title: Cholinergic and oxidative stress mechanisms in sudden infant death syndrome.
abstract: OBJECTIVE
  To determine whether biochemical parameters of cholinergic and oxidative stress function including red cell acetylcholinesterase (AChE), serum/plasma thyroglobulin, selenium, iron, ferritin, vitamins C, E, and A affect risk in apparent life-threatening event (ALTE), sudden infant death syndrome (SIDS), and sudden unexpected death in infancy (SUDI). To assess these biochemical parameters as a function of age; and for influence of pharmacology and epidemiology, including infant health, care, and feeding practices.
  
  
  METHODS
  A multicentre, case-control study with blood samples from 34 ALTE and 67 non-ALTE (control) infants matched for age, and 30 SIDS/SUDI and four non-SIDS/non-SUDI (post-mortem control) infants.
  
  
  RESULTS
  Levels/activity of the biochemical parameters were not significantly different in ALTE vs. control infants, with the exception of higher vitamin C levels in the ALTE group (p = 0.009). In ALTE and control groups, AChE and thyroglobulin levels increased and decreased respectively from birth to attain normal adult levels from 6 months. Levels of iron and ferritin were higher in the first 6 month period for all infant groups studied, intersecting with vitamin C levels peaking around 4 months of age.
  
  
  CONCLUSIONS
  Lower AChE levels and higher combined levels of iron and vitamin C in the first 6 months of life may augment cholinergic and oxidative stress effect, particularly at the age when SIDS is most prevalent. This may contribute to risk of ALTE and SIDS/SUDI events during infancy.
authors.affiliation: Canterbury Cot Death Fellow, Community Paediatric Unit, Christchurch, New Zealand. anne@ccst.co.nz
authors.forename: Anne
authors.initials: A
authors.lastname: Dick
authors.forename: Rodney
authors.initials: R
authors.lastname: Ford
mesh_terms: D000110:Acetylcholinesterase / Q000097:blood*; D000367:Age Factors; D000704:Analysis of Variance; D016022:Case-Control Studies; D018678:Cholinergic Agents / Q000378:metabolism*; D005293:Ferritins / Q000097:blood; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007501:Iron / Q000097:blood; D009520:New Zealand / Q000453:epidemiology; D018384:Oxidative Stress / Q000502:physiology*; D012016:Reference Values; D012307:Risk Factors; D012643:Selenium / Q000097:blood; D013398:Sudden Infant Death / Q000209:etiology*; D011795:Surveys and Questionnaires; D013954:Thyroglobulin / Q000097:blood; D014815:Vitamins / Q000097:blood
chemical_list: D018678:Cholinergic Agents; D014815:Vitamins; D005293:Ferritins; D013954:Thyroglobulin; D007501:Iron; D000110:Acetylcholinesterase; D012643:Selenium
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