Cortisol Levels in Children with Haemoglobinopathies in North Jordan

Bashir, Nabil; Al-Hader, Abdel Fattah A.; Al-Shareef, Labib

doi:10.1093/tropej/39.1.30

Cited by 5 publications

(3 citation statements)

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“…It was previously shown that Caucasian children release much less cortisol following immunization than Japanese children (4) , and this can explain why decreases of type 1 diabetes occurred in Caucasian children (5) whereas decreases in type 2 diabetes occurred in Japanese children following the discontinuation of the BCG vaccine (6) . In this paper, children from Sardinia, who have a high prevalence of genetic traits or mutations (glucose-6 phosphate dehydrogenase and thalassemia) (7) that lead to decreased cortisol activity (8) , had the lowest levels of childhood obesity but the highest rates of type 1 diabetes in Italy.…”

Section: Resultsmentioning

confidence: 90%

Italian pediatric data support hypothesis that simultaneous epidemics of type 1 diabetes and type 2 diabetes/metabolic syndrome/obesity are polar opposite responses (i.e., symptoms) to a primary inflammatory condition

Classen¹

2011

Journal of Pediatric Endocrinology and Metabolism

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We previously postulated that iatrogenic infl ammation caused epidemics of type 2 diabetes/metabolic syndrome/obesity by activating an immune suppressive cortisol response which protects against type 1 diabetes and other autoimmune diseases. In the current study, data on the incidence of obesity in different Italian provinces was compared with the incidence of type 1 diabetes in the same region. The association between obesity and type 1 diabetes was analyzed using Wilcoxon rank analysis. Results showed an inverse relationship; the regions with the highest rate of obesity (Campania and Lazia) were associated with a protective effect against type 1 diabetes. However, regions with the lowest rates of obesity were associated with the highest rate of type 1 diabetes. These results are consistent with previous analysis across different racial groups; races with high cortisol activity had an increased rate of type 2 diabetes but were protected from type 1 diabetes.

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Section: Resultsmentioning

confidence: 90%

Italian pediatric data support hypothesis that simultaneous epidemics of type 1 diabetes and type 2 diabetes/metabolic syndrome/obesity are polar opposite responses (i.e., symptoms) to a primary inflammatory condition

Classen¹

2011

Journal of Pediatric Endocrinology and Metabolism

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“…Bashir et al, (Jordan) reported a low cortisol level in 57% of patients with thalassemia with mean cortisol level of 182 ± 32 nmol/L compared with 420 ± 100 nmol/L in control group indicating in vivo hypoadrenalism [17].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Adrenal, Parathyroid and Cardiac Dysfunction in Patients with Beta Thalassemia Major

Mahdi¹,

Garadah²,

Hassan³

et al. 2013

IJCM

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Background: Adrenal and parathyroid insufficiency are uncommon in patients with transfusion dependent Beta Thalassemia (β-TM). Further, myocardial echocardiographic abnormalities are recognized but with a variable outcomes Aim: The aim is to determine the prevalence of adrenal and parathyroid insufficiency in patient with transfusion dependent β-TM. And to assess left ventricle systolic and diastolic function using Pulsed Doppler (PD) and Tissue Doppler (DT) echocardiogram. Methods:The study was conducted on patients with β-TM (n = 99, age 15.92 ± 8.92 years) and compared with an age-matched controls (n = 98 age 15.79 ± 8.94 years). In all participants echocardiographic indices of M mode and PD and TD were performed. Blood samples were withdrawn for measuring the serum cortisol, parathyroid and Ferritin. Correlation between the level of cortisol and ferritin level was evaluated. Results: Patients with β-TM compared with controls, had significantly thicker LV septal wall index of 0.65 ± 0.26 vs 0.44 ± 0.2190, p < 0.001 and LV posterior wall of 0.65 ± 0.235 vs 0.43 ± 0.214, p < 0.001, with no significant dilation of LV cavity in systole and diastole. The systolic function of LVFE% was normal of 51.95 ± 5.5 vs 5.0 ± 5.6, p = 0.23. Furthermore patients with β-TM had higher E/A ratio (1.54 ± 0.18 vs 1.23 ± 0.17, p < 0.01) and shorter deceleration time (DT) (170.53 ± 13.3 vs 210.50 ± 19.20 m sec, p < 0.01). The ratio of transmitral E wave velocity to the tissue Doppler E wave at the basal septal mitral annulus (E/Em) was significantly higher in β-TM group (19.68 ± 2.81 vs 13.86 ± 1.41, p < 0.05). ...

