Læknablaðið : fylgirit - 03.01.2017, Blaðsíða 17

X V I I I V Í S I N D A R Á Ð S T E F N A H Í
F Y L G I R I T 9 1
LÆKNAblaðið/Fylgirit 91 2017/103 17
ors (IP), but is dependent on the activation of both prostaglandin and
nitric oxide (NO) signaling pathways.
Conclusion: The potency and efficacy of PP13 in dilating resistance
vessels from both the uterus and mescentery encourages evaluation of
PP13 as a possible therapy for diseases characterized by insufficient uter-
oplacental blood flow such as preeclampsia and maternal hypertension.
E 31 Maternal protein intake and offspring blood
pressure 20 years later
Laufey Hrólfsdóttir1, Ekaterina Maslova2, Dorte Rytter3, H. Bodil Bech3, Bryndís E.
Birgisdóttir4, Ingibjörg Gunnarsdóttir4, Charlotta Granström2, B. Tine Henriksen5, F.
Sjurdur Olsen2, Þórhallur I. Halldórsson4
1Unit for Nutrition Research, Faculty of Food Science and Nutrition, UI, 2Centre for
Fetal Programming, Statens Serum Institute, 3Department of Public Health, Section for
Epidemiology, Aarhus University, 4Faculty of Food Science and Nutrition, Háskóli Íslands,
5Department of Pediatrics, Aarhus University Hospital
lah10@hi.is
Background: Results from two cohort studies in Scotland established
in the 1950s and 60s (Aberdeen and Motherwell) suggested that high
protein diet during pregnancy may adversely influence offspring blood
pressure. Our objective was to examine this association in the Aarhus
Birth Cohort (1988-89).
Methods: The Aarhus Birth Cohort is a prospective cohort of 965 women
who gave birth in 1988-89 and whose offspring (n=434) participated in
a clinical examination ~20 years later. Macronutrient intake was assess-
ed in gestational week 30 using food frequency questionnaires (FFQ)
and a 15-minute face-to-face interview. Multivariable adjusted linear
regression was used to examine the associations between dietary car-
bohydrate substitution with protein and offspring blood pressure. Main
analyses were adjusted for offspring’s sex, mother’s age, pre-pregnancy
BMI, parity, smoking status during pregnancy and educational level.
Results: The mean (SD) total energy intake was 8.7 (2.3) MJ/d. The mean
carbohydrate, fat and protein intake was 51, 31, and 16E% respectively.
After adjustment, mean offspring diastolic blood pressure increased when
substituting carbohydrates with protein (highest compared to the lowest
quintile of protein: ∆=2.4 mmHg; 95% CI: 0.4, 4.4; p for trend 0.03). Similar,
though not significant differences were found for systolic blood pressure
(∆=2.6 mmHg; 95% CI: -0.0, 5.3; p for trend 0.08). Additional adjustment
for offspring BMI and alcohol consumption did not appreciably alter
effect estimates.
Conclusions: In line with previous findings, increasing maternal dietary
protein intake at the expense of carbohydrate was associated with modest
increase in offspring blood pressure in young adulthood.
E 32 Health and Wellbeing of children in compulsory schools in
Iceland before and after economic collapse in 2008
Geir Gunnlaugsson1, Hrefna Pálsdóttir2, Jón Sigfússon2, Inga D. Sigfúsdóttir2
1Faculty of Social and Human Sciences, University of Iceland, and International Society for
Social Paediatrics and Child Health, 2 Icelandic Centre for Social Research and Analysis, and
Reykjavik University
geirgunnlaugsson@hi.is
Background and aims: Health and wellbeing of children may suffer
during times of crisis. Here the aim is to describe and analyse health and
wellbeing of Icelandic adolescents in the period before and after October
2008 when the national banking system collapsed.
Methods: Data from surveys conducted in the period 1997-2014 by the
Icelandic Centre for Social Research and Analysis (ICSRA) in compulsory
schools. It includes questions on the children’s general health and well-
being, happiness, health behaviour, school, financial situation, parental
support, and sport.
Results: In February 2009, a few months after the collapse, about 90%
of school children aged 10–12 years reported that they felt rather well or
very well during lessons, girls more so than boys. Adolescents reported
either improved satisfaction with their life situation or no change after
the collapse compared with the year 200o. In 2014, 14-15 years old
adolescents report more time spent with parents and better parental
support, more happiness, less use of tobacco and alcohol, and increa-
sed participation in sports compared to the period before the collapse.
Conclusions: Despite some gender differences, Icelandic children
reported generally improved health and well-being after the crisis or no
change in the period under study, and they report significant improvem-
ent in happiness. One contributing factor might be the felt better parental
support after the crisis compared to before it. Parents should be made
aware of the importance for them ‘to be there’ for the the health and well-
being of their children.
E 33 Kidney Disease in APRT Deficiency Presenting in Childhood
Hrafnhildur L. Runólfsdóttir1, Runólfur Pálsson2, Inger M. Ágústsdóttir3, Ólafur S.
Indriðason2, Viðar Ö. Eðvarðsson3
1Landspitali University Hospital, 2Division of Nephrology, Landspitali University Hospital,
3Children's Medical Center, Landspitali University Hospital
hrafnhr@landspitali.is
Introduction: Adenine phosphoribosyltransferase deficiency (APRTd) is
an inherited disorder of purine metabolism that causes nephrolithiasis
and chronic kidney disease (CKD). Scarce data are available on APRTd
presenting in childhood.
Methods: Patients with APRTd in the RKSC Registry presenting with
clinical manifestations of the disorder before age 18 years were included.
Estimated glomerular filtration rate (eGFR) was calculated using the mod-
ified Schwartz (children <18 years) and CKD-EPI equations (adults). CKD
was defined as eGFR <60 ml/min/1.73 m2 and acute kidney injury (AKI)
according to the KDIGO criteria.
Results: Nineteen children presented at a median age of 1.6 (range, 0.2-
16.5) years, 11 (58%) of whom experienced reddish-brown diaper spots, 7
(37%) had kidney stones, 8 (42%) had lower urinary tract symptoms and
3 (16%) had AKI. Diagnosis was delayed in 6 patients (32%) for a median
of 29.2 (20.1-39.2) years. Twelve patients were placed on allopurinol at 2.1
(0.6-16.5) years of age. During follow-up of 18.9 (1.7-31.5) years, 3 of these
12 patients developed 4 kidney stone events and AKI occurred in 4. Six
patients did not initiate pharmacotherapy until age 29.8 (20.5-42.4) years.
At last follow-up, 5 of these 6 patients had experienced 11 kidney stone
events, 3 suffered 6 episodes of AKI, 2 had stage 3 CKD while 1 progressed
to end-stage renal disease.
Conclusions: A substantial proportion of patients with APRTd present
in childhood. Diagnostic delay frequently results in progressive kidney
disease. APRTd must be excluded in children with kidney stones, renal
dysfunction or reddish-brown diaper spots.
E 34 Ónæmisglæðirinn LT-K63 eykur virkjun og lifun B-frumna í
músaungum með aukna BAFFR og BCMA tjáningu
Stefanía P. Bjarnarson, Auður A. Aradóttir Pind, Ingileif Jónsdóttir
Ónæmisfræðideild, Landspítali
stefbja@landspitali.is