title: Evaluation of antioxidative/oxidative status and prolidase parameters in cases of inguinal hernia with joint hypermobility syndrome.
abstract: OBJECTIVE
  Most previous reports have shown that the basic mechanism of inguinal hernia involves insufficient collagen strength and metabolism. The aim of this study was to evaluate whether joint hypermobility is involved in the development of inguinal hernia in children and to investigate oxidative stress parameters and prolidase activity in tissue samples from children with inguinal hernia.
  
  
  METHODS
  This cross-sectional study involving 41 patients (age, 6.36 ± 2.96 years) with inguinal hernia treated in the pediatric surgery department of our institution and 40 age- and sex-matched controls (age, 6.02 ± 3.13 years) was performed from May to December 2011. Joint hypermobility was assessed using the Beighton criteria in all patients. Hernia sacs were analyzed with respect to the total antioxidative/oxidative status and prolidase activity. The patients were divided into two groups (inguinal hernia with and without hypermobility) according to a Beighton score cut-off of ≥6.
  
  
  RESULTS
  A total of 81 subjects aged 3-10 years participated. The ratio of joint hypermobility was significantly higher in patients than in controls (p = 0.01). The prolidase activity, total oxidant status, and oxidative stress index were higher in tissue samples from patients with joint hypermobility (p < 0.001).
  
  
  CONCLUSIONS
  Our results show that joint hypermobility syndrome is associated with inguinal hernia in children and that increased prolidase activity and oxidative stress in tissue samples from patients with joint hypermobility syndrome are related to collagen tissue damage and turnover.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, Harran University, 63100, Sanliurfa, Turkey, cevikmuazzez@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Cevik
authors.forename: P
authors.initials: P
authors.lastname: Yazgan
authors.forename: N
authors.initials: N
authors.lastname: Aksoy
mesh_terms: D000975:Antioxidants / Q000032:analysis; D002648:Child; D003094:Collagen / Q000032:analysis / Q000378:metabolism; D003430:Cross-Sectional Studies; D004150:Dipeptidases / Q000032:analysis / Q000378:metabolism*; D004535:Ehlers-Danlos Syndrome / Q000150:complications / Q000378:metabolism*; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007593:Joint Instability / Q000151:congenital; D008297:Male; D016877:Oxidants / Q000378:metabolism; D018384:Oxidative Stress; D010537:Peritoneum / Q000737:chemistry* / Q000378:metabolism
chemical_list: D000975:Antioxidants; D016877:Oxidants; D003094:Collagen; D004150:Dipeptidases; C022449:proline dipeptidase