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Adelantado-Renau M, Duncan M, Crotti M, Monzonís-Carda I, Moliner-Urdiales D, Beltran-Valls MR. The bidirectional longitudinal association between academic performance and cardiovascular disease risk factors in adolescents. Am J Hum Biol 2024:e24069. [PMID: 38491386 DOI: 10.1002/ajhb.24069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION The limited prior research examining the association between academic performance and cardiovascular disease (CVD) risk factors in youth did not explore the reciprocal association between these constructs, and analyzed CVD risk factors individually. Thus, the aim of the present study was to explore the bidirectional longitudinal association between clustered CVD risk score and academic performance in adolescents over a 24-month interval. METHODS A total of 237 adolescents (45.6% girls), aged 13.9 ± 0.3 years old at baseline, from DADOS (Deporte, ADOlescencia y Salud) study were included in this study. A clustered CVD risk score was created by calculating the mean age- and gender-standardized z-scores of waist circumference, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio, triglycerides, homeostatic model assessment of insulin resistance, and cardiorespiratory fitness (inversed). Academic performance was assessed through the final academic grades and the test of educational abilities. RESULTS Our results showed that the clustered CVD risk score at baseline was not associated with academic performance 24 months later (all p > .05). Nevertheless, except for physical education, academic grades at baseline were inversely associated with clustered CVD risk score at follow-up in adolescents (β ranged from -0.140 to -0.102; all p < .05). No associations were found between academic abilities at baseline and clustered CVD risk score at follow-up (all p > .05). CONCLUSION Academic grades could help predict CVD risk 24 months later during adolescence. Education professionals should foster adolescents' academic performance not only to improve academic results but also to maximize future cardiovascular health benefits.
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Affiliation(s)
| | - Michael Duncan
- Coventry University, Centre of Sport, Exercise and Life Science, Coventry, UK
| | - Matteo Crotti
- Coventry University, Centre of Sport, Exercise and Life Science, Coventry, UK
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Lin D, Chen D, Huang J, Li Y, Wen X, Ou P, Shi H. Breastfeeding is associated with reduced risks of central obesity and hypertension in young school-aged children: a large, population-based study. Int Breastfeed J 2023; 18:52. [PMID: 37697319 PMCID: PMC10496387 DOI: 10.1186/s13006-023-00581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 08/04/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Previous studies examined the effects of breastfeeding on measured values of body circumferences or blood pressure during childhood. However, limited data are available for the association between child feeding and a specific disease diagnosed as central obesity or hypertension. Hence, we aimed to examine whether the type and duration of breastfeeding are associated with obesity/central obesity or hypertension in young school-aged children. METHODS We matched the data obtained from a cross-sectional survey in 2019 with retrospective breastfeeding information recorded in the database. Heights, weights, waist circumferences, and blood pressures of 8480 children in first grade of primary schools in Shanghai, China were measured to diagnose obesity, central obesity, and hypertension. Data on child feeding was collected retrospectively from clinical records. Associations between the type/duration of breastfeeding and children's measured values of body mass index, waist circumference, and blood pressure were analysed by linear regression. Associations between the type/duration of breastfeeding and risks of obesity, central obesity, and hypertension were analysed by generalised linear models. RESULTS Breastfeeding duration was inversely associated with blood pressure values in children in the first grade. Each month's increase in the duration of any breastfeeding was associated with a 0.07 mmHg decrease in systolic blood pressure (P < 0.01) and a 0.05 mmHg decrease in diastolic blood pressure (P < 0.01). Any breastfeeding > one month was associated with a reduced risk of hypertension (adjusted risk ratio 0.84; 95% CI 0.73, 0.96, P = 0.01). Exclusive breastfeeding > one month was associated with a reduced risk of central obesity (adjusted risk ratio 0.76; 95% CI: 0.60, 0.96, P = 0.02). Any breastfeeding > 12 months was linked with a lower risk of hypertension (adjusted risk ratio 0.83; 95% CI 0.70, 0.98, P = 0.03). CONCLUSIONS Lack of breastfeeding is associated with higher risks of central obesity and hypertension during middle childhood. As a potential component of the public health strategy to reduce population levels of metabolic and cardiovascular diseases, breastfeeding could be a vital prevention strategy.
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Affiliation(s)
- Dan Lin
- Fujian Maternity and Child Health Hospital, Fuzhou, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Didi Chen
- Minhang Center of Disease Control and Prevention, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Jun Huang
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Yun Li
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Xiaosa Wen
- Minhang Center of Disease Control and Prevention, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Ping Ou
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
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Bustos-Aibar M, Aguilera CM, Alcalá-Fdez J, Ruiz-Ojeda FJ, Plaza-Díaz J, Plaza-Florido A, Tofe I, Gil-Campos M, Gacto MJ, Anguita-Ruiz A. Shared gene expression signatures between visceral adipose and skeletal muscle tissues are associated with cardiometabolic traits in children with obesity. Comput Biol Med 2023; 163:107085. [PMID: 37399741 DOI: 10.1016/j.compbiomed.2023.107085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/28/2023] [Accepted: 05/27/2023] [Indexed: 07/05/2023]
Abstract
Obesity in children is related to the development of cardiometabolic complications later in life, where molecular changes of visceral adipose tissue (VAT) and skeletal muscle tissue (SMT) have been proven to be fundamental. The aim of this study is to unveil the gene expression architecture of both tissues in a cohort of Spanish boys with obesity, using a clustering method known as weighted gene co-expression network analysis. For this purpose, we have followed a multi-objective analytic pipeline consisting of three main approaches; identification of gene co-expression clusters associated with childhood obesity, individually in VAT and SMT (intra-tissue, approach I); identification of gene co-expression clusters associated with obesity-metabolic alterations, individually in VAT and SMT (intra-tissue, approach II); and identification of gene co-expression clusters associated with obesity-metabolic alterations simultaneously in VAT and SMT (inter-tissue, approach III). In both tissues, we identified independent and inter-tissue gene co-expression signatures associated with obesity and cardiovascular risk, some of which exceeded multiple-test correction filters. In these signatures, we could identify some central hub genes (e.g., NDUFB8, GUCY1B1, KCNMA1, NPR2, PPP3CC) participating in relevant metabolic pathways exceeding multiple-testing correction filters. We identified the central hub genes PIK3R2, PPP3C and PTPN5 associated with MAPK signaling and insulin resistance terms. This is the first time that these genes have been associated with childhood obesity in both tissues. Therefore, they could be potential novel molecular targets for drugs and health interventions, opening new lines of research on the personalized care in this pathology. This work generates interesting hypotheses about the transcriptomics alterations underlying metabolic health alterations in obesity in the pediatric population.
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Affiliation(s)
- Mireia Bustos-Aibar
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071, Granada, Spain.
| | - Concepción M Aguilera
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071, Granada, Spain; Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029, Madrid, Spain.
| | - Jesús Alcalá-Fdez
- Department of Computer Science and Artificial Intelligence, Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, 18071, Granada, Spain.
| | - Francisco J Ruiz-Ojeda
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071, Granada, Spain; RG Adipocytes and Metabolism, Institute for Diabetes and Obesity, Helmholtz Diabetes Center at the Helmholtz Zentrum München, Neuherberg, 85764, Munich, Germany.
| | - Julio Plaza-Díaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071, Granada, Spain; Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Ontario, Canada.
| | - Abel Plaza-Florido
- PROmoting FITness and Health through physical activity research group, Sport and Health University Research Institute, Department of Physical Education and Sports, University of Granada, 18071, Granada, Spain; Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California at Irvine, Irvine, 92617, CA, United States.
| | - Inés Tofe
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029, Madrid, Spain; University Clinical Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba, University of Córdoba, 14004, Córdoba, Spain.
| | - Mercedes Gil-Campos
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029, Madrid, Spain; University Clinical Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba, University of Córdoba, 14004, Córdoba, Spain.
| | - María J Gacto
- Department of Software Engineering, University of Granada, 18071, Granada, Spain.
| | - Augusto Anguita-Ruiz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071, Granada, Spain; Barcelona Institute for Global Health, ISGlobal, 08003, Barcelona, Spain.
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Ruiz-Ojeda FJ, Anguita-Ruiz A, Rico MC, Leis R, Bueno G, Moreno LA, Gil-Campos M, Gil Á, Aguilera CM. Serum levels of the novel adipokine isthmin-1 are associated with obesity in pubertal boys. World J Pediatr 2023; 19:864-872. [PMID: 36595188 PMCID: PMC10423122 DOI: 10.1007/s12519-022-00665-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/21/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1 (ISM1) and obesity-related phenotypes in a population of Spanish children and to investigate the plausible molecular alterations behind the alteration of the serum levels of this protein in children with obesity. METHODS The study population is a sub-cohort of the PUBMEP research project, consisting of a cross-sectional population of 119 pubertal children with overweight (17 boys, 19 girls), obesity (20 boys, 25 girls), and normal weight (17 boys, 21 girls). All subjects were classified into experimental groups according to their sex, obesity, and insulin resistance (IR) status. They were counted anthropometry, glucose and lipid metabolism, inflammation and cardiovascular biomarkers as well as isthmin-1 (ISM1) serum levels. This population was intended as a discovery population to elucidate the relationship between obesity and ISM1 levels in children. Furthermore, the study population had blood whole-genome DNA methylation examined, allowing deepening into the obesity-ISM1 molecular relationship. RESULTS Higher serum ISM1 levels were observed in boys with obesity than in normal weight (P = 0.004) and overweight (P = 0.007) boys. ISM1 serum levels were positively associated with body mass index (BMI) Z-score (P = 0.005) and fat mass (P = 0.058) and negatively associated with myeloperoxidase (MPO) (P = 0.043) in boys. Although we did not find associations between ISM1 serum levels and metabolic outcomes in girls, which may indicate a putative sexual dimorphism, fat mass was positively associated in all children, including boys and girls (P = 0.011). DNA methylation levels in two-enhancer-related CpG sites of ISM1 (cg03304641 and cg14269097) were associated with serum levels of ISM1 in children. CONCLUSIONS ISM1 is associated with obesity in boys at the pubertal stage, elucidating how this protein might be of special relevance as a new biomarker of obesity in children. Further studies including a longitudinal design during puberty are needed.
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Affiliation(s)
- Francisco Javier Ruiz-Ojeda
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain.
- Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain.
- Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento S/N. 18016 Armilla, Granada, Spain.
- RG Adipocytes and Metabolism, Institute for Diabetes and Obesity, Helmholtz Center Munich, 85764, Munich, Germany.
| | - Augusto Anguita-Ruiz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain.
- Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain.
- Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento S/N. 18016 Armilla, Granada, Spain.
- Barcelona Institute for Global Health, ISGlobal, 08003, Barcelona, Spain.
| | - Maria C Rico
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento S/N. 18016 Armilla, Granada, Spain
| | - Rosaura Leis
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
- Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
- Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS) CHUS-USC, 15706, Santiago de Compostela, Spain
- Unit of Pediatric Gastroenterology, Hepatology and Nutritio, Pediatric Service, University Clinical Hospital of Santiago (CHUS), 15706, Santiago de Compostela, Spain
| | - Gloria Bueno
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
- GENUD Research group, Institute of Sanitary Research of Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza-CITA, Zaragoza, Spain
- Unit of Pediatric Endocrinology, University Clinical Hospital Lozano Blesa, 50009, Zaragoza, Spain
| | - Luis A Moreno
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
- GENUD Research group, Institute of Sanitary Research of Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza-CITA, Zaragoza, Spain
| | - Mercedes Gil-Campos
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, 14071, Córdoba, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain
- Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento S/N. 18016 Armilla, Granada, Spain
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
| | - Concepción M Aguilera
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain
- Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento S/N. 18016 Armilla, Granada, Spain
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
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Walter SM, Dai Z, Wang K. Comorbidities of Rural Children and Adolescents with Migraine and without Migraine. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1133. [PMID: 37508629 PMCID: PMC10378174 DOI: 10.3390/children10071133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/16/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: Migraine is associated with comorbidities that are common in the general rural pediatric population. The purpose of this study is to evaluate the differences in the occurrence of comorbidities between rural children and adolescents with and without migraine. (2) Methods: A cross-sectional, secondary data analysis using electronic medical records of 1296 patients (53.8% females, aged 12.4 ± 3.2) was completed. Mann-Whitney U test was used to detect the difference in the number of comorbidities between the two groups. Chi-square test was used to identify the differences in the number of comorbidities, which were classified as low (0-1 comorbidities), medium (2-3 comorbidities), and high (4 or plus comorbidities) degree of comorbidities. (3) Results: Significant differences were found between those children and adolescents with migraine vs. those without for depression (p < 0.0001), anxiety (p < 0.0001), and Ehlers-Danlos Syndrome (EDS; p = 0.0309). A marginally significant difference was found between those children and adolescents with migraine (47.2%; n = 306) vs. those without (42.1%; n = 273) for unhealthy weight (p = 0.0652). Approximately 40% of the migraineurs had 2-3 comorbidities, whereas 32% of the non-migraineurs had 2-3 comorbidities (p = 0.0003). (4) Conclusions: Findings demonstrate the importance of identifying comorbidities associated with rural pediatric migraine in order to develop effective treatment strategies that optimize patient outcomes.
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Affiliation(s)
- Suzy Mascaro Walter
- Department of Family and Community Health, School of Nursing, West Virginia University, Morgantown, WV 26506, USA
| | - Zheng Dai
- Health Affairs Institute, West Virginia University, Morgantown, WV 26506, USA
| | - Kesheng Wang
- Department of Family and Community Health, School of Nursing, West Virginia University, Morgantown, WV 26506, USA
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Agostinis-Sobrinho C, Kievisiene J, Dubey V, Rauckiene-Michealsson A, Norkiene S, Ramirez-Velez R, Reuter CP, Brand C, Mota J, Santos R. Cardiovascular health behavior and blood pressure in adolescents: A longitudinal analysis. Nutr Metab Cardiovasc Dis 2022; 32:1766-1773. [PMID: 35599087 DOI: 10.1016/j.numecd.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The ideal cardiovascular health behaviors (ICHB) have been associated with a subsequent positive health status in adults. However, evidence regarding blood pressure (BP) and ICHB in adolescents is scarce. The aim of this prospective cohort was to evaluate the impact of accumulation of ICHB on BP values in adolescents over two years. METHODS This is a longitudinal analysis with 445 adolescents (232 girls) aged 12-18 years old. Resting blood pressure was measured at baseline and 2 years later, and ICHBs at baseline according to standard procedures. Based on the American Heart Association definition, the ICHB index was defined as a sum of meeting the ICHBs (from 0 to 4, where 4 would be the healthiest profile of all ICHBs) for a healthy diet, physical activity, smoking status and body mass index. RESULTS Adjusted means values (ANCOVA) of BP parameters through achievement of a greater number of (between 1-4) the ICHBs (adjusting for potential confounders, age, sex, pubertal stage and socioeconomic status) showed that, as increase the number of ICHB accumulated as a lower the BP levels [ICHB and SBP (F3.435) = 4.501, p = 0.004), DBP (F(3.435) = 2.725, p = 0.044), pulse pressure (F(3.435) = 4.004, p = 0.008), and rate pressure product (F(3.435) = 2.866, p = 0.036)] over two years. CONCLUSION A lower number of ICHB (smoking status, body mass index, physical activity, and diet) during adolescence play a key role on blood pressure over two years. A higher number of ICHB is seen to be associated with a lower risk of short-term, hypertension.
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Affiliation(s)
| | | | - Viney Dubey
- Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | | | - Sigute Norkiene
- Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Robinson Ramirez-Velez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health, Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Cezane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz Do Sul, Santa Cruz Do Sul, RS, Brazil
| | - Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz Do Sul, Santa Cruz Do Sul, RS, Brazil
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
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Llorente-Cantarero FJ, Leis R, Rupérez AI, Anguita-Ruiz A, Vázquez-Cobela R, Flores-Rojas K, González-Gil EM, Aguilera CM, Moreno LA, Gil-Campos M, Bueno G. Prepubertal Children With Metabolically Healthy Obesity or Overweight Are More Active Than Their Metabolically Unhealthy Peers Irrespective of Weight Status: GENOBOX Study. Front Nutr 2022; 9:821548. [PMID: 35495947 PMCID: PMC9040553 DOI: 10.3389/fnut.2022.821548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background and Aim The association of a metabolically healthy status with the practice of physical activity (PA) remains unclear. Sedentarism and low PA have been linked to increased cardiometabolic risk. The aim of this study was to evaluate the PA levels in metabolically healthy (MH) or unhealthy (MU) prepubertal children with or without overweight/obesity. Methods A total 275 children (144 boys) with 9 ± 2 years old were selected for the GENOBOX study. PA times and intensities were evaluated by accelerometry, and anthropometry, blood pressure, and blood biochemical markers were analyzed. Children were considered to have normal weight or obesity, and further classified as MH or MU upon fulfillment of the considered metabolic criteria. Results Classification resulted in 119 MH children (21% with overweight/obesity, referred to as MHO) and 156 MU children (47% with overweight/obesity, referred to as MUO). Regarding metabolic profile, MHO showed lower blood pressure levels, both systolic and diastolic and biochemical markers levels, such as glucose, Homeostatic Model Assessment of Insulin Resistance, triglycerides and higher HDL-c levels than MUO (P < 0.001). In addition, MHO children spent more time in PA of moderate intensity compared with MUO children. In relation to vigorous PA, MH normal weight (MHN) children showed higher levels than MUO children. Considering sex, boys spent more time engaged in moderate, vigorous, and moderate–vigorous (MV) PA than girls, and the number of boys in the MH group was also higher. Conclusion Prepubertal MHO children are less sedentary, more active, and have better metabolic profiles than their MUO peers. However, all children, especially girls, should increase their PA engagement, both in terms of time and intensity because PA appears to be beneficial for metabolic health status itself.
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Affiliation(s)
- Francisco Jesús Llorente-Cantarero
- Department of Specific Didactics, Faculty of Education, Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain.,Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Rosaura Leis
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Department of Pediatrics, University of Santiago de Compostela, Santiago de Compostela, Spain.,Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Instituto de Investigación Sanitaria de Santiago (IDIS), University Clinical Hospital of Santiago, Santiago de Compostela, Spain
| | - Azahara I Rupérez
- Grupo de Nutrición, Alimentación, Crecimiento y Desarrollo (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Augusto Anguita-Ruiz
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Biochemistry and Molecular Biology II, Center of Biomedical Research, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain.,Instituto de Investigación Biosanitariaibs, Granada, Spain
| | - Rocío Vázquez-Cobela
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Department of Pediatrics, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Katherine Flores-Rojas
- Metabolism and Investigation Unit, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - Esther M González-Gil
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Grupo de Nutrición, Alimentación, Crecimiento y Desarrollo (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain.,Department of Biochemistry and Molecular Biology II, Center of Biomedical Research, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain.,Instituto de Investigación Biosanitariaibs, Granada, Spain
| | - Concepción M Aguilera
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Biochemistry and Molecular Biology II, Center of Biomedical Research, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain.,Instituto de Investigación Biosanitariaibs, Granada, Spain
| | - Luis A Moreno
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Grupo de Nutrición, Alimentación, Crecimiento y Desarrollo (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Mercedes Gil-Campos
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Metabolism and Investigation Unit, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - Gloria Bueno
- Center of Biomedical Research on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Grupo de Nutrición, Alimentación, Crecimiento y Desarrollo (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain.,Unidad de Endocrinología Pediátrica, Hospital Clínico Lozano Blesa, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
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Tang X, Liu Y, Hu J, Zhai L, Jia L, Ding N, Ma Y, Wen D. Association of waist circumference with blood pressure and familial dietary habits in preschool children: a cross-sectional study in northeastern China. Ital J Pediatr 2022; 48:53. [PMID: 35365196 PMCID: PMC8973802 DOI: 10.1186/s13052-022-01236-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background Childhood obesity increases the risk of elevated blood pressure (BP) in children. Body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) are traditional obesity indices, but the extent to which these indices are associated with elevated BP in childhood remains debatable. Moreover, the familial dietary environment plays an important role in obesity, so it is necessary to determine the most relevant dietary factors for childhood obesity to prevent elevated BP. Our study aimed to identify the obesity indices that are most closely associated with elevated BP and then to determine the independent familial dietary factors for those obesity indices. Method A total of 605 children aged 2 to 6 years, as well as their parents, were involved in this study. The weight, height, WC and BP of the children were measured. Information on familial environments was obtained by questionnaires completed by the parents. BMI, WC and WHtR were standardized into z scores, and categorical variables of these three obesity indices were defined as BMI Category, WC Category and WHtR Category. Logistic regression was used to analyse the associations between all obesity indices and elevated BP. Multivariate linear regression and logistic regression were used to determine the independent factors for obesity indices. Results The obesity indices that were most closely associated with elevated BP were WC and WC Category. Parental BMI, birth weight, eating wheat as a staple food, appetite, eating speed, snacking while watching TV, parental encouragement to eat a diverse assortment of foods and drinking milk were independently associated with WC in both males and females. The risk of abdominal obesity increased 1.375 times in males and 1.631 times in females if appetite increased one level. If eating speed increased one level, the risk of abdominal obesity increased 1.165 times in males and 0.905 times in females. Females who drank milk more than 6 times per week had a 0.546 times lower risk of abdominal obesity. Conclusion WC was an anthropometric parameter more closely associated with elevated BP. In addition to genetics, some familial dietary factors involving eating preference, eating habits and parental feeding practice were independently associated with WC and abdominal obesity in preschool children. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-022-01236-3.
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Affiliation(s)
- Xiao Tang
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,School of Public Health, Dalian Medical University, Dalian, Liaoning Province, 116044, P.R. China
| | - Yang Liu
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Lingling Zhai
- School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Lihong Jia
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.,School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Ning Ding
- Institute of International Medical Education, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China. .,Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang, Liaoning Province, 110122, P.R. China.
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Wang X, Hu J, Huang S, Yang Z, Dong Y, Dong B, Ma J, Liang W. Exploring Overweight Risk Trajectories During Childhood and Their Associations With Elevated Blood Pressure at Late Adolescence: a Retrospective Cohort Study. Hypertension 2022; 79:1605-1613. [PMID: 35094521 DOI: 10.1161/hypertensionaha.121.18714] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Overweight during childhood is significantly associated with higher risk of high blood pressure (HBP) in later life. However, recognition of critical intervention period is limited. We aimed to analyze the changes in overweight risk during school-age and its relationship with HBP. METHODS Seventeen thousand eight hundred sixteen school-aged children (53.9% boys) with a mean follow-up time of 8.2 years were involved. Children's overweight was defined as body mass index Z score ≥1 and was fitted with a group-based trajectory model. The 4 trajectories were labeled as constant low, high decreasing, low rising, and constant high according to the change of overweight risk during follow-up. Population-averaged logit model and log-binomial regression models were used to analyze HBP risk. Cox proportional hazard model was used to analyze the HBP incidence among distinct groups. RESULTS Children with higher overweight risk generally had higher HBP risk during follow-up. However, the HBP risk in low rising group was low at baseline and increased to 3.14 (95% CI, 2.54-3.88; P<0.001) for boys and 3.23 (95% CI, 2.08-5.01; P=0.004) for girls at end point, which were comparable to the relative risk in the constant high group (4.60 [95% CI, 4.02-5.27] for boys and 5.28 [95% CI, 3.94-7.07] for girls). CONCLUSIONS Findings of this study provide insights on patterns of overweight risks during childhood. Children with transition from normal to overweight during teen years would be high-risk in HBP incidence.
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Affiliation(s)
- Xijie Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China. (X.W., W.L.).,Institute for Healthy China, Tsinghua University, Beijing, China. (X.W., W.L.).,Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Australia (J.H.)
| | - Sizhe Huang
- Zhongshan Health Care Centers for Primary and Secondary School, Guangdong, China (S.H.)
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China. (X.W., W.L.).,Institute for Healthy China, Tsinghua University, Beijing, China. (X.W., W.L.)
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10
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Pires LV, González-Gil EM, Anguita-Ruiz A, Bueno G, Gil-Campos M, Vázquez-Cobela R, Pérez-Ferreirós A, Moreno LA, Gil Á, Leis R, Aguilera CM. The Vitamin D Decrease in Children with Obesity Is Associated with the Development of Insulin Resistance during Puberty: The PUBMEP Study. Nutrients 2021; 13:nu13124488. [PMID: 34960039 PMCID: PMC8709093 DOI: 10.3390/nu13124488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 01/16/2023] Open
Abstract
Obesity and cardiometabolic risk have been associated with vitamin D levels even in children. The objective of the present study was to evaluate the association between insulin resistance (IR), cardiometabolic risk factors, and vitamin D in children from prepubertal to pubertal stages. A total of 76 children from the PUBMEP study, aged 4–12 years at baseline, were included. Children were evaluated in prepubertal and pubertal stages. Anthropometric measurements and selected cardiometabolic risk biomarkers, such as plasma glucose, blood lipids, insulin, adiponectin, leptin, and blood pressure, and serum 25-hydroxyvitamin D (25(OH)D) were determined. Children were categorized by obesity degree and IR status combined before and after puberty. Paired t-test and multivariate linear regression analyses were conducted. During puberty, the increase in triacylglycerols, insulin, and HOMA-IR and the decrease in QUICKI were significantly associated with the reduction in 25(OH)D (B = −0.274, p = 0.032; B = −0.219, p = 0.019; B = −0.250, p = 0.013; B = 1.574, p = 0.013, respectively) after adjustment by BMI-z, sex, and pubertal stage. Otherwise, prepubertal non-IR children with overweight/obesity that became IR during puberty showed a significant decrease in 25(OH)D and HDL-c, and an increase in waist circumference and triacylglycerol concentrations (p < 0.05 for all) over time. These results suggest that changes in IR seem to be associated with an effect on 25(OH)D levels during puberty, especially in children with overweight.
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Affiliation(s)
- Liliane Viana Pires
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain; (L.V.P.); (E.M.G.-G.); (A.A.-R.); (Á.G.)
- Center of Biomedical Research, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n, 18016 Armilla, Spain
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Federal University of Sergipe, Saint Cristopher 49100-000, Brazil
| | - Esther M. González-Gil
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain; (L.V.P.); (E.M.G.-G.); (A.A.-R.); (Á.G.)
- Center of Biomedical Research, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n, 18016 Armilla, Spain
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (G.B.); (L.A.M.)
| | - Augusto Anguita-Ruiz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain; (L.V.P.); (E.M.G.-G.); (A.A.-R.); (Á.G.)
- Center of Biomedical Research, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n, 18016 Armilla, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
| | - Gloria Bueno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (G.B.); (L.A.M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
- Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Mercedes Gil-Campos
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
- Department of Pediatric Endocrinology, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), Reina Sofia University Clinical Hospital, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Cordoba, Spain
| | - Rocío Vázquez-Cobela
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
- Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Pediatric Department (USC), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), University Clinical Hospital, 15706 Santiago de Compostela, Spain;
| | - Alexandra Pérez-Ferreirós
- Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Pediatric Department (USC), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), University Clinical Hospital, 15706 Santiago de Compostela, Spain;
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, 50009 Zaragoza, Spain; (G.B.); (L.A.M.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
- Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain; (L.V.P.); (E.M.G.-G.); (A.A.-R.); (Á.G.)
- Center of Biomedical Research, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n, 18016 Armilla, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
- Instituto de Investigación Biosanitaria ibs., 18012 Granada, Spain
| | - Rosaura Leis
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
- Instituto de Investigación Biosanitaria ibs., 18012 Granada, Spain
- Correspondence: (R.L.); (C.M.A.)
| | - Concepción M. Aguilera
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain; (L.V.P.); (E.M.G.-G.); (A.A.-R.); (Á.G.)
- Center of Biomedical Research, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n, 18016 Armilla, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (M.G.-C.); (R.V.-C.)
- Department of Pediatric Endocrinology, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), Reina Sofia University Clinical Hospital, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Cordoba, Spain
- Correspondence: (R.L.); (C.M.A.)
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11
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Chen M, Ma Y, Ma T, Li Y, Gao D, Chen L, Liu J, Zhang Y, Jiang J, Wang X, Dong Y, Ma J. The association between growth patterns and blood pressure in children and adolescents: A cross-sectional study of seven provinces in China. J Clin Hypertens (Greenwich) 2021; 23:2053-2064. [PMID: 34847290 PMCID: PMC8696227 DOI: 10.1111/jch.14393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/12/2021] [Accepted: 11/02/2021] [Indexed: 01/22/2023]
Abstract
Aimed to investigate the associations between different growth patterns with high blood pressure, and further examine the mediation effect of BMI between growth patterns and high blood pressure among children and adolescents. A total of 31581 children and adolescents aged 7–18 years were selected based on the stratified cluster sampling method. Logistics regression models were used to calculate the odds rations (ORs) and 95% confidence interval (95%CI) of the association between different growth patterns and high blood pressure. Mediation effect analyses were applied to estimate the effect of BMI on the increase of blood pressure levels in different growth patterns. In different sex and ages, compared to reference group of normal growth, blood pressure levels and prevalence of high blood pressure of the catch‐up growth were higher, but that of the catch‐down growth were lower. The prevalence of high blood pressure was 11.69%, 16.06%, and 9.68% in normal growth, catch‐up growth, and catch‐down growth, respectively. In total, compared with the normal growth pattern, the ORs (95%CI) of high blood pressure, high systolic blood pressure and high diastolic blood pressure in the catch‐up growth were 1.171(1.073,1.280), 1.110(1.001,1.230) and 1.141(1.025,1.270) (p < .05), respectively. Additionally, the mediation effect of current BMI existed in the association between blood pressure levels and different growth patterns, particularly in boys. Our findings suggested that different growth patterns after birth could modify blood pressure, and the potential risks of high blood pressure could be increased by catch‐up growth at childhood and adolescence.
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Affiliation(s)
- Manman Chen
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Ying Ma
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Tao Ma
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Yanhui Li
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Di Gao
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Li Chen
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Jieyu Liu
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Yi Zhang
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Jun Jiang
- Department of Plant Science and Landscape Architecture, University of Maryland, College Park, Maryland, USA
| | - Xinxin Wang
- School of Public Health and Management, Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Ningxia, China
| | - Yanhui Dong
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Jun Ma
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
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12
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Impact of Physical Activity Intensity Levels on the Cardiometabolic Risk Status of Children: The Genobox Study. Int J Sport Nutr Exerc Metab 2021; 32:102-110. [PMID: 34853181 DOI: 10.1123/ijsnem.2021-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 10/07/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022]
Abstract
Childhood obesity has been related to metabolic syndrome and low-grade chronic inflammation. This study aimed to evaluate the impact of physical activity intensities and practice on inflammation, endothelial damage, and cardiometabolic risk factors in children. There were 513 participants, aged 6-14 years, recruited for the study. Physical activity was measured by accelerometry, and the children were classified into four groups according to quartiles of moderate to vigorous physical activity (MVPA) practice as very low active, low active, moderate active, and high active. Anthropometric measures, blood pressure, and plasma metabolic and proinflammatory parameters were analyzed. Very low active group presented a worse lipid profile and higher insulin, leptin, adiponectin, resistin, matrix metallopeptidase-9, and tissue plasminogen activator inhibitor-1, while lower levels of tumor necrosis factor-alpha, Type 1 macrophages, and interleukin 8 than high-active children. Regression analyses showed that a higher MVPA practice was associated with lower levels of triacylglycerols (β: -0.118; p = .008), resistin (β: -0.151; p = .005), tPAI (β: -0.105; p = .046), and P-selectin (β: -0.160; p = .006), independently of sex, age, and body mass index (BMI). In contrast, a higher BMI was associated with higher levels of insulin (β: 0.370; p < .001), Homeostasis Model Assessment (β: 0.352; p < .001), triacylglycerols (β: 0.209; p < .001), leptin (β: 0.654; p < .001), tumor necrosis factor-alpha (β: 0.182; p < .001), Type 1macrophages (β: 0.181; p < .001), and tissue plasminogen activator inhibitor (β: 0.240; p < .001), independently of sex, age, and MVPA. A better anthropometric, metabolic, and inflammatory profile was detected in the most active children; however, these differences were partly due to BMI. These results suggest that a higher MVPA practice and a lower BMI in children may lead to a better cardiometabolic status.
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13
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Cao D, Chen Y, Gao X, Zhu Y, Wu D, Liu G. Hypertension in 172 Chinese Children: An 8-Year Retrospective Study. J NIPPON MED SCH 2021; 88:178-188. [PMID: 34193741 DOI: 10.1272/jnms.jnms.2021_88-301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND We evaluated children with hypertension and compared those with essential and secondary (including renal and non-renal) hypertension. METHODS This retrospective study analyzed data from hypertensive children (age, 0-18 years) referred for treatment between January 2008 and December 2015. Demographic factors, causative factors, and medical treatments were evaluated. Treatment failure was defined as a systolic or diastolic blood pressure ≥95th percentile for age, gender, and height on three separate occasions, despite treatment. All patients not meeting the failure criteria were considered to have controlled hypertension. The control rate was defined as the proportion of patients with controlled blood pressure. RESULTS Among 172 consecutive patients, 28% had essential hypertension and 72% had secondary hypertension. As compared with children with secondary hypertension, those with essential hypertension had a higher frequency of family history of hypertension (P<0.001), a higher body mass index (BMI) (P=0.001), lower frequency of proteinuria (P=0.003), lower uric acid (P=0.04), and lower triglyceride (P=0.048). The medications used in the controlled group were similar to those used in the uncontrolled group. Angiotensin-converting enzyme inhibitors (ACEIs) were only used in nephrogenic patients, and a higher rate of ACEI use seemed to increase control rates. Control rates did not significantly differ by age, number of drugs, or cause of hypertension. CONCLUSIONS As compared with children with secondary hypertension, those with essential hypertension were more likely to have a family history of hypertension and had a higher BMI, lower frequency of proteinuria, and lower uric acid and triglyceride concentrations. Treatment guidelines for essential and secondary hypertension should be established for children of all ages.
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Affiliation(s)
- Di Cao
- Medical Affairs Department, Children's Hospital of Fudan University
| | - Yewei Chen
- Department of Pharmacy, Children's Hospital of Fudan University
| | - Xuan Gao
- Department of Pharmacy, Children's Hospital of Fudan University
| | - Yiqing Zhu
- Department of Pharmacy, Children's Hospital of Fudan University
| | - Dan Wu
- Department of Pharmacy, Children's Hospital of Fudan University
| | - Gongbao Liu
- Medical Affairs Department, Children's Hospital of Fudan University
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14
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Leon EBD, Tavares BM, Fernandes TG, Gonçalves RL, Franco FFS, Souza MBCAD, Fischer FM, Barroso BIDL. Study of Cardiovascular Risks in Adolescents (ERICA): factors associated with work in adolescence. CIENCIA & SAUDE COLETIVA 2021; 26:2601-2612. [PMID: 34231673 DOI: 10.1590/1413-81232021267.08912021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to verify the association between work and sociodemographic factors, health behaviors, and cardiovascular risk in Brazilian adolescents. Data from the Study of Cardiovascular Risks in Adolescents (ERICA) were analyzed, with a sample of 37,815 adolescents aged 12-17 years and morning shift students. Considering complex sampling, crude and adjusted Prevalence Ratios (PR) were calculated with interval estimates for variables by Poisson multiple regression model with robust variance estimate. The sociodemographic factors associated with work among Brazilian adolescents were male gender (PR 1.34), aged 15-17 years, with maternal schooling up to elementary school (PR 1.26), public school students (PR 1.63), and from the rural area (PR 1.90). Regarding lifestyle habits and social behavior, the association was significant in physically active (PR 1.19) and alcohol-consuming students (PR 1.35). In conclusion, work among Brazilian adolescent morning shift students is still strongly linked to social issues. Work was associated with alcohol consumption, and there was no association with metabolic markers.
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Affiliation(s)
- Elisa Brosina de Leon
- Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas (UFAM). Av. General Rodrigo Octávio 6200, Coroado I. 69080-900 Manaus AM Brasil.
| | | | - Tiótrefis Gomes Fernandes
- Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas (UFAM). Av. General Rodrigo Octávio 6200, Coroado I. 69080-900 Manaus AM Brasil.
| | - Roberta Lins Gonçalves
- Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas (UFAM). Av. General Rodrigo Octávio 6200, Coroado I. 69080-900 Manaus AM Brasil.
| | - Fernanda Figueiroa Sanchez Franco
- Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas (UFAM). Av. General Rodrigo Octávio 6200, Coroado I. 69080-900 Manaus AM Brasil.
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Beltran-Valls MR, Santos R, Mota J, Moreira C, Lopes L, Agostinis-Sobrinho C. The mediating role of adiposity in the longitudinal association between cardiorespiratory fitness and blood pressure in adolescents: LabMed cohort study. Eur J Clin Invest 2021; 51:e13430. [PMID: 33047322 DOI: 10.1111/eci.13430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this prospective cohort study was to examine whether the association between the cardiorespiratory fitness (CRF) at baseline and blood pressure (BP) at follow-up is mediated by adiposity in adolescents. MATERIALS AND METHODS The sample comprised 734 adolescents (349 girls) aged 12-18 years from the LabMed Physical Activity Cohort Study. The variables of interest were measured in 2011 (baseline) and in 2013 (2-year follow-up). CRF was assessed by the 20-m shuttle run test. Body mass index, waist circumference, body fat percentage, pubertal status and resting BP were assessed according to standard procedures. Boot-strapped mediation procedures were performed, and indirect effects (IE) with confidence intervals (CI) not including zero were considered statistically significant. RESULTS After adjusting for potential confounders, body mass index acted as a mediator of the relationship between CRF and systolic BP (IE = -0. 023; CI = -0.039; -0.009), pulse pressure (IE = -0.023; CI = -0.034; -0.012) and rate product pressure (IE = -2.839; CI = -5.329; -0.340). Similar results were obtained for waist circumference as mediator for systolic BP (IE = -0.019; CI = -0.033; -0.005), pulse pressure (IE = -0.017; CI = -0.028; -0.007) and rate product pressure (IE = -3.793; CI = -6.097; -1.689). Likewise, body fat percentage mediated the association for: systolic BP (IE = -0.029; CI = -0.048; -0.010), pulse pressure (IE = -0.027; CI = -0.041; -0.013) and rate product pressure (IE = -4.280; CI = -7.488; -1.264). CONCLUSIONS Adiposity mediated the association between CRF and BP in adolescents. Therefore, both optimal CRF and adiposity levels are important to maintain normal BP ranges throughout adolescence.
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Affiliation(s)
- Maria Reyes Beltran-Valls
- LIFE Research Group, University Jaume I, Castellon, Spain.,Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.,National Physical Activity Promotion Program, Directorate-General of Health, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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16
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Othman Tan SES, Mohamad SD, Ahmad MZ. Compensatory renal hypertrophy in reflux nephropathy presenting as hypertensive emergency. Oxf Med Case Reports 2021; 2021:omaa132. [PMID: 33614043 PMCID: PMC7885145 DOI: 10.1093/omcr/omaa132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/17/2020] [Indexed: 11/25/2022] Open
Abstract
Hypertensive emergency in the paediatric population is not uncommon. However, due to its numerous etiologies, care should be taken in determining the approach of management. We report a case of a child who presented with double vision, giddiness and elevated blood pressure. Blood investigations were normal. Renal ultrasound and magnetic resonance imaging of the abdomen were performed which both showed findings suspicious of a large heterogeneous mass at the lower pole of the left kidney with dysplastic right kidney. A final diagnosis of bilateral vesicoureteric reflux with left compensatory hypertrophy was made based upon micturating cystourethrography findings and was later confirmed by 99mTc-dimercaptosuccinic acid (DMSA) study. The objective of this case is to share the importance of the appropriate choice of radiological examinations, not only in achieving an accurate diagnosis but to ensure that unnecessary investigations are avoided.
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Affiliation(s)
| | - Siti Dayana Mohamad
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Muhamad Zabidi Ahmad
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
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17
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Spindle Cell Hemangioma and Atypically Localized Juxtaglomerular Cell Tumor in a Patient with Hereditary BRIP1 Mutation: A Case Report. Genes (Basel) 2021; 12:genes12020220. [PMID: 33546375 PMCID: PMC7913579 DOI: 10.3390/genes12020220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/17/2022] Open
Abstract
Spindle cell hemangioma is a benign vascular tumor typically occurring in the dermis or subcutis of distal extremities as red-brown lesions that can grow in both size and number over time. They can be very painful and potentially disabling. A family history of cancer or previous history may be relevant and must be taken into consideration. Juxtaglomerular cell tumor (reninoma) is an extremely rare cause of secondary hypertension diagnosed mostly among adolescents and young adults. Excessive renin secretion results in secondary hyperaldosteronism. Subsequent hypokalemia and metabolic alkalosis, together with high blood pressure, are clues for clinical diagnosis. Histological examination of the excised tumor leads to a definitive diagnosis. Reninoma is found in subcapsular localization, in most cases as a solitary mass, in imaging studies of kidneys. Exceptionally, it can be located in another part of a kidney. Both spindle cell hemangioma and reninoma are extremely rare tumors in children and adolescents. Herein, the authors present a case report of a patient with hereditary BRCA1 interacting protein C-terminal helicase 1 (BRIP1) mutation, spindle cell hemangioma, and secondary hypertension caused by atypically localized reninoma.
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18
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Agostinis-Sobrinho C, Ramírez-Vélez R, Norkiene S, Dâmaso A, de Piano Ganen A, Masquio DCL, Rauckienė-Michaelsson A, Mota J, Santos R. Association of Adipocytokines and Inflammatory Biomarkers with Blood Pressure in Adolescents: A Longitudinal Analysis. Nutr Metab Cardiovasc Dis 2020; 30:2296-2302. [PMID: 32912795 DOI: 10.1016/j.numecd.2020.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Several cross-sectional, but few prospective, studies suggest that inflammation may be involved in the development of high blood pressure. We examined markers of inflammation for their associations with blood pressure levels over a two-year period in healthy adolescents. METHODS AND RESULTS The sample comprised 406 adolescents (209 girls) aged 12-18 years in the LabMed Physical Activity Study were followed-up for 2 years. Anthropometric (weigh, height, BMI), markers of inflammation (high sensitivity C-reactive protein, complement factors C3 and C4, fibrinogen, leptin and adiponectin) and ambulatory blood pressure (BP) were collected. Socioeconomic status, pubertal development, adherence to Mediterranean diet and cardiorespiratory fitness were measured for adjustment for potential confounders. Adjusted linear regression models revealed a significant association of Leptin/Adiponectin (L/A) Ratio (baseline) with systolic BP (β = 0.120; p < 0.034) and with diastolic BP (β = 0.125; p < 0.036) at follow-up (full adjusted model). Leptin was associated with systolic BP at follow-up (β = 0.102; p < 0.038) after adjustment for systolic BP at baseline, height, pubertal stage, socioeconomic status, adherence to Mediterranean diet, cardiorespiratory fitness, however, not independently of BMI. CONCLUSION L/A ratio was positively associated with systolic BP and diastolic BP even after adjusting confounding variables. Therefore, a higher misbalance between leptin and adiponectin (higher L/A ratio) early adolescence may exert a negative effect BP levels in late adolescence regardless of several confounders factors.
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Affiliation(s)
| | - Robinson Ramírez-Vélez
- Universidad Pública de Navarra (UPNA)-Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008, Pamplona, Navarra, Spain
| | | | - Ana Dâmaso
- Federal University of São Paulo - Paulista Medicine School Graduate Program in Nutrition, São Paulo, SP, Brazil
| | - Aline de Piano Ganen
- Faculty of Health Sciences, Klaipeda University, Lithuania; São Camilo University Center - Professional Master in Nutrition: From Birth to Adolescence, São Paulo, SP, Brazil
| | - Deborah C Landi Masquio
- Faculty of Health Sciences, Klaipeda University, Lithuania; São Camilo University Center - Professional Master in Nutrition: From Birth to Adolescence, São Paulo, SP, Brazil
| | | | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
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19
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Sendzikaite S, Sudikiene R, Tarutis V, Lubaua I, Silis P, Rybak A, Jankauskiene A, Litwin M. Prevalence of arterial hypertension, hemodynamic phenotypes, and left ventricular hypertrophy in children after coarctation repair: a multicenter cross-sectional study. Pediatr Nephrol 2020; 35:2147-2155. [PMID: 32529324 DOI: 10.1007/s00467-020-04645-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study aimed to evaluate hemodynamic phenotypes and prevalence of left ventricular hypertrophy in children after coarctation repair with right arm and leg blood pressure difference < 20 mmHg. Secondary objectives were analysis of effects of age at intervention, residual gradient across the descending aorta, and type of correction. METHODS Blood pressure status and left ventricular hypertrophy were diagnosed according to European Society of Hypertension 2016 guidelines. RESULTS Of 90 patients with a median age 12.5 (8.9-15.8) years, 8.5 (6.0-11.8) years after coarctation repair who were included, 42 (46.7%) were hypertensive. Isolated systolic hypertension dominated among 29 hypertensive patients with uncontrolled or masked hypertension (25 of 29; 86.2%). Of the 48 patients with office normotension, 14.6% (7) had masked hypertension, 8.3% (4) had ambulatory prehypertension, and 54.2% (26) were truly normotensive. Left ventricular hypertrophy was diagnosed in 29 patients (32.2%), including 14 of 42 (33.3%) hypertensive and 15 of 48 (31.3%) normotensive patients. The peak systolic gradient across the descending aorta was greater in hypertensive subjects (33.3 ± 12.7 mmHg) compared with normotensive subjects (25 ± 8.2 mmHg, p = 0.0008). Surgical correction was performed earlier than percutaneous intervention (p < 0.0001) and dominated in 40 of 48 (83.3%) normotensive versus 24 of 42 (57.1%) hypertensive patients (p = 0.006). CONCLUSIONS Arterial hypertension with isolated systolic hypertension as the dominant phenotype and left ventricular hypertrophy are prevalent even after successful coarctation repair. Coarctation correction from the age of 9 years and older was associated with a higher prevalence of hypertension.
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Affiliation(s)
- Skaiste Sendzikaite
- Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania.
| | - Rita Sudikiene
- Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - Virgilijus Tarutis
- Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - Inguna Lubaua
- Clinic for Paediatric Cardiology and Cardiac Surgery, Children's Clinical University Hospital, Stradins University, Riga, Latvia
| | - Pauls Silis
- Clinic for Paediatric Cardiology and Cardiac Surgery, Children's Clinical University Hospital, Stradins University, Riga, Latvia
| | - Agata Rybak
- Department of Cardiology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Augustina Jankauskiene
- Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - Mieczyslaw Litwin
- Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland
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20
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Fu QY, Ma L, Li CC, He ZJ, Wang WH, Luo KF, Liu Y, Zhang ZH, Yang ZB, Tang HL, Yan JH. Hypertension/prehypertension and its determinants in pediatric IgA nephropathy. Medicine (Baltimore) 2020; 99:e22310. [PMID: 33019406 PMCID: PMC7535649 DOI: 10.1097/md.0000000000022310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Immunoglobulin A nephropathy (IgAN) is a major cause of secondary hypertension (HT) of renal origin - a significant prognostic factor of IgAN. In children, similar to HT, prehypertension (pre-HT) is becoming a significant health issue. However, the role of secondary HT and pre-HT (HT/pre-HT) in the progression of pediatric IgAN remains unclear. We investigated the effects of HT/pre-HT on prognosis and its determinants as well as their correlation with clinicopathological parameters to identify more effective therapeutic targets.This single-center retrospective study compared clinicopathological features and treatment outcomes between patients with and without HT/pre-HT in 108 children with IgAN. Independent risk factors for HT/pre-HT were evaluated; segmental glomerulosclerosis was a significant variable, whose relationship with clinicopathological parameters was analyzed.Clinical outcomes of patients with and without HT/pre-HT differed considerably (P = .006) on ≥6 months follow-up. Patients with HT/pre-HT reached complete remission less frequently than those without HT/pre-HT (P = .014). Age, serum creatinine, prothrombin time, and segmental glomerulosclerosis or adhesion were independent risk factors for HT/pre-HT in pediatric IgAN (P = .012, P = .017, P = .002, and P = .016, respectively). Segmental glomerulosclerosis or adhesion was most closely associated with glomerular crescents (r = 0.456, P < .01), followed by Lees grades (r = 0.454, P < .01), renal arteriolar wall thickening (r = 0.337, P < .01), and endocapillary hypercellularity (r = 0.306, P = .001). The intensity of IgA deposits, an important marker of pathogenetic activity in IgAN, was significantly associated with the intensity and location of fibrinogen deposits (intensity: r = 0.291, P = .002; location: r = 0.275, P = .004).HT/pre-HT in pediatric IgAN patients is an important modifiable factor. A relationship is observed between HT/pre-HT and its determinants, especially segmental glomerulosclerosis. Potential therapeutic approaches for IgAN with HT/pre-HT might be directed toward the management of coagulation status, active lesions, and hemodynamics for slowing disease progression.
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21
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Llorente-Cantarero FJ, Aguilar-Gómez FJ, Anguita-Ruiz A, Rupérez AI, Vázquez-Cobela R, Flores-Rojas K, Aguilera CM, Gonzalez-Gil EM, Gil-Campos M, Bueno-Lozano G, Leis R. Changes in Physical Activity Patterns from Childhood to Adolescence: Genobox Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197227. [PMID: 33023228 PMCID: PMC7579043 DOI: 10.3390/ijerph17197227] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 01/10/2023]
Abstract
Longitudinal changes of physical activity (PA) from childhood into adolescence have not been accurately described yet for the Spanish population. The aim of this study is to evaluate the changes of PA, assessed by accelerometry and anthropometric measures in a cohort of 213 children from the prepubertal to pubertal period, focusing on those with valid data from both time points (n = 75). Sedentary time (ST) increased about 50%, while all PA intensities declined from the pre-pubertal to pubertal period. Light PA (LPA) was the major contributor, decreasing by about 30%. Boys were more active than girls in both periods, but they showed a higher decline in PA, especially moderate-to-vigorous PA (MVPA). The proportion who reached the recommendation of 60 min of MVPA decreased by 33.3% in boys and 4.6% in girls. Children with obesity or overweight had lower MVPA than those with normal-weight in the pre-pubertal period, but no differences were found in the pubertal period. This study shows a decrease of PA and an increase of sedentarism in the transition from childhood to adolescence, particularly in boys. Regardless of body weight, adolescents tend to be less active. Therefore, prevention programs should be implemented to achieve optimal PA and reduce sedentarism during infancy considering the differences found by sex.
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Affiliation(s)
- Francisco Jesús Llorente-Cantarero
- Department of Specific Didactics, Faculty of Education, University of Córdoba, 14071 Córdoba, Spain;
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
| | - Francisco Javier Aguilar-Gómez
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), University of Córdoba, 14004 Córdoba, Spain; (F.J.A.-G.); (K.F.-R.)
| | - Augusto Anguita-Ruiz
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Armilla, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, 18012 Granada, Spain
| | - Azahara Iris Rupérez
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
- GENUD Researchgroup, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS), 50009 Aragón, Zaragoza, Spain
| | - Rocío Vázquez-Cobela
- Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Department of Pediatrics, University Clinical Hospital of Santiago, University of Santiago de Compostela, 15701 Santiago de Compostela, Spain;
| | - Katherine Flores-Rojas
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), University of Córdoba, 14004 Córdoba, Spain; (F.J.A.-G.); (K.F.-R.)
| | - Concepción M. Aguilera
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Armilla, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, 18012 Granada, Spain
| | - Esther M. Gonzalez-Gil
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Armilla, 18016 Granada, Spain
- GENUD Researchgroup, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS), 50009 Aragón, Zaragoza, Spain
| | - Mercedes Gil-Campos
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), University of Córdoba, 14004 Córdoba, Spain; (F.J.A.-G.); (K.F.-R.)
- Correspondence:
| | - Gloria Bueno-Lozano
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
- GENUD Researchgroup, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS), 50009 Aragón, Zaragoza, Spain
- Pediatric Endocrinology Unit, Lozano Blesa University Clinical Hospital of Zaragoza, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | - Rosaura Leis
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (A.A.-R.); (A.I.R.); (C.M.A.); (E.M.G.-G.); (G.B.-L.); (R.L.)
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22
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A Multi-Omics Approach Reveals New Signatures in Obese Allergic Asthmatic Children. Biomedicines 2020; 8:biomedicines8090359. [PMID: 32961859 PMCID: PMC7555790 DOI: 10.3390/biomedicines8090359] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/26/2020] [Accepted: 09/14/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Asthma is a multifactorial condition where patients with identical clinical diagnoses do not have the same clinical history or respond to treatment. This clinical heterogeneity is reflected in the definition of two main endotypes. We aimed to explore the metabolic and microbiota signatures that characterize the clinical allergic asthma phenotype in obese children. Methods: We used a multi-omics approach combining clinical data, plasma and fecal inflammatory biomarkers, metagenomics, and metabolomics data in a cohort of allergic asthmatic children. Results: We observed that the obese allergic asthmatic phenotype was markedly associated with higher levels of leptin and lower relative proportions of plasma acetate and a member from the Clostridiales order. Moreover, allergic children with a worse asthma outcome showed higher levels of large unstained cells, fecal D lactate and D/L lactate ratio, and with a higher relative proportion of plasma creatinine and an unclassified family member from the RF39 order belonging to the Mollicutes class. Otherwise, children with persistent asthma presented lower levels of plasma citrate and dimethylsulfone. Conclusion: Our integrative approach shows the molecular heterogeneity of the allergic asthma phenotype while highlighting the use of omics technologies to examine the clinical phenotype at a more holistic level.
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Sousa-Sá E, Ruiz JR, Zhang Z, Pereira JR, Veldman SLC, Okely AD, Santos R. Sedentary time and blood pressure in Australian toddlers: The get-up study longitudinal results. J Sports Sci 2020; 39:227-231. [PMID: 32896199 DOI: 10.1080/02640414.2020.1812836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Epidemiological data suggests that the genesis of cardiovascular disease occurs during childhood. Sedentary time (ST) is a main driver of high blood pressure (BP) in adolescents and adults. However, associations between ST and cardiovascular health in young children are uncertain. Prospective associations between ST and BP were assessed among 172 toddlers (88 boys), aged 19.5 ± 3.9 months at baseline, recruited from the GET-UP! Study, Australia and followed over a 12-month period. BP was measured with a digital monitor and z-scores were computed by age and sex for systolic and diastolic BP. Total ST was measured over 7 days using Actigraph accelerometers and expressed over a 24-h period. Multilevel linear regression models were used to assess regression coefficients and standard errors, predicting BP at follow-up from ST at baseline. Analyses controlled for socio-economic status, height, age, gender, group (intervention or control) and zWC at baseline. Adjusted analyses showed that total ST did not predict systolic or diastolic BP (β = 0.0009, p = 0.368 and β = 0.002, p = 0.05, respectively). Most likely, longer follow-up periods might be needed to confirm or rule out our results, as the effects of cumulative ST over time on BP values are prone to manifest later in life and track into adolescence and adulthood.
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Affiliation(s)
- Eduarda Sousa-Sá
- Early Start, University of Wollongong , Wollongong, Australia.,Illawarra Health and Medical Research Institute , Wollongong, Australia
| | - Jonatan R Ruiz
- PROFITH (Promotingfitness and Health through Physical Activity) Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada , Granada, Spain
| | - Zhiguang Zhang
- Early Start, University of Wollongong , Wollongong, Australia
| | - João R Pereira
- Early Start, University of Wollongong , Wollongong, Australia.,Research Unit for Sport and Physical Activity, University of Coimbra , Coimbra, Portugal
| | | | - Anthony D Okely
- Early Start, University of Wollongong , Wollongong, Australia.,Illawarra Health and Medical Research Institute , Wollongong, Australia
| | - Rute Santos
- Early Start, University of Wollongong , Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto , Porto, Portugal
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24
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Das SK, McIntyre HD, Al Mamun A. Early life predictors of development of blood pressure from childhood to adulthood: Evidence from a 30-year longitudinal birth cohort study. Atherosclerosis 2020; 311:91-97. [PMID: 32949948 DOI: 10.1016/j.atherosclerosis.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 08/21/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS The early life predictors of changes in the blood pressures of offspring between childhood and young adulthood have not been well defined. Thus, this study aimed to determine the life course association of offspring's blood pressure with prenatal and early infancy lifestyle, and other factors taking advantage of a large community-based, longitudinal study of a birth cohort in Australia - the MUSP study. METHODS The systolic and diastolic blood pressure (SBP, DBP) was measured for 3793, 3782, 2628 and 1780 offspring of the Australian longitudinal cohort study at 5, 14, 21 and 30 years of their age, respectively. Individual PP and mean arterial pressure (MAP) was equated, and Generalized Estimating Equations with time (age) and predictor interaction modelling were performed. RESULTS Blood pressures of the offspring increased significantly between 5 and 30 years. Early life factors such as pre-pregnancy overweight/obesity, and hypertensive disorder in pregnancy were significantly positively associated, and duration of gestation and pre-pregnancy thinness of the mothers negatively associated with this life course increase in the offspring's blood pressure. Rapid increase in body weight from birth to 5 years had a strong association with increasing blood pressures components throughout their life course. CONCLUSIONS Several maternal pre-pregnancy and pregnancy factors along with the early life growth characteristics of offspring are important predictors of increase in blood pressure of the offspring from their childhood to adulthood.
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Affiliation(s)
- Sumon Kumar Das
- Menzies School of Health Research, Charles Darwin University, NT 0810, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, Australia.
| | - Harold David McIntyre
- Mater Clinical School, The University of Queensland, Brisbane, Australia; Mater Medical Research Institute, Raymond Tce, South Brisbane, Qld 4101, Australia
| | - Abdullah Al Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia
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25
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Abstract
PURPOSE OF REVIEW To review the haemodynamic characteristics of paediatric hypertension. RECENT FINDINGS Pulsatile components of blood pressure are determined by left ventricular dynamics, aortic stiffness, systemic vascular resistance and wave propagation phenomena. Recent studies delineating these factors have identified haemodynamic mechanisms contributing to primary hypertension in children. Studies to date suggest a role of cardiac over activity, characterized by increased heart rate and left ventricular ejection, and increased aortic stiffness as the main haemodynamic determinants of primary hypertension in children.
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Affiliation(s)
- Ye Li
- King's College London British Heart Foundation Centre, London, UK
- Department of Clinical Pharmacology, St Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK
| | - Emily Haseler
- Department of Pediatric Nephrology, Evelina London Children's Hospital, London, UK
| | - Phil Chowienczyk
- King's College London British Heart Foundation Centre, London, UK.
- Department of Clinical Pharmacology, St Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK.
| | - Manish D Sinha
- King's College London British Heart Foundation Centre, London, UK
- Department of Pediatric Nephrology, Evelina London Children's Hospital, London, UK
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26
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Sousa-Sá E, Zhang Z, Pereira JR, Veldman SLC, Okely AD, Santos R. The Get-Up! study: adiposity and blood pressure in Australian toddlers. Porto Biomed J 2020; 5:e063. [PMID: 32734008 PMCID: PMC7386441 DOI: 10.1097/j.pbj.0000000000000063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/29/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Because the elevated blood pressure (BP) in childhood is strongly associated with overweight and is a risk factor for later cardiovascular disease, a need to comprehend the early development of BP and its association with overweight is needed. We assessed differences of BP by weight status in Australian toddlers. METHODS From the Get-Up! Study in Australia, this sample included 265 toddlers (136 boys), aged 19.6 ± 4.2 months. BP was measured with a digital vital signs monitor. Participants were categorized as nonoverweight and overweight according to the World Health Organization definition for body mass index (BMI). Physical activity was captured with activPAL accelerometers, during childcare hours. To test differences in BP between nonoverweight and overweight children, we performed an analysis of covariance adjusting for sex, age, physical activity, and socioeconomic status. RESULTS Children with overweight showed higher z systolic BP values (P = .042 for BMI and P = .023 for waist circumference) when compared to nonoverweight children. However, no differences were found for z diastolic BP levels, between overweight and nonoverweight children. After adjustments for potential confounders (socioeconomic status, physical activity, sex, and age), there were no significant differences in BP variables between BMI and waist circumference groups. CONCLUSIONS No associations between adiposity and BP levels were found in this sample. The unadjusted results, however, showed that children with higher levels of adiposity (BMI and waist circumference) exhibited higher levels of BP. Additional research is needed to determine which environmental and genetic factors might contribute to pediatric hypertension, particularly among toddlers.
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Affiliation(s)
- Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong
- Research Unit for Sport and Physical Activity, University of Coimbra, Coimbra
| | | | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
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Leis R, Jurado-Castro JM, Llorente-Cantarero FJ, Anguita-Ruiz A, Iris Rupérez A, Bedoya-Carpente JJ, Vázquez-Cobela R, Aguilera CM, Bueno G, Gil-Campos M. Cluster Analysis of Physical Activity Patterns, and Relationship with Sedentary Behavior and Healthy Lifestyles in Prepubertal Children: Genobox Cohort. Nutrients 2020; 12:nu12051288. [PMID: 32370020 PMCID: PMC7282254 DOI: 10.3390/nu12051288] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 12/31/2022] Open
Abstract
Sedentary habits during childhood are associated with adverse health outcomes. The aim of this work was to cluster lifestyle behaviors and metabolic biomarkers to establish different patterns in children. Their physical and sedentary activities were evaluated by accelerometry, and questionnaires that included lifestyle behaviors, such as adherence to a Mediterranean diet, anthropometry and blood biochemical markers. Cluster analysis was performed to establish different groups based on physical activity levels. A total of 489 children were finally selected. Cluster 1 included children with a mostly sedentary state, whereas Cluster 3 included the most active children and Cluster 2 included children that did not fit into either the sedentary or the highly active groups. In Cluster 3, 56% of children were in a sports club, and a lower percentage used electronic devices in their rooms compared to the other groups. Cluster 1 children exhibited higher insulin, HOMA-IR and triacylglycerides with respect to the other groups. No differences were found regarding adherence to a Mediterranean diet. The choice to practice an extracurricular sport could be an influencing factor to increase exercise and ensure an active lifestyle in children. Reducing or limiting screen time mainly in children’s rooms could contribute to an active lifestyle.
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Affiliation(s)
- Rosaura Leis
- Unidad de Investigación en Nutrición, Crecimiento y Desarrollo Humano de Galicia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, IDIS, 15706 Santiago de Compostela, Spain; (R.L.); (J.J.B.-C.); (R.V.-C.)
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
| | - Jose Manuel Jurado-Castro
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, 14071 Córdoba, Spain;
| | - Francisco Jesus Llorente-Cantarero
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Department of Artistic and Corporal Education, Faculty of Education, University of Córdoba, 14004 Córdoba, Spain
| | - Augusto Anguita-Ruiz
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Armilla, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs, 18014 Granada, Spain
| | - Azahara Iris Rupérez
- GENUD Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50013 Zaragoza; Spain;
| | - Juan Jose Bedoya-Carpente
- Unidad de Investigación en Nutrición, Crecimiento y Desarrollo Humano de Galicia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, IDIS, 15706 Santiago de Compostela, Spain; (R.L.); (J.J.B.-C.); (R.V.-C.)
| | - Rocío Vázquez-Cobela
- Unidad de Investigación en Nutrición, Crecimiento y Desarrollo Humano de Galicia, Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, IDIS, 15706 Santiago de Compostela, Spain; (R.L.); (J.J.B.-C.); (R.V.-C.)
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
| | - Concepción María Aguilera
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Armilla, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs, 18014 Granada, Spain
| | - Gloria Bueno
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- GENUD Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50013 Zaragoza; Spain;
- Unidad de Endocrinología Pediátrica, Hospital Clínico Lozano Blesa, Facultad de Medicina, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Correspondence: ; Tel.: +34-619223420
| | - Mercedes Gil-Campos
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain; (F.J.L.-C.); (A.A.-R.); (C.M.A.); (M.G.-C.)
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, 14071 Córdoba, Spain;
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Multimodal Photoplethysmography-Based Approaches for Improved Detection of Hypertension. J Clin Med 2020; 9:jcm9041203. [PMID: 32331360 PMCID: PMC7230564 DOI: 10.3390/jcm9041203] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022] Open
Abstract
Elevated blood pressure (BP) is a major cause of death, yet hypertension commonly goes undetected. Owing to its nature, it is typically asymptomatic until later in its progression when the vessel or organ structure has already been compromised. Therefore, noninvasive and continuous BP measurement methods are needed to ensure appropriate diagnosis and early management before hypertension leads to irreversible complications. Photoplethysmography (PPG) is a noninvasive technology with waveform morphologies similar to that of arterial BP waveforms, therefore attracting interest regarding its usability in BP estimation. In recent years, wearable devices incorporating PPG sensors have been proposed to improve the early diagnosis and management of hypertension. Additionally, the need for improved accuracy and convenience has led to the development of devices that incorporate multiple different biosignals with PPG. Through the addition of modalities such as an electrocardiogram, a final measure of the pulse wave velocity is derived, which has been proved to be inversely correlated to BP and to yield accurate estimations. This paper reviews and summarizes recent studies within the period 2010–2019 that combined PPG with other biosignals and offers perspectives on the strengths and weaknesses of current developments to guide future advancements in BP measurement. Our literature review reveals promising measurement accuracies and we comment on the effective combinations of modalities and success of this technology.
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Anguita-Ruiz A, Mendez-Gutierrez A, Ruperez AI, Leis R, Bueno G, Gil-Campos M, Tofe I, Gomez-Llorente C, Moreno LA, Gil Á, Aguilera CM. The protein S100A4 as a novel marker of insulin resistance in prepubertal and pubertal children with obesity. Metabolism 2020; 105:154187. [PMID: 32084430 DOI: 10.1016/j.metabol.2020.154187] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND S100A4 is a metastasis-associated protein also reported as a promising marker for dysfunctional white adipose tissue (WAT) and insulin resistance (IR) in adult and adolescent populations. OBJECTIVE We aimed to evaluate the association between the protein S100A4 and obesity and IR in children and during pubertal development. DESIGN AND METHODS The study design consisted of three cross-sectional populations of 249, 11 and 19 prepubertal children respectively (named study population 1, 2 and 3), and a longitudinal population of 53 girls undergoing sexual maturation (study population 4). All subjects were classified into experimental groups according to their sex, obesity and IR status. All study populations counted on anthropometry, glucose, and lipid metabolism, inflammation and cardiovascular biomarkers as well as S100A4 plasma levels measured. The study population 1 was intended as the discovery population in which to elucidate the relationship between Obesity-IR and S100A4 plasma levels in prepubertal children. The cross-sectional populations 2 and 3 further counted on WAT gene expression data for investigating the molecular basis of this association. Instead, the longitudinal study population 4 presented blood whole-genome DNA methylation data at each temporal record, allowing deepening into the Obesity-IR-S1004 relationship during puberty as well as deciphering plausible epigenetic mechanisms altering S100A4 plasma levels. RESULTS S100A4 plasma levels were strongly associated with several metabolic and anthropometric outcomes, namely IR, in prepubertal non-diabetic obese children. We also found highly significant positive associations during the course of puberty between the increase in S100A4 levels and the increase in HOMA-IR (P = 0.0003, FDR = 0.005) and insulin levels (P = 0.0003, FDR = 0.005). Methylation in two-enhancer related CpG sites of the S100A4 region (cg07245635 and cg10447638) was associated with IR biomarkers at the prepubertal stage and with longitudinal changes in these measurements. We further reported an association between visceral WAT (vWAT) S100A4 expression and HOMA-IR, insulin levels and BMI Z-Score, but not with circulating S100A4. CONCLUSIONS We report for the first time the association of S100A4 with IR and WAT dysfunction in prepubertal populations as well as how the change in plasma S100A4 levels accompanies longitudinal trajectories of IR in children during pubertal development. Moreover, we propose epigenetic changes in two methylation sites and an altered S100A4 vWAT expression as plausible molecular mechanisms underlying this disturbance in obesity.
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Affiliation(s)
- Augusto Anguita-Ruiz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Spain; Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n. 18016 Armilla, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain
| | - Andrea Mendez-Gutierrez
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Spain; Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n. 18016 Armilla, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain
| | - Azahara I Ruperez
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Rosaura Leis
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain; Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Pediatric Department (USC), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Gloria Bueno
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Mercedes Gil-Campos
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain; Department of Pediatric Endocrinology, Reina Sofia University Clinical Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
| | - Inés Tofe
- Department of Pediatric Endocrinology, Reina Sofia University Clinical Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
| | - Carolina Gomez-Llorente
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Spain; Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n. 18016 Armilla, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Luis A Moreno
- CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Spain; Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n. 18016 Armilla, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain
| | - Concepción M Aguilera
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Spain; Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n. 18016 Armilla, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; CIBEROBN, (Physiopathology of Obesity and Nutrition CB12/03/30038), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain.
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Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K, Rudan I. Global Prevalence of Hypertension in Children: A Systematic Review and Meta-analysis. JAMA Pediatr 2019; 173:1154-1163. [PMID: 31589252 PMCID: PMC6784751 DOI: 10.1001/jamapediatrics.2019.3310] [Citation(s) in RCA: 279] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Reliable estimates of the prevalence of childhood hypertension serve as the basis for adequate prevention and treatment. However, the prevalence of childhood hypertension has rarely been synthesized at the global level. OBJECTIVE To conduct a systematic review and meta-analysis to assess the prevalence of hypertension in the general pediatric population. DATA SOURCES PubMed, MEDLINE, Embase, Global Health, and Global Health Library were searched from inception until June 2018, using search terms related to hypertension (hypertension OR high blood pressure OR elevated blood pressure), children (children OR adolescents), and prevalence (prevalence OR epidemiology). STUDY SELECTION Studies that were conducted in the general pediatric population and quantified the prevalence of childhood hypertension were eligible. Included studies had blood pressure measurements from at least 3 separate occasions. DATA EXTRACTION AND SYNTHESIS Two authors independently extracted data. Random-effects meta-analysis was used to derive the pooled prevalence. Variations in the prevalence estimates in different subgroups, including age group, sex, setting, device, investigation period, BMI group, World Health Organization region and World Bank region, were examined by subgroup meta-analysis. Meta-regression was used to establish the age-specific prevalence of childhood hypertension and to assess its secular trend. MAIN OUTCOMES AND MEASURES Prevalence of childhood hypertension overall and by subgroup. RESULTS A total of 47 articles were included in the meta-analysis. The pooled prevalence was 4.00% (95% CI, 3.29%-4.78%) for hypertension, 9.67% (95% CI, 7.26%-12.38%) for prehypertension, 4.00% (95% CI, 2.10%-6.48%) for stage 1 hypertension, and 0.95% (95% CI, 0.48%-1.57%) for stage 2 hypertension in children 19 years and younger. In subgroup meta-analyses, the prevalence of childhood hypertension was higher when measured by aneroid sphygmomanometer (7.23% vs 4.59% by mercury sphygmomanometer vs 2.94% by oscillometric sphygmomanometer) and among overweight and obese children (15.27% and 4.99% vs 1.90% among normal-weight children). A trend of increasing prevalence of childhood hypertension was observed during the past 2 decades, with a relative increasing rate of 75% to 79% from 2000 to 2015. In 2015, the prevalence of hypertension ranged from 4.32% (95% CI, 2.79%-6.63%) among children aged 6 years to 3.28% (95% CI, 2.25%-4.77%) among those aged 19 years and peaked at 7.89% (95% CI, 5.75%-10.75%) among those aged 14 years. CONCLUSIONS AND RELEVANCE This study provides a global estimation of childhood hypertension prevalence based on blood pressure measurements in at least 3 separate visits. More high-quality epidemiologic investigations on childhood hypertension are still needed.
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Affiliation(s)
- Peige Song
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Yan Zhang
- Faculty of Life Science and Medicine, Kings College London, London, United Kingdom
| | - Jinyue Yu
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Mingming Zha
- Medical School Southeast University, Nanjing, Jiangsu, China
| | - Yajie Zhu
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Kazem Rahimi
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
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Wu Y, Cao Y, Song J, Tian Y, Wang M, Li M, Wang X, Huang Z, Li L, Zhao Y, Qin X, Hu Y. Antihypertensive drugs use over a 5-year period among children and adolescents in Beijing, China: An observational study. Medicine (Baltimore) 2019; 98:e17411. [PMID: 31577753 PMCID: PMC6783152 DOI: 10.1097/md.0000000000017411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Evidence on the prescription patterns of antihypertensive drug use in children and adolescents in China is scarce. A descriptive analysis of the Beijing Medical Claim Data, which covered over 95% of the urban residents, was conducted to investigate antihypertensive prescribing patterns and trends in children and adolescents aged under 18 from 2009 to 2014 in Beijing, China. An additional meta-analysis of trends in hypertension prevalence was conducted to compare trends with antihypertensive medications.A total of 11,882 patients received at least 1 prescription for antihypertensive drugs from 2009 to 2014. The number of annual antihypertensive users increased from 2009 to 2012, then declined steadily until 2014, which was consistent with the trend of the hypertension prevalence estimated from the meta-analysis. β-receptor blockers, thiazide diuretics, and angiotensin-converting enzyme inhibitors were the 3 most commonly prescribed antihypertensive drugs. More boys took the antihypertensive drugs than girls. For users aged under 3 years, thiazide diuretics, α-receptor blockers, and angiotensin-converting enzyme inhibitors were the most prescribed drugs, while β-receptor blockers, thiazide diuretics were the most used drugs for users above 3 years.In conclusion, antihypertensive drug prescribing for children and adolescents increased from 2009 to 2014, with different characteristics in different subgroups.
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Affiliation(s)
- Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Zhe Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Lin Li
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing
| | - Yaling Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
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Outdili Z, Marti-Soler H, Bovet P, Chiolero A. Performance of blood pressure measurements at an initial screening visit for the diagnosis of hypertension in children. J Clin Hypertens (Greenwich) 2019; 21:1352-1357. [PMID: 31359590 DOI: 10.1111/jch.13645] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/19/2019] [Accepted: 05/28/2019] [Indexed: 12/21/2022]
Abstract
Hypertension in children is defined as sustained elevated blood pressure (BP) over several visits. For the screening of hypertension, it is standard to obtain several BP readings at the initial visit. There is however no recommendation on the minimum number of readings needed. We evaluated the performance of BP readings obtained at one initial screening visit to predict the diagnosis of hypertension in children. In a school-based study conducted in Switzerland, BP was measured three times on up to three visits in 5207 children. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of elevated BP at the initial screening visit for the identification of hypertension were estimated using the 1st, 2nd, and 3rd BP readings (R1, R2, R3), as well as (R1 + R2)/2 and (R1 + R2 + R3)/3). These performance indices were compared with the reference method (R2 + R3)/2. The ability of BP readings to discriminate children with and without hypertension was evaluated with receiver operating characteristic curve analysis. The prevalence of systolic/diastolic hypertension was 2.2%. The greatest performance to identify children with hypertension was obtained with R2 (sensitivity: 97%; specificity: 88%; PPV: 15%; NPV: 100%) and the reference method, (R2 + R3)/2 (sensitivity: 100%; specificity: 90%; PPV: 18%; NPV: 100%). The ability to discriminate using R1, R2, (R1 + R2)/2, and (R2 + R3)/2 for the identification of hypertension was strong (AUC: 0.89, 0.93, 0.92, and 0.95, respectively). Obtaining two BP readings and using only the second one at a screening visit may be sufficient as initial step for the identification of hypertension in children.
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Affiliation(s)
| | | | - Pascal Bovet
- Unisanté, University of Lausanne, Lausanne, Switzerland
| | - Arnaud Chiolero
- Unisanté, University of Lausanne, Lausanne, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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Persistence of elevated blood pressure during childhood and adolescence: a school-based multiple cohorts study. J Hypertens 2019. [PMID: 29517559 DOI: 10.1097/hjh.0000000000001699] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Blood pressure (BP) screening is advocated in children. However, identification of children with sustained elevated BP is difficult because of high BP variability. We assessed the tracking of BP and the persistence of elevated BP across childhood and adolescence. METHODS Three cohorts of children from schools in the Seychelles were examined on two occasions at 3-4-year intervals. Obesity was defined as BMI at least 95th sex-specific, and age-specific percentile. On each visit, BP was based on the average of two readings and elevated BP was defined as BP at least 95th sex-specific, age-specific, and height-specific percentile. RESULTS Data was collected in 4519 children of mean ages of 5.5 and 9.2 years, 6065 of ages of 9.2 and 12.5 years, and 5967 of ages of 12.5 and 15.6 years, respectively. Prevalence of elevated BP was 10% at age 5.5 years, 10% at 9.2 years, 7% at 12.5 years, and 9% at 15.6 years, respectively. Among children with elevated BP at the initial visit, the proportions who had elevated BP at the subsequent visit 3-4 years later was 13% between ages of 5.5 and 9.2 years, 19% between 9.2 and 12.5 years, and 27% between 12.5 and 15.6 years. These proportions were higher among obese children with elevated BP, that is, 33, 35, and 39%, in each cohort, respectively. Tracking coefficients were slightly larger for SBP (range of tracking coefficients: 0.23-0.40) than for DBP (range: 0.19-0.35), and increased with age. By comparisons, tracking coefficients for BMI were much higher (range: 0.74-0.84). CONCLUSION During childhood and adolescence, having an elevated BP on one occasion is a weak predictor of elevated BP 3-4 years later. Tracking is, however, larger in older and obese children than in younger and nonobese children.
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Ruiz-Ojeda FJ, Anguita-Ruiz A, Rupérez AI, Gomez-Llorente C, Olza J, Vázquez-Cobela R, Gil-Campos M, Bueno G, Leis R, Cañete R, Moreno LA, Gil A, Aguilera CM. Effects of X-chromosome Tenomodulin Genetic Variants on Obesity in a Children's Cohort and Implications of the Gene in Adipocyte Metabolism. Sci Rep 2019; 9:3979. [PMID: 30850679 PMCID: PMC6408551 DOI: 10.1038/s41598-019-40482-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 10/18/2018] [Indexed: 01/01/2023] Open
Abstract
Tenomodulin (TNMD) is a type II transmembrane glycoprotein that has been recently linked to obesity, and it is highly expressed in obese adipose tissue. Several sex-dependent associations have been observed between single-nucleotide polymorphisms (SNPs) of the TNMD gene, which is located in the X-chromosome, and obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome in adults. On the other hand, results are lacking for children. We aimed (i) to study the association between TNMD genetic variants and metabolic complications related to childhood obesity and (ii) to investigate the function of TNMD in human adipocytes. We conducted a case-control, multicenter study in 915 Spanish children and demonstrated significant positive associations between TNMD genetic variants and BMI z-score, waist circumference, fasting glucose, and insulin resistance in boys, highlighting the SNP rs4828038. Additionally, we showed a BMI-adjusted inverse association with waist circumference in girls. Second, in vitro experiments revealed that TNMD is involved in adipogenesis, along with glucose and lipid metabolism in differentiated adipocytes, and these effects may be mediated through AMPK activation. Hence, these results suggest that TNMD genetic variants could be potentially useful as early life risk indicators for obesity and T2DM. In addition, we support the fact that TNMD exhibits significant metabolic functions in adipocytes.
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Affiliation(s)
- Francisco Javier Ruiz-Ojeda
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n., 18016, Armilla, Granada, Spain. .,Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, 18014, Spain.
| | - Augusto Anguita-Ruiz
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n., 18016, Armilla, Granada, Spain.,Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, 18014, Spain.,Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain
| | - Azahara I Rupérez
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n., 18016, Armilla, Granada, Spain.,Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Carolina Gomez-Llorente
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n., 18016, Armilla, Granada, Spain.,Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, 18014, Spain.,Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain
| | - Josune Olza
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n., 18016, Armilla, Granada, Spain.,Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, 18014, Spain.,Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain
| | - Rocío Vázquez-Cobela
- Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Pediatric Department (USC), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Mercedes Gil-Campos
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain.,Department of Paediatrics, Reina Sofia University Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), University of Córdoba, Avda Menéndez Pidal s/n, 14004, Córdoba, Spain
| | - Gloria Bueno
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain.,Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón),, Zaragoza, Spain
| | - Rosaura Leis
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain.,Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Pediatric Department (USC), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Ramón Cañete
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain.,Department of Paediatrics, Reina Sofia University Hospital, Institute Maimónides of Biomedicine Investigation of Córdoba (IMIBIC), University of Córdoba, Avda Menéndez Pidal s/n, 14004, Córdoba, Spain
| | - Luis A Moreno
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain.,Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón),, Zaragoza, Spain
| | - Angel Gil
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n., 18016, Armilla, Granada, Spain.,Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, 18014, Spain.,Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain
| | - Concepcion Maria Aguilera
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n., 18016, Armilla, Granada, Spain. .,Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, Granada, 18014, Spain. .,Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, 28029, Spain.
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Lim JE, Kim HO, Rhee SY, Kim MK, Kim YJ, Oh B. Gene-environment interactions related to blood pressure traits in two community-based Korean cohorts. Genet Epidemiol 2019; 43:402-413. [PMID: 30770579 DOI: 10.1002/gepi.22195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/08/2018] [Accepted: 11/26/2018] [Indexed: 01/11/2023]
Abstract
Hypertension is a complex disorder caused by genetic and environmental risk factors. Recently, genome-wide association studies (GWASs) identified more than 100 genetic variants for blood pressure traits and hypertension. However, the interactions between these genetic variants and environmental factors have not been systematically investigated. Therefore, we examined the interaction between genetic and environmental risk factors in blood pressure traits using the genetic risk score (GRS). Two Korean community-based cohorts, Cohort I (KARE; N = 8,840) and Cohort II (CAVAS; N = 9,599), were used for this study, and GRSs were calculated from 42 GWAS single-nucleotide polymorphisms (SNPs) that were validated for their association in these cohorts. We calculated GRSs in both ways by considering the effect sizes of each SNP (weighted GRS) and not considering the effect sizes (unweighted GRS). The unweighted GRS was strongly associated with systolic blood pressure, diastolic blood pressure, and hypertension (p = 9.03 × 10 -47 , p = 9.41 × 10 -48 , and p = 3.22 × 10 -55 by meta-analysis, respectively) and the weighted GRS showed the similar results. The environmental factors of body mass index, waist circumference, and drinking status were significantly associated with blood pressure traits, and the interaction between these factors and GRSs were examined. However, no interactions were found with either the GRS or the individual SNPs considered for the GRS. Our findings show that it is challenging to find GRS-environment interactions regarding blood pressure traits.
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Affiliation(s)
- Ji Eun Lim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hye Ok Kim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Mi Kyung Kim
- Institute for Health and Society, Hanyang University, Seoul, Republic of Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Yeon-Jung Kim
- Division of Biobank for Health Science, Center for Genome Science, Korea National Institute of Health, Chungcheongbuk-do, Republic of Korea
| | - Bermseok Oh
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
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The cardiovascular phenotype of childhood hypertension: a cardiac magnetic resonance study. Pediatr Radiol 2019; 49:727-736. [PMID: 31053874 PMCID: PMC6614159 DOI: 10.1007/s00247-019-04393-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/07/2019] [Accepted: 02/21/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cardiovascular phenotype is poorly characterized in treated pediatric hypertension. Cardiovascular magnetic resonance imaging (MRI) can be used to better characterize both cardiac and vascular phenotype in children with hypertension. OBJECTIVE To use MRI to determine the cardiac and vascular phenotypes of different forms of treated hypertension and compare the results with those of healthy children. MATERIALS AND METHODS Sixty children (15 with chronic renal disease with hypertension, 15 with renovascular hypertension, 15 with essential hypertension and 15 healthy subjects) underwent MRI with noninvasive blood pressure measurements. Cardiovascular parameters measured include systemic vascular resistance, total arterial compliance, left ventricular mass and volumetric data, ejection fraction and myocardial velocity. Between-group comparisons were used to investigate differences in the hypertension types. RESULTS Renal hypertension was associated with elevated vascular resistance (P≤0.007) and normal arterial compliance. Conversely, children with essential hypertension had normal resistance but increased compliance (P=0.001). Renovascular hypertension was associated with both increased resistance and compliance (P≤0.03). There was no difference in ventricular volumes, mass or cardiac output between groups. Children with renal hypertension also had lower systolic and diastolic myocardial velocities. CONCLUSION Cardiovascular MRI may identify distinct vascular and cardiac phenotypes in different forms of treated childhood hypertension. Future studies are needed to investigate how this may inform further optimisation of blood pressure treatment in different types of hypertension.
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Zheng W, Mu J, Chu C, Hu J, Yan Y, Ma Q, Lv Y, Xu X, Wang K, Wang Y, Deng Y, Yan B, Yang R, Yang J, Ren Y, Yuan Z. Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age. J Am Soc Nephrol 2018; 29:2835-2846. [PMID: 30420422 DOI: 10.1681/asn.2018030263] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 10/10/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Although high BP is one of the most important factors affecting renal function, whether longitudinal BP trajectories in early life course are associated with renal function damage in later life is unclear. METHODS To investigate the correlation between BP trajectories from childhood to adulthood and renal function in middle age, we used group-based trajectory models to identify BP trajectories in 2430 individuals (aged 6-15 years old at baseline) participating in the ongoing Hanzhong Adolescent Hypertension Cohort. We tested the association between these trajectories and subclinical renal damage in middle age, adjusting for several covariates. RESULTS We identified four distinct systolic BP trajectories among 2430 subjects: low stable, moderate stable, high stable, and moderate increasing on the basis of systolic BP levels at baseline and during the 30-year follow-up period. The urinary albumin-to-creatinine ratio (uACR) was higher in moderate stable, high stable, and moderate increasing groups compared with the low stable group. A total of 228 individuals had subclinical renal disease by 2017. Compared with the low stable trajectory group, the other groups had increasingly greater odds of experiencing subclinical renal disease in middle age. These associations were not altered after adjustment for other covariates, except for in the moderate stable group. Analyzed results were similar for the mean arterial pressure and diastolic BP trajectory groups. CONCLUSIONS Higher BP trajectories were correlated with higher of uACR levels and risk of subclinical renal disease in middle age. Identifying long-term BP trajectories from early age may assist in predicting individuals' renal function in later life.
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Affiliation(s)
- Wenling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Jianjun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China;
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Jiawen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yongbo Lv
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xianjing Xu
- Department of Cardiovascular Medicine, Henan Province People's Hospital, Zhengzhou, People's Republic of China
| | - Keke Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Ying Deng
- Department of Cardiovascular Medicine, Hanzhong No. 405 Hospital, Hanzhong, People's Republic of China
| | - Bo Yan
- Department of Cardiovascular Medicine, Hanzhong Central Hospital, Hanzhong, People's Republic of China; and
| | - Ruihai Yang
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Jun Yang
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Yong Ren
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Zuyi Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
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Rios-Leyvraz M, Bovet P, Bochud M, Genin B, Russo M, Rossier MF, Tabin R, Chiolero A. Estimation of salt intake and excretion in children in one region of Switzerland: a cross-sectional study. Eur J Nutr 2018; 58:2921-2928. [PMID: 30341681 DOI: 10.1007/s00394-018-1845-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/15/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Salt intake among children in Switzerland is unknown. The objectives of this study were to determine salt excretion and to identify the main dietary sources of salt intake among children in one region of Switzerland. METHODS We conducted a cross-sectional study using a convenient sample of children 6-16 years of age in Valais, Switzerland, between 2016 and 2018. All children visiting several regional health care providers and without any clinical condition that could affect sodium intake or excretion were eligible. Each child completed a 24-h urine collection to assess salt excretion and two dietary questionnaires to assess dietary sources of salt intake. Weight and height were measured. RESULTS Data were available on 94 children (55 boys and 39 girls; mean age 10.5 years; age range 6-16 years). The mean 24-h salt urinary excretion was 5.9 g [SD 2.8; range 0.8-16.0; 95% confidence interval (CI) 5.3-6.5]. Two-thirds (62%) of the children had salt excretions above recommendations of maximum intake (i.e., ≥ 2 g per day for children up to 6 years of age and ≥ 5 g per day for children 7-16 years of age). The salt excretion tended to be higher during the week-end (6.0 g, 95% CI 5.4-6.6) than during the week (5.4 g, 95% CI 4.3-6.7). The main sources of salt intake were pastas, potatoes, and rice (23% of total salt intake), pastries (16%), bread (16%), and cured meats (10%). One child out of three (34%) added salt to their plate at the table. CONCLUSIONS Salt intake in children in one region of Switzerland was high. Our findings suggest that salt intake in children could be reduced by lowering salt content in commonly eaten foods. TRIAL REGISTRATION NUMBER NCT02900261.
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Affiliation(s)
- Magali Rios-Leyvraz
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), route de la Corniche 10, 1010, Lausanne, Switzerland.
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), route de la Corniche 10, 1010, Lausanne, Switzerland
| | - Murielle Bochud
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), route de la Corniche 10, 1010, Lausanne, Switzerland
| | - Bernard Genin
- Hospital Center of Valais Romand, Hospital of Valais, Sion, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Michel Russo
- Hospital Center of Valais Romand, Hospital of Valais, Sion, Switzerland
| | - Michel F Rossier
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Central Institute of the Hospitals, Hospital of Valais, Sion, Switzerland
| | - René Tabin
- Hospital Center of Valais Romand, Hospital of Valais, Sion, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Arnaud Chiolero
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), route de la Corniche 10, 1010, Lausanne, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
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Rosário R, Santos R, Lopes L, Agostinis-Sobrinho C, Moreira C, Mota J, Póvoas S, Oliveira A, Padrão P, Moreira P, Abreu S. Fruit, vegetable consumption and blood pressure in healthy adolescents: A longitudinal analysis from the LabMed study. Nutr Metab Cardiovasc Dis 2018; 28:1075-1080. [PMID: 30207270 DOI: 10.1016/j.numecd.2018.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS The associations between fruit and vegetable consumption and high blood pressure among adults are well studied. Nonetheless, data on the influence of a low consumption of fruit and vegetables on cardiovascular disease risk, particularly blood pressure, among healthy adolescents are scarce. Therefore, we aim to analyse the associations between fruit and/or vegetable intake and blood pressure over a two-year period in healthy adolescents. METHODS AND RESULTS As part of a cohort, 606 adolescents from the LabMed Physical Activity study were evaluated in 2011 (baseline) and 2013 (follow-up). Blood pressure was measured according to standardized procedures and fruit and vegetable consumption was assessed with a food frequency questionnaire. Anthropometric variables, socioeconomic status, pubertal stage and lifestyle determinants were gathered and used as confounders. Prospective associations between fruit and/or vegetable intake and blood pressure were examined using generalized linear models. Girls who consumed more fruit at baseline had a significant decrease in diastolic blood pressure at follow-up [unstandardized beta: -0.005 mmHg (95%CI: -0.01; -0.0002) (p = 0.038)]. CONCLUSION In apparently healthy adolescents, fruit intake may already start to have an effect in blood pressure. Girls who consumed more fruit exhibited lower levels of diastolic blood pressure.
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Affiliation(s)
- R Rosário
- School of Nursing, University of Minho, Portugal; Health Sciences Research Unit-Nursing, Escola Superior de Enfermagem de Coimbra, Portugal.
| | - R Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal; Early Start, Faculty of Social Sciences, School of Education, University of Wollongong, Australia
| | - L Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - C Agostinis-Sobrinho
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal; Faculty of health Sciences, Klaipeda University, Lithuania; Physical Education, Physiotherapy and Dance, Federal University of the South of Brazil, Porto Alegre, Rio Grande do Sul, Brazil
| | - C Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - J Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - S Póvoas
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal
| | - A Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - P Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, Portugal; Institute of Public Health, University of Porto, Portugal
| | - P Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Portugal; Institute of Public Health, University of Porto, Portugal
| | - S Abreu
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal; Universidade Lusófona do Porto, Portugal
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Chen XT, Yang S, Yang YM, Zhao HL, Chen YC, Zhao XH, Wen JB, Tian YR, Yan WL, Shen C. Exploring the relationship of peripheral total bilirubin, red blood cell, and hemoglobin with blood pressure during childhood and adolescence. J Pediatr (Rio J) 2018; 94:532-538. [PMID: 29107800 DOI: 10.1016/j.jped.2017.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/16/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Total bilirubin is beneficial for protecting cardiovascular diseases in adults. The authors aimed to investigate the association of total bilirubin, red blood cell, and hemoglobin levels with the prevalence of high blood pressure in children and adolescents. METHODS A total of 3776 students (aged from 6 to 16 years old) were examined using cluster sampling. Pre-high blood pressure and high blood pressure were respectively defined as the point of 90th and 95th percentiles based on the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Both systolic and diastolic blood pressure were standardized into z-scores. RESULTS Peripheral total bilirubin, red blood cell and hemoglobin levels were significantly correlated with age, and also varied with gender. Peripheral total bilirubin was negatively correlated with systolic blood pressure in 6- and 9-year-old boys, whilst positively correlated with diastolic blood pressure in the 12-year-old boys and 13- to 15-year-old girls (p<0.05). Higher levels of red blood cell and hemoglobin were observed in pre-high blood pressure and high blood pressure students when compared with their normotensive peers (p<0.01). The increases in red blood cell and hemoglobin were significantly associated with high blood pressure after adjusting for confounding factors. The ORs (95% CI) of each of the increases were 2.44 (1.52-3.92) and 1.04 (1.03-1.06), respectively. No statistical association between total bilirubin and high blood pressure was observed (p>0.05). CONCLUSION Total bilirubin could be weakly correlated with both systolic and diastolic blood pressure, as correlations varied with age and gender in children and adolescents; in turn, the increased levels of red blood cell and hemoglobin are proposed to be positively associated with the prevalence of high blood pressure.
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Affiliation(s)
- Xiao-Tian Chen
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China
| | - Song Yang
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Ya-Ming Yang
- Center for Disease Control and Prevention of Yixing City, Yixing, China
| | - Hai-Long Zhao
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Yan-Chun Chen
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Xiang-Hai Zhao
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Jin-Bo Wen
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China
| | - Yuan-Rui Tian
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China
| | - Wei-Li Yan
- Children's Hospital of Fudan University, Department of Clinical Epidemiology, Shanghai, China
| | - Chong Shen
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China.
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Agostinis-Sobrinho C, García-Hermoso A, Ramírez-Vélez R, Moreira C, Lopes L, Oliveira-Santos J, Póvoas SC, Mota J, Santos R. Longitudinal association between ideal cardiovascular health status and muscular fitness in adolescents: The LabMed Physical Activity Study. Nutr Metab Cardiovasc Dis 2018; 28:892-899. [PMID: 30111494 DOI: 10.1016/j.numecd.2018.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/22/2018] [Accepted: 05/22/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIMS Muscular fitness is an emerging predictor for cardiovascular disease mortality. The ideal cardiovascular health metrics has been inversely related to a subsequent cardiometabolic health in adulthood. However, evidence regarding muscular fitness and ideal cardiovascular health in adolescents is scarce. This study aimed to examine the longitudinal association between ideal cardiovascular health index and muscular fitness. METHODS AND RESULTS This study cohort consisted of 331 adolescents (183 girls) from the LabMed Physical Activity Study who were followed from 2011 to 2013. Ideal cardiovascular health, as defined by the American Heart Association, was determined as meeting ideal health factors (total cholesterol, blood pressure, and glucose) and behaviors (smoking status, body mass index, physical activity, and diet). Handgrip strength and standing long jump tests assessed muscular fitness and were transformed into standardized values according to age and sex. ANCOVA showed a significant association between the accumulation of ideal cardiovascular health metrics at baseline and muscular fitness indices at follow-up (F(4, 322) = 2.280, p = 0.04). In addition, the higher the number of ideal cardiovascular health metrics accumulated, the higher the likelihood of having a high muscular fitness over a two-year period (p for trend = 0.01), after adjustments for age, sex, pubertal stage and socioeconomic status and muscular fitness at baseline. CONCLUSION The ideal cardiovascular health status during adolescence was associated with high muscular fitness levels over a two-year period.
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Affiliation(s)
- C Agostinis-Sobrinho
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal; Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania.
| | - A García-Hermoso
- Physical Activity, Sport and Health Sciences Laboratory, University of Santiago de Chile, USACH, Santiago de Chile, Chile
| | - R Ramírez-Vélez
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, DC, Colombia
| | - C Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - L Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - J Oliveira-Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - S C Póvoas
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal
| | - J Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - R Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal; Early Start Research Institute, Faculty of Social Sciences, School of Education, University of Wollongong, Australia
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Chen X, Yang S, Yang Y, Zhao H, Chen Y, Zhao X, Wen J, Tian Y, Yan W, Shen C. Exploring the relationship of peripheral total bilirubin, red blood cell, and hemoglobin with blood pressure during childhood and adolescence. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Bussenius H, Zeck AM, Williams B, Haynes-Ferere A. Surveillance of Pediatric Hypertension Using Smartphone Technology. J Pediatr Health Care 2018; 32:e98-e104. [PMID: 30005962 DOI: 10.1016/j.pedhc.2018.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/11/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Elevated blood pressure is becoming increasingly common in the pediatric population. Hypertension costs nearly $51 billion/year, and cardiovascular disease is responsible for 17% of the nation's health care expenditures. Traditionally, time-consuming and complicated interpretation standards result in infrequent pediatric blood pressure screenings. This may lead to the under-diagnosis of pediatric hypertension. Early detection of elevated blood pressure is important in order to prevent hypertension related conditions such as, target organ damage, left ventricular hypertrophy, and cerebrovascular disease. The aim of this study was to observe the prevalence of pediatric hypertension among children and adolescents age 3-18 using the smartphone application Pedia BP®. The purpose of this study was to (1) identify the prevalence of elevated blood pressure in a sample of children and adolescents and (2) evaluate any association between BMI, age, and blood pressure classification. METHOD A quantitative, descriptive study was conducted to evaluate the prevalence of pediatric hypertension in 81 preschool and school age children. App users were trained with the online take2heart course available at take2heart.com. The manual systolic and diastolic blood pressure readings were entered into the application, along with the patient's gender, age, height, and weight. Pedia BP® instantly calculated the blood pressure classification of the patient based on percentiles. Quantitative data from the Pedia BP® data repository were analyzed using descriptive statistics. RESULTS We found that 54.3% of our sample were normotensive, 23.5% had prehypertension, 13.6% had stage 1 hypertension, and 8.6% had stage 2 hypertension. As seen in Figure 3, the majority of subjects with stage 1 (72.7%) and stage 2 hypertension (57.1%) were found in school-age children. We found that 3.7% of children were underweight, 48.1% were at a healthy weight, 21% were overweight, and 27.2% were obese. DISCUSSION Pedia BP® was shown to be an effective screening tool to easily classify blood pressure readings on an individual basis. The prevalence of hypertension in our sample was higher than previously reported in the literature. Annual evaluation of blood pressures in preschool and school age children are warranted to identify and address hypertension. Pedia BP® was shown to be an effective screening tool to easily classify blood pressure readings on an individual basis. Pedia BP® offers benefits not only for patients, but for primary care providers, nurses, economists, insurance companies, hospitals, and clinics. Ultimately, Pedia BP® (1) increases awareness of elevated blood pressures among children and adolescents, (2) engages the health care community to screen for elevated blood pressures, (3) implements innovative technology, and (4) activates the potential for a population-based surveillance tool.
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Nolan RP, Feldman R, Dawes M, Kaczorowski J, Lynn H, Barr SI, MacPhail C, Thomas S, Goodman J, Eysenbach G, Liu S, Tanaka R, Surikova J. Randomized Controlled Trial of E-Counseling for Hypertension. Circ Cardiovasc Qual Outcomes 2018; 11:e004420. [DOI: 10.1161/circoutcomes.117.004420] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 06/04/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Robert P. Nolan
- Peter Munk Cardiac Centre (R.P.N., R.T., J.S.)
- University of Toronto, Ontario, Canada (R.P.N., S.T., J.G., G.E.)
| | - Ross Feldman
- St. Boniface Hospital, University of Manitoba, Winnipeg, Canada (R.F.)
| | - Martin Dawes
- University of British Columbia, Vancouver, Canada (M.D., S.I.B.)
| | | | - Hazel Lynn
- Grey Bruce Health Unit, Owen Sound, Ontario, Canada (H.L.)
| | - Susan I. Barr
- University of British Columbia, Vancouver, Canada (M.D., S.I.B.)
| | - Carolyn MacPhail
- Health PEI, Community Health, Charlottetown, Prince Edward Island, Canada (C.M.)
| | - Scott Thomas
- University of Toronto, Ontario, Canada (R.P.N., S.T., J.G., G.E.)
| | - Jack Goodman
- University of Toronto, Ontario, Canada (R.P.N., S.T., J.G., G.E.)
| | - Gunther Eysenbach
- Global eHealth (G.E.), University Health Network, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada (R.P.N., S.T., J.G., G.E.)
| | - Sam Liu
- University of Victoria, British Columbia, Canada (S.L.)
| | - Rika Tanaka
- Peter Munk Cardiac Centre (R.P.N., R.T., J.S.)
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Changes in muscular fitness and its association with blood pressure in adolescents. Eur J Pediatr 2018; 177:1101-1109. [PMID: 29740692 DOI: 10.1007/s00431-018-3164-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/20/2018] [Accepted: 04/25/2018] [Indexed: 01/02/2023]
Abstract
The aims of this study were to examine the longitudinal association between muscular fitness (MF) and blood pressure (BP) 2 years later, and to determine whether changes in MF over a 2-year period were associated with BP at follow-up, in adolescents. The sample comprised 734 youths (349 girls) aged from 12 to 18 years. MF was assessed with the standing long jump and handgrip tests. Socioeconomic status, pubertal stage, waist circumference, resting BP, and cardiorespiratory fitness were measured according to standard procedures. Regression analyses showed a significant inverse association between MF at baseline and systolic BP (β = - 0.072; p = 0.032) and rate pressure product (β = - 0.124; p < 0.001) at follow-up, after adjustments for age, sex, height, pubertal stage, and socioeconomic status. However, when analyses were further adjusted for waist circumference and cardiorespiratory fitness, these associations did not remain significant. Adolescents with persistently high and increasing MF exhibited the lowest levels of diastolic BP (F(3, 721) = 3.814, p = 0.018) and systolic BP (F(3, 721) = 3.908, p = 0.014) when compared to those with persistent low MF after adjustment for age, sex, height, socioeconomic status, cardiorespiratory fitness, and waist circumference.Conclusion: This study suggests that persistent greater and increasing MF in youth are associated with lower levels of BP across the adolescence. What is Known: • Currently, there is a growing interest on the health benefits of muscular fitness. • Cross-sectional studies have identified an association between muscular fitness and blood pressure in adolescents. What is New: • Changes in muscular fitness during adolescence were associated with systolic and diastolic BP over a 2-year period. • Adolescents with persistently low muscular fitness exhibited the highest levels of diastolic and systolic BP.
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Chen Y, Liang X, Zheng S, Wang Y, Lu W. Association of Body Fat Mass and Fat Distribution With the Incidence of Hypertension in a Population-Based Chinese Cohort: A 22-Year Follow-Up. J Am Heart Assoc 2018; 7:e007153. [PMID: 29745366 PMCID: PMC5907541 DOI: 10.1161/jaha.117.007153] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 12/08/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND There have been few studies on the association between the incidence of hypertension and the presence and distribution of body fat. The aim of this article was to evaluate this association. METHODS AND RESULTS Data were obtained from the China Health Nutrition Survey, a 22-year cohort study of 12 907 participants. Body mass index and triceps skinfold thickness were used as markers of body fat, whereas waist circumference (WC) was used as a marker of fat distribution. Cox regression was used to examine the association of body mass index, WC, and skinfold thickness with the incidence of hypertension. The interval between the baseline and hypertension diagnosis was the time variable, and hypertension was the end event. The mean age and proportion of men and women were 38.29 and 38.03 years and 45.63% and 54.37%, respectively. Compared with normal WC, abdominal obesity was associated with hypertension (P<0.001; crude hazard ratio, 2.11; 95% confidence interval, 1.89-2.37). Similarly, overweight (crude hazard ratio, 1.75; 95% confidence interval, 1.64-1.87) and obesity (crude hazard ratio, