Nuts consumption and hypertension risks in children: a mediating role of circulating lipid metabolites

BACKGROUND

Although nuts play an important role in preventing cardiovascular disease, the metabolic cues by which nuts regulate blood pressure have not been fully understood.Aims:We conducted a nested case-control study in a prospective cohort study of Southwest China children to explore the potential lipid metabolites related to the relationship between nut dietary and blood pressure.

METHODS

Forty-three hypertension cases and 53 controls serum samples were obtained for lipidomic data analysis using a liquid chromatography mass spectrometry platform.

RESULTS

We identified four lipid metabolites that are associated with nut intake by a generalized linear model and logistic regression analysis, including phosphatidylglycerol 43:6 [PG (43:6)], phosphatidylcholine 18:0/20:3 [PC (18:0/20:3)], and two phosphatidylethanolamine (PE) compounds [PE (P-16:0/20:4) and PE (P-22:0/18:2)]. Logistic regression analysis indicated that the levels of PG (43:6) and PE (P-16:0/20:4) were negatively associated with hypertension in children, which might be useful biomarkers for predicting childhood hypertension. Further mediation analysis revealed that PG (43:6) and PC (18:0/20:3) function as mediating variables between nut intake and blood pressure levels.

CONCLUSION

This study provides scientific evidence that nut consumption induces some beneficial changes in lipid metabolism, which may reduce the risk of hypertension in children.

The correlation between nuts and algae-less diet and children's blood pressure: from a cross-sectional study in Chongqing

BACKGROUND

Nuts and algae have been shown to improve BP levels, but their effectiveness is controversial.

AIMS

This study aims to illustrate the effect of dietary pattern with nuts and algae-less on BP levels in children and adolescents from a cross-sectional study.

METHODS

A total of 5645 children from the Chongqing Children's Health Cohort, aged 9.34 ± 1.74 years with 52.05% males, were analyzed. Stratified analysis was conducted to explore the differences between the two dietary patterns in urban or rural areas, as well as the differences in different gender. Logistic regression was used to analyze the influence factors of increased BP. And a GLM was used to analyze the influence of the two dietary patterns on systolic blood pressure (SBP, mmHg), diastolic blood pressure (DBP, mmHg), and mean arterial pressure (MAP, mmHg).

RESULTS

Children with nuts and algae-less dietary patterns had higher SBP (104.68 ± 10.31 vs 103.81 ± 9.74, P = .006), DBP (64.27 ± 7.53 vs 63.55 ± 7.52, P = .002), and MAP (77.74 ± 7.75 vs 76.97 ± 7.52, P = .001) compared with those children with a balanced diet. After adjusting for covariates, the nuts and algae-less diet was a risk factor for hypertension in children when compared with the balanced diet(OR(95%CI):1.455(1.097,1.930), P = .009). The nuts and algae-less diet has a significant influence on SBP (104.68 ± 10.31 mmHg vs.103.81 ± 9.74 mmHg, P = .006). Stratified analysis by sex showed that nuts and algae-less dietary patterns had a more significant impact on females than males.

CONCLUSION

Nuts and algae-less dietary pattern correlated with increased BP levels in children, and a greater impact on SBP levels was found in females, suggesting that a balanced diet with appropriate nuts and algae should be proposed for children in China.

The associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents: a prospective cohort study

Uncontrolled pediatric hypertension may increase the risk of hypertension in adulthood. Several studies have reported an association between hematological parameters and blood pressure (BP) levels. However, epidemiologic evidence of this association in children and adolescents remains scarce. This study aims to explore the associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents. This longitudinal study was conducted with 1368 participants aged 6-8 years from baseline visit to follow-up visit. Compared with participants from the normal blood pressure (BP) group, participants from the elevated BP group had significantly higher baseline red blood cell (RBC) counts, hemoglobin (Hb) counts and hematocrit (Hct) levels (all P < 0.001). A multilevel linear mixed model was conducted to analyze the relationship between hematological parameters and BP levels. The results suggested that SBP, DBP and MAP increased significantly with a quartile increase of levels of hematological parameters (all P < 0.05). Furthermore, a multilevel mixed logistic regression model was used to analyze the risk of per interquartile range increase in hematological parameters on the incidence of prehypertension and hypertension. The risk of prehypertension and hypertension incidence increased by (1.34 (95%CIs: 1.20, 1.50)), (1.38 (95%CIs: 1.24,1.54)), (1.33 (95%CIs: 1.19,1.50)), (1.14 (95%CIs: 1.03,1.26)) fold with a one-quartile increase in levels of RBC, Hb, Hct and Fe, respectively (all P < 0.05). This longitudinal study showed that hematological parameters were positively associated with BP levels in healthy children and adolescents, which excluded the effect of antihypertensive drugs on BP levels that often appeared in adults.