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“…[13] Bashir et al, (Jordan) reported a low cortisol level in 57% of patients with thalassemia with mean cortisol level of 182∓32nmol/L compared with 420∓100 nmol/L in control group indicating in vivo hypoadrenalism. [17] In one study of 435 there were 32.5% patients with hypogonadotrophic hypogonadism and reduced pubertal growth spurt stature in 35%, acquired hypothyroidism in 5.9%, hypoparathyroidism in 1.2% and DM in 9.4 %. [5] Delayed puberty and short stature of adrenal insufficiency are common findings but it seems adrenal pituitary axis is almost not affected.…”

Section: Discussionmentioning

confidence: 99%

Adrenal gland dysfunction and myocardial Tissue Doppler echocardiographic abnormalities in Patients with Beta Thalassemia Major: cross sectional study

Garadah

Jaradat

Mahdi

et al. 2013

IJM

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Background: Adrenal, parathyroid gland and myocardial echocardiographic abnormalities are recognized with variable outcomes in patients with transfusion dependent Beta-Thalassemia major (ß-TM). Aim: In this cross-sectional analytic study in patients with ß-TM, we evaluate the left ventricle systolic and diastolic function using Pulsed Doppler (PD) and Tissue Doppler (DT) echocardiogram with simultaneous measurement of serum level of cortisol and parathyroid hormone. Methods: The study was conducted on patients with β-TM (n = 99, age 15.92±8.92 years) and compared with an agematched controls (n = 98 age 15.79±8.94 years). In all participants echocardiographic indices of M mode and PD and TD were performed. Blood samples were withdrawn for measuring the serum cortisol, parathyroid and Ferritin. Correlation between the level of cortisol and ferritin level was evaluated. The ratio of transmitral E wave velocity to the tissue Doppler E wave at the basal septal mitral annulus (E/Em) was significantly higher in β-TM group (19.68±2.81 vs. 13.86±1.41, P<0.05). The tissue Doppler systolic wave (Sm) velocity and the early diastolic wave (Em) were significantly lower in β-TM group compared with controls with Sm, of 4.82±1.2 vs. 6.22±2.1 cm/sec, P<0.05 and (Em) of 3.51±2.7 vs. 4.12±2.5 cm/sec P<0.05, respectively). The tricuspid valve velocity was significantly higher in β-TM patients compared with controls (2.85±0.56 vs. 1.743±0.47 m/sec, respectively, P<0.01). The prevalence of adrenal insufficiency in patients with ß-TM was 16 %, hypoparathyroidism of 4.5%. There was a weak negative correlation between serum level of cortisol and the serum Ferritin. Conclusion: Patients with β-thalassemia major had a high prevalence of subclinical adrenal insufficiency of 16%, hypoparathyroidism of 4.5% with weak negative correlation between the low level of cortisol ≤160 nmol/L and high serum ferritin. Echocardiographic Pulsed Doppler showed a restrictive LV diastolic pattern suggestive of advanced diastolic dysfunction but preserved left ventricle systolic function.

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Cortisol Levels in Children with Haemoglobinopathies in North Jordan

Cited by 5 publications

References 0 publications

Italian pediatric data support hypothesis that simultaneous epidemics of type 1 diabetes and type 2 diabetes/metabolic syndrome/obesity are polar opposite responses (i.e., symptoms) to a primary inflammatory condition

Italian pediatric data support hypothesis that simultaneous epidemics of type 1 diabetes and type 2 diabetes/metabolic syndrome/obesity are polar opposite responses (i.e., symptoms) to a primary inflammatory condition

The Prevalence of Adrenal, Parathyroid and Cardiac Dysfunction in Patients with Beta Thalassemia Major

Adrenal gland dysfunction and myocardial Tissue Doppler echocardiographic abnormalities in Patients with Beta Thalassemia Major: cross sectional study

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