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A 17-days-old, breast fed, female neonate presented with low-grade fever (37.8°C) and no obvious clinical signs. A blood sample, drawn for a sepsis work-up, appeared viscous and with a purple shade. After centrifugation, serum appeared white and creamy (figure 1A, B). Cholesterol was 29 mmol/L, HDL-cholesterol 0.54 mmol/L, triglycerides were 218 mmol/L. Apolipoprotein A 5.53 μmol/L and apolipoprotein B 0.08 g/L. …

The number of overweight children is constantly increasing in both developed and underdeveloped countries. Most epidemiological surveys consider school age children with little attention being given to preschool age children. This study was undertaken to define the prevalence of being overweight or obese in a population of children 3–6 years of age, living in North-East Italy. We also identified differences when comparing body mass index (BMI) data against three different national and international standards. The study involved 258 children (124 males and 134 females) with an average age of 4.8 years. Weight and height were obtained for each child and BMI was calculated according to the formula weight (kg)/height (m)2. The prevalence of overweight and obese subjects was then determined using the growth curves of the Centers for Disease Control and Prevention (CDC), the growth curves of the International Obesity Task Force (IOTF) and the curves published in 2003 by Luciano et al. All three methods gave similar, but not identical, estimates of the prevalence of overweight in both boys and girls. However, when determining the prevalence of obesity, the use of the CDC curves led to a significantly higher prevalence of obesity in both males and females when compared to the growth charts of the IOTF and Luciano et al. The use of the CDC growth curves leads to an increase in the prevalence of obesity when evaluating children under 5 years of age. The lower cut-off values inherent in the CDC charts, in contrast to the ones proposed by the IOTF, allow for earlier identification of a larger number of subjects with weight problems and therefore provide the potential for earlier intervention.

Background and aim Anti-ZnT8 antibodies (ZnT8A) were recently proposed as a new independent serological marker in Type 1 diabetes (T1D), leading to a significant improvement of the positive predictive value of autoantibody measurement in this setting. The aim of this retrospective multicentre study was to investigate ZnT8A as a complement to the current T1D autoantibody assays in a large cohort of paediatric Italian patients. Methods ZnT8A were assessed by ELISA in 213 T1DM paediatric patients referred to six different centres in North-East Italy. Fifty-four were analysed at disease onset, 79 within 4 years from diagnosis and 80 after 5 or more years from diagnosis. Retrospective data about islet cell autoantibodies (ICA), anti-insulin (IAA), anti-glutamate decarboxylase (GADA) and anti-protein tyrosine phosphatase IA-2 (IA-2A) antibodies were collected and compared. Results Overall, ZnT8A showed positive results in 106/213 (49.8 %) T1D patients and were found in 10 (4.7 %) subjects previously classified as autoantibody negative based on the existing markers (GADA, IA-2A, IAA and ICA), increasing the overall diagnostic sensitivity from 85.9 to 90.6 %. ZnT8A disclosed the same sensitivity (61.1 %) at disease onset as GADA (61.1 %) and higher than IA-2A (53.7 %), with only GADA showing much persistence in the long-term follow-up. Focusing on patients at disease onset, all the ICA positive were associated with at least one positive autoantibody among GADA, IA-2A and ZnT8A, 16.7 % of whom presenting only anti-ZnT8-positive antibodies. Conclusion This study confirms ZnT8A as an important additional and independent diagnostic marker of T1D and supports its introduction in the routine diagnostic process to replace less sensitive methods and improve the overall autoantibody sensitivity. Electronic supplementary material The online version of this article (doi:10.1007/s13317-015-0068-4) contains supplementary material, which is available to authorized users.