Effect of Massage on treatment of preterm feeding intolerance: Study protocol for a randomized controlled trial

AIM

To evaluate the effectiveness of massage on treating feeding intolerance (FI).

DESIGN

A randomized, controlled, prospective clinical trial.

METHODS

A total of 104 preterm infants whose gestational age between 28 and 34 weeks and birth weight between 1000 and 2000 g with diagnosis of FI were recruited. Participants were stratified by birth weight (1000-1499 g or 1500-2000 g) and randomized to either the intervention group, who will receive 7 days of massage, or the control group. The primary outcome is the time to reach full enteral nutrition. Secondary outcomes include duration of FI, change of body index, length of hospitalization, change of gastric residual volume, abdomen circumference and defecation measurement before and after 7 days of intervention.

RESULTS

Results of this study, which includes index on FI and physical development, have the potential to provide evidence that massage will alleviate symptoms of FI, and contribute to the long-term positive outcome of preterm infants.

Analysis of dietary patterns on cardiovascular risks in children: from a cross-sectional and a longitudinal study

OBJECTIVES

Diet is one of the main risk factors for cardiovascular disease (CVD), while the evidence about the relationship between dietary pattern (DP) and CVD in children is scarce. This study aims to explore the association between DP and CVD risk in children.

STUDY DESIGN

This was a cross-sectional and longitudinal study.

METHODS

This research was conducted among 4351 children aged 6-12 years old in 2014, then the subgroup children in 2014 were followed up in 2019. Dietary intakes were assessed using a food frequency questionnaire. DP was clustered based on 15 food items, and finally, four main DPs were obtained.

RESULTS

Four major DPs were identified: (1) low intake of nuts and algae pattern, (2) low-energy intake pattern, (3) high-energy intake pattern, and (4) regular DP. Compared with the regular diet pattern, the low intake of nuts and algae pattern was associated with the increased risk of higher systolic blood pressure (107.71 mm Hg vs 105.78 mm Hg, P < 0.001), diastolic blood pressure (64.98 mm Hg vs 63.91 mm Hg, P = 0.0056), hypertension (odds ratio [OR]:1.44, 95% confidence interval [CI]: 1.10, 1.88; P = 0.0036), dyslipidemia (OR: 2.41, 95% CI: 1.28, 4.52; P = 0.0194), and obesity (OR: 1.48, 95% CI: 1.16, 1.89; P = 0.0003) in children from a cross-sectional aspect in 2014 and it was also found associated with an increased risk of hypertension (OR: 2.67, 95% CI: 1.45, 4.92; P = 0.0017) in 2019.

CONCLUSIONS

Low nuts and algae intake combinations in children seemed associated with increased CVD risk. Such findings are imperative for national development of dietary recommendation for the prevention of CVDs.

The policy implemented by the government and the protection effect of PM2.5 decreasing on blood pressure in adolescents: From a quasi-experimental study

Background

High particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) exposure levels posed a great risk to human health, but the protection effects of environmental protection on cardiovascular disease have not been systematically evaluated. This study aims to illustrate the effect of the decreased concentration of PM2.5 on blood pressure level in adolescents after enacting the protection measures of environment from a cohort study.

Methods

A quasi-experimental study including 2415 children from the Chongqing Children's Health Cohort, aged 7.32 ± 0.60 years with normal blood pressure at baseline, with 53.94% males, were analysed. Both the generalised linear regression model (GLM) and Poisson regression model were used to calculate the impact of the declining exposure level of PM2.5 on blood pressure and the incidence of prehypertension and hypertension.

Results

The annual mean PM2.5 concentration in 2014 and in 2019 were 65.01 ± 6.46 µgmes per cubic metre (μg / m³), 42.08 ± 2.04 μg / m³ respectively, and the decreased PM2.5 concentration between 2014 and 2019 was 22.92 ± 4.51 μg / m³. The effect of decreased PM2.5 concentration by 1μg / m³ on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and the difference of blood pressure (BP) indexes between 2014 and 2019 were all significant (P < 0.001). The absolute differences of SBP (-3.598 mmHg; 95% confidence interval (CI) = -4.47,-2.72 mm Hg), DBP (-2.052 mmHg; 95% CI = -2.80,-1.31 mm Hg) and MAP (-2.568 mmHg; 95% CI = -3.27,-1.87 mm Hg) in the group with a decreased level of ≥25.56 μg / m³ were more significant than those in a decreased concentration of PM2.5 for <25.56 μg / m³ (P < 0.001). And the incidence of prehypertension and hypertension for three occasions blood pressure diagnose was 2.21% (95% CI = 1.37%-3.05%, P = 0.001) in children with PM2.5 decreased level ≤25.56 μg / m³ (50%), which was significant higher than its' counterparts 0.89% (95% CI = 0.37%-1.42%, P = 0.001).

Conclusions

Our study found the etiological relationship between the declining PM2.5 concentration and the BP values and the incidence of prehypertension and hypertension in children and adolescents, suggesting continuous environmental protection measures in China have achieved remarkable health benefits.

Analysis of cytokine levels, cytological findings, and MP-DNA level in bronchoalveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia

BACKGROUND

The present study was conducted to determine the inflammatory response in the lungs of children with Mycoplasma pneumoniae pneumonia (MPP).

METHODS

This study retrospectively analyzed cytokine levels, cytological findings, and M. pneumoniae (MP)-DNA level in the bronchoalveolar lavage fluid (BALF) of 96 children with MPP. The study utilized Spearman's correlation method to evaluate the contribution of BALF and blood parameters in MPP children.

RESULTS

(1) A total of 96 MPP children were classified into the Low MP-DNA MPP group (BALF MP-DNA ≤ 105 copies/mL) and the High MP-DNA MPP group (BALF MP-DNA > 105 copies/mL); the Non-fever MPP group (no fever during the entire course of pneumonia) and the Fever MPP group; the Defervescence MPP group (fever had subsided at the time of bronchoscopy) and the Fervescence MPP group; and the Mild MPP group and the Severe MPP group. (2) The High MP-DNA MPP, Fever MPP, Fervescence MPP, and Severe MPP groups had higher levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-α (TNF-α) in their BALF (all p < .05). (3) The proportions of neutrophils and macrophages in the BALF of the High MP-DNA MPP and Fever MPP groups increased and decreased, respectively (all p < .05). (4) In the BALF of MPP children, MP-DNA, IL-6, IL-10, TNF-α, and interferon gamma (IFN-γ) levels positively correlated with neutrophil proportion while negatively correlated with macrophage proportion (all p < .05). (5) The MP-DNA, IL-6, IL-10, TNF-α, and IFN-γ levels in the BALF of MPP children were positively correlated with the levels of C-reactive protein, procalcitonin, lactic dehydrogenase, fibrinogen, and d-dimer, while they were negatively correlated with the albumin level (all p < .05).

CONCLUSIONS

In children with MPP, the pulmonary inflammatory immune response was stronger in the High MP-DNA MPP, Fever MPP, Fervescence MPP, and Severe MPP groups. The relationship between pulmonary cytokine levels, MP-DNA load, and serum inflammatory parameters were found to be weak.

Environmental noise exposure and health outcomes: an umbrella review of systematic reviews and meta-analysis

BACKGROUND

Environmental noise is becoming increasingly recognized as an urgent public health problem, but the quality of current studies needs to be assessed. To evaluate the significance, validity and potential biases of the associations between environmental noise exposure and health outcomes.

METHODS

We conducted an umbrella review of the evidence across meta-analyses of environmental noise exposure and any health outcomes. A systematic search was done until November 2021. PubMed, Cochrane, Scopus, Web of Science, Embase and references of eligible studies were searched. Quality was assessed by AMSTAR and Grading of Recommendations, Assessment, Development and Evaluation (GRADE).

RESULTS

Of the 31 unique health outcomes identified in 23 systematic reviews and meta-analyses, environmental noise exposure was more likely to result in a series of adverse outcomes. Five percent were moderate in methodology quality, the rest were low to very low and the majority of GRADE evidence was graded as low or even lower. The group with occupational noise exposure had the largest risk increment of speech frequency [relative risk (RR): 6.68; 95% confidence interval (CI): 3.41-13.07] and high-frequency (RR: 4.46; 95% CI: 2.80-7.11) noise-induced hearing loss. High noise exposure from different sources was associated with an increased risk of cardiovascular disease (34%) and its mortality (12%), elevated blood pressure (58-72%), diabetes (23%) and adverse reproductive outcomes (22-43%). In addition, the dose-response relationship revealed that the risk of diabetes, ischemic heart disease (IHD), cardiovascular (CV) mortality, stroke, anxiety and depression increases with increasing noise exposure.

CONCLUSIONS

Adverse associations were found for CV disease and mortality, diabetes, hearing impairment, neurological disorders and adverse reproductive outcomes with environmental noise exposure in humans, especially occupational noise. The studies mostly showed low quality and more high-quality longitudinal study designs are needed for further validation in the future.

Risk factors of brain abscess in neonatal meningitis: a propensity score-matched study

Brain abscess is a rare but life-threatening complication of meningitis. The purpose of this study was to identify clinical features and potentially relevant factors of brain abscess in neonates with meningitis. This study was a propensity score-matched case-control study of neonates with brain abscess and meningitis in a tertiary pediatric hospital between January 2010 and December 2020. A total of 16 neonates with brain abscess were matched to 64 patients with meningitis. Demography, clinical characteristics, laboratory results, and pathogens were collected. Conditional logistic regression analyses were performed to identify the independent risk factors associated with brain abscess. The most common pathogen we found in the brain abscess group was Escherichia coli. Risk factors of brain abscess were identified: multidrug-resistant bacterial infection (OR, 11.204; 95% CI, 2.315-54.234; p = 0.003), C-reactive protein (CRP) > 50 mg/L (OR, 11.652; 95% CI, 1.799-75.470; p = 0.010).  Conclusion: The risk factors of brain abscess are multidrug-resistant bacterial infection and CRP > 50 mg/L. Monitoring the level of CRP is essential. Bacteriological culture and rational use of antibiotics are necessary for the prevention of MDR bacterial infection as well as the occurrence of brain abscess. What is Known: • Morbidity and mortality of neonatal meningitis have declined, but brain abscess associated with neonatal meningitis is still life-threatening. What is New: • This study investigated relevant factors related to brain abscess. • It is important for neonatologists to perform prevention, early identification, and appropriate interventions for neonates with meningitis.

Aortic Regurgitation Requiring Unplanned Surgery following Transcatheter Closure of Ventricular Septal Defect in Children: Incidence and Risk Factors

INTRODUCTION

Our aim was to investigate the incidence and risk factors for aortic regurgitation (AR) requiring unplanned surgery after transcatheter closure of ventricular septal defect (VSD) in children.

METHODS

Medical records of 876 children with VSD who underwent transcatheter closure from July 2009 to September 2018 in our hospital were retrospectively reviewed. Groups with and without new-onset or increasing AR requiring unplanned surgery were compared. Univariate and multivariate analyses were used to identify the possible risk factors. Smoothing plot and threshold effect analysis were carried out to find the relationship between possible factors and risk of new-onset or increasing AR.

RESULTS

A total of 29 children (3.3%) underwent unplanned surgery after transcatheter closure owing to new-onset or increasing AR, including 6 children with new-onset AR and 23 children with increasing AR. Multivariate regression analysis revealed that preoperative mild AR (OR: 60.39, 95% CI: 11.53-316.30, p < 0.001), larger ratio between diameter to body surface area (OR: 1.25, 95% CI: 1.01-1.55, p = 0.039), intracristal VSD (OR: 34.09, 95% CI: 4.07-285.65, p < 0.001), and shorter distance from the upper edge of defect to the aortic valve (or the sub-aortic rim) (OR: 0.12, 95% CI: 0.05-0.27, p < 0.001) were risk factors for new-onset or increasing AR requiring unplanned surgery. And, low risk of AR after muscular VSD transcatheter closure was found. An L-shaped nonlinear relationship between the sub-aortic rim and the risk of new-onset or increasing AR was observed, and the risk of new-onset or increasing AR with the sub-aortic rim up to the turning point (2 mm) (adjusted OR: 0.00, 95% CI: 0.00-0.08; p =0.001). With a median time of 7.3 years' follow-up, no new-onset or increasing AR has been found for children who initially did not have unplanned surgery.

CONCLUSION

Preoperative mild AR, larger ratio between diameter to body surface area, intracristal VSD, and shorter distance of the sub-aortic rim (especially <2 mm) could increase the risk of new-onset or increasing AR requiring unplanned surgery after transcatheter closure of VSD.