9c2254afdea5a46e5619 (MD5) / Fundação de Ensino e Pesquisa em Ciências da Saúde (FEPECS) / A hiperinsulinemia no ambiente intrauterino é o principal determinante do DM infantil. Avaliar a relação entre marcadores maternos e neonatais e DM em crianças de zero a 10 anos. Estudo de caso-controle, onde foram incluídas 1400 crianças, diabéticas (449 casos) e não diabéticas (951 controles). Os marcadores dos recém-nascidos [peso, comprimento e IP, no momento do parto, e tempo de aleitamento (meses)] e os maternos [Índice de massa corporal (IMC), classes de IMC, tipo de parto e presença de DMG e Hipertensão arterial na gestação] foram associados ao DM infantil. Para a análise estatística foram empregados o teste do Qui-quadrado ou exato de Fisher e calculados os valores de Odds ratio [OR] e respectivos IC 95%, adotando-se p < 0,05. RESULTADOS  As crianças diabéticas tinham maior peso (27,282 Kg) e estatura (1,27 m), resultando em maior IMC nos casos (16,442 vs 15,735 Kg/m2) (p = 0,000). As mães do grupo de casos apresentaram sobrepeso e obesidade (66,8% vs 45,0%), maior ocorrência de cesárea (62,0% vs 43,0%) e associação com DMG (27,8% vs 10,2%) e hipertensão arterial (18,0% vs 8,2%). Os marcadores dos recém-nascidos não diferenciaram os casos dos controles (p ≥ 0,05). Na análise univariada foram resultados significativos IMC, cesárea, DMG e Hipertensão arterial, com valores de OR de, respectivamente, 1,98; 2,19; 3,39 e 2,46 (p ≤ 0,05). Na multivariada, sobrepeso e obesidade (OR = 1,53), cesárea (OR = 1,73) e DMG (OR = 2,00) favoreceram o desenvolvimento DM infantil (p < 0,05). Sobrepeso e obesidade, cesárea e DMG, presentes na gestação, confirmaram-se como fator de risco independente para o DM infantil / Hyperinsulinemia in the intrauterine environment is the major determinant of DM (Diabetes Mellitus) in children. To evaluate the relationship between maternal and neonatal markers and DM in children up to 10 years. METHOD  case-control study, including 1400 diabetic (449 cases) and nondiabetic children (951 controls). Newborns markers [weight, length and ponderal index, at delivery, and duration of breastfeeding (months)] and maternal markers [Body Mass Index (BMI), BMI classes, type of delivery and the presence of GDM (Gestational Diabetes Mellitus) and Hypertension in pregnancy] were associated with childhood DM. For the statistical analysis, the chi-square or Fisher's exact test was used, and values of Odds Ratio [OR] and their several CI95% (Confidence Interval) were calculated by adopting p <0.05. RESULTS  The diabetic children had higher weight (27.282 kg) and height (1.27 m) resulting in higher BMI (16.442 vs. 15.735 kg/m2) (p = 0.000). Mothers in the case group were overweight or obese (66.8% vs 45.0%), had higher incidence of cesarean section (62.0% vs 43.0%) and association with GDM (27.8% vs 10.2 %) and hypertension (18.0% vs 8.2%). Newborns markers did not differed cases from controls (p ≥ 0.05). In the univariate analysis, significant results were BMI, cesarean section, GDM and hypertension, with OR values of, respectively, 1.98, 2.19, 3.39 and 2.46 (p ≤ 0.05). In multivariate analysis, overweight and obesity (OR = 1.53), cesarean section (OR = 1.73) and GDM (OR = 2.00) favored the development of DM in children (p <0.05). Overweight and obesity, cesarean section and GDM during pregnancy were confirmed as independent risk factor for DM in children

Aims: The thesis deals with the biomarkers of early renal injury, namely albuminuria and neutrophil gelatinase-associated lipocalin (NGAL). The aims in the case of albuminuria were the implementation of HPLC method, comparing HPLC with immunoturbidimetric (IT) method and monitoring the relationship to the diagnosis of diabetes mellitus. The aim of urinary NGAL (and eventually other markers) examination was to verify its reliability in the prediction of acute kidney injury (AKI). Methods: We investigated albuminuria in fresh urine samples in the groups of 636 diabetics and 456 nondiabetics using the HPLC method (Agilent 1200, Agilent Technologies, USA) and immunoturbidimetrically (Cobas Integra 400, Roche Diagnostics); we studied the correlations and relationships between albuminuria and glycated hemoglobin HbA1c. We investigated urinary NGAL by chemiluminescent microparticle immunoassay (Architect i4000, Abbott) in children's groups: 1) after renal transplantation (N = 15), 2) with acute or chronic kidney disease (N = 28); and in adult patient's groups: 1) after cardiac surgery (N = 10) and 2) post angiography (N = 41). Results: Albuminuria determined by HPLC was statistically significantly higher than albuminuria determined by IT. We excluded nonspecificity of the HPLC method. Results indicate...