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    Breast-feeding duration and childhood acute leukemia and lymphomas in a sample of Turkish children
    (Lippincott Williams & Wilkins, 2006) Altinkaynak, Sevin; Selimoglu, Mukadder Ayse; Turgut, Ahmet; Kilicaslan, Buket; Ertekin, Vildan
    Objectives: Whether breast-feeding is associated with decreased incidence of the lymphoid malignancies in children is uncertain. We evaluated childhood acute leukemia and lymphoma in relation to duration of breast-feeding. Methods: We investigated this issue in a case-control study comprising 137 patients, aged I to 16 years, with acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin or non-Hodgkin lymphoma, in addition to 146 controls matched for age and sex. Results: The median duration of breast-feeding among patients was shorter than that of controls (10 vs 12 months). Patients with ALL and AML had shorter mean breast-feeding duration compared with healthy children (P = 0.001 and P < 0.001, respectively). The shortest mean breast-feeding duration was noted in the children with AML. Breast-feeding for a duration of 0 to 6 months, when compared with feeding of longer than 6 months, was associated with increased odds ratios (ORs) for ALL [OR = 2.44, 95% confidence interval (Cl) = 1.17-5.101, AML (OR = 6.67 95% Cl = 1.32-33.69), Hodgkin lymphoma (OR 3.33, 95% Cl = 0.60-18.54), non-Hodgkin lymphoma (OR 1.90, 95% Cl = 0.68-5.34) and overall (OR = 2.54, 95% Cl = 1.51-4.26). Conclusions: Our findings suggest that breast-feeding of more than 6 months is protective against childhood lymphoid malignancies, especially for AML and ALL.
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    Serum ghrelin levels in children with primary protein-energy malnutrition
    (Wiley, 2008) Altinkaynak, Sevin; Selimoglu, Mukadder A.; Ertekin, Vildan; Kilicarslan, Buket
    Background: Ghrelin, an appetite-stimulating peptide, increases in cachectic conditions. It probably reflects peripheral nutritional status and influences nutrient intake and growth. The aim of the present study was to determine serum ghrelin levels in children with primary protein-energy malnutrition (PEM) and to find if any correlation exists between serum ghrelin levels and the clinical presentation of those patients. Methods: Twenty-eight children with primary PEM and 10 healthy children were included. Serum fasting ghrelin levels were measured using radioimmunoassay. Results: Mean serum ghrelin level of healthy children and those with PEM were 107.7 +/- 40.1 pg/mL and 141.6 +/- 123.8 pg/mL, respectively (P < 0.001). Ghrelin levels were independent of age and sex (P > 0.05). Ghrelin was negatively correlated with body mass index in healthy children (P < 0.01), but not in those with PEM (P > 0.05). Mean serum ghrelin level of children with moderate malnutrition was higher than that of children with severe malnutrition (199.2 +/- 154.1 pg/mL vs 98.4 +/- 74.3 pg/mL, P < 0.05). Mean serum ghrelin levels of patients with kwashiorkor, marasmic kwashiorkor, and marasmus were 127.9 +/- 97.8 pg/mL, 138.7 +/- 95.8 pg/mL, and 162.3 +/- 185.0 pg/mL, respectively (P > 0.05). Conclusion: Serum ghrelin level is higher in patients with PEM, especially in those with marasmus, compared to healthy children. Although this observation suggests that ghrelin helps to fight malnutrition in children, it is obvious that further studies are needed to clarify the exact pathogenetic mechanism regarding this condition.