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The effect of gluten-free diet on β-cell residual capacity, immune function and gut microbiome in children with newly diagnosed type 1. diabetes
Neuman, Vít ; Šumník, Zdeněk (advisor) ; Pelikánová, Terezie (referee) ; Škvor, Jaroslav (referee)
The effect of gluten-free diet on β-cell residual capacity, immune function and gut microbiome in children with newly diagnosed type 1. diabetes Abstract The pathophysiology of the onset and progression of type 1 diabetes (T1D) is not fully understood. Gluten has a proinflammatory effect on the immune system and is therefore considered as one of the factors affecting the onset and progression of T1D. The aim of the thesis is to allow a complex insight into the role of the GFD on the residual β-cell capacity, T1D control, gut microbiome, gut permeability, subtypes of immune cells and the effect of gut microbiome transfer into germ-free non-obese diabetic (NOD) mice on the incidence of diabetes. On the group of 45 children with T1D (26 intervention group, 19 control group) we proved the association of the GFD with slower decrease of β-cell residual capacity (the difference in the trend of C-peptide decrease 409 pmol/l/year; p = 0,04) and lower HbA1c (by 7,8 mmol/mol; p=0,02). We also described the changes in the gut bacteria that were differentially abundant after the administration of the GFD and the changes in abundance of the regulatory and effector immune cells. We showed there was no change in the gut permeability with respect to the study group. We also proved that the transfer of human gut microbiota...
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The effect of serum 25-hydroxycholekalciferol levels on musculoskeletal system in children with inflammatory bowel disease
Maratová, Klára ; Šumník, Zdeněk (advisor) ; Zapletalová, Jiřina (referee) ; Kutílek, Štěpán (referee)
The effect of serum 25-hydroxycholekalciferol levels on musculoskeletal system in children with inflammatory bowel disease Background: Low bone mineral density and osteoporosis represent severe secondary complications that can be a result of childhood chronic disease. According to Frost's mechanostat theory impaired muscle functions may contribute to the changes observed on the skeleton. Aims: The aim of this study was to: 1) evaluate parameters of bone mineral density, bone geometry and dynamic muscle functions in children and adolescent with chronic disease - inflammatory bowel disease (IBD) and type 1 diabetes (T1D); 2) evaluate a possible effect of vitamin D deficiency and vitamin D supplementation or duration of the disease on the musculoskeletal unit; 3) determine clinical or laboratory predictors of muscle and bone parameters. Methods: The study was divided into two substudies according to the diagnosis. Seventy patients with IBD (median age 13.8 years) were included in one study, fifty-five of which completed all of the planned procedures. During the study, IBD patients were supplemented with 2000 IU/d of vitamin D. In the second study 95 patients with T1D were included (median age 16.4 years). BMD and bone geometry of non-dominant tibia was evaluated using peripheral quantitative computed...
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Changes in Bone and Mineral Metabolism and the Role of Vitamin D in Very Low Birth Weight Infants
Matějek, Tomáš ; Skálová, Sylva (advisor) ; Šumník, Zdeněk (referee) ; Kutílek, Štěpán (referee)
Changes in bone and mineral metabolism and the role of vitamin D in very low birth weight infants. Firstly, the aim of dissertation work was to estimate physiological parathyroid hormone (PTH) levels and their relationship with bone metabolism parameters in otherwise healthy preterm newborns with birth weight 1000-1500 g. Secondly, to evaluate vitamin D status in mothers and their very low birth weight infants (VLBW) at birth and at discharge with currently recommended supplementation of vitamin D. Thirdly, to compare clinical outcomes of VLBW infants with 25-hydroxy vitamin D [25(OH)D] levels ≤ and > 25 nmol/l in umbilical cord blood and finally to evaluate umbilical cord vitamin D as a risk factor for respiratory distress syndrome in preterm infants. It is a set of prospective observational studies involving immature newborns with birth weight below 1500 g. The parameters of mineral and bone metabolism were analysed in umbilical cord blood and newborn serum and urine during hospitalisation (PTH, 25-hydroxy vitamin D, S-Ca, S-P, ALP, U-Ca, U-P) and in pregnant women before delivery (25-hydroxy vitamin D). Bone mineralization was evaluated by bone densitometry. In a pilot study, from the total 134 examined serum samples for PTH levels the estimated reference range was 1.6 - 9.3 pmol/l. From the...
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The role of peripheral quantitative CT in early diagnostics of osteoporosis in chronically ill children
Souček, Ondřej ; Šumník, Zdeněk (advisor) ; Hoza, Jozef (referee) ; Zapletalová, Jiřina (referee)
Patients with Turner syndrome (TS) have increased fracture risk and decreased bone density, patients with severe hemophilia have low bone density. The etiology of these changes hasn't been completely elucidated in any of the two diseases. Our aimes were to assess bone density and geometry at the radius using a new method peripheral quantitative CT densitometry (pQCT) and to describe associations between densitometry parameters and estrogen treatment in TS and laboratory as well as clinical markers of disease severity in haemophilia. Sixty-seven girls with TS (median age 14.3 years, range 6.0-19.4) and 42 boys with haemophilia (median age 12.7 years, range 6.6-19.2) have been measured using peripheral quantitative CT at the radius. The results have been compared to published reference data. Girls with TS had decreased cortical bone density and thinner cortex. These parameters were positively correlated to the length of estrogen treatment. Trabecular bone density was normal in prepubertal girls but it was decreased after puberty. There was no association between trabecular bone density and the estrogen treatment. Boys with haemophilia had decreased trabecular density and low muscle area at the forearm. Densitometry parameters were influenced neither by the clotting factor VIII/IX level nor by the frequency of...
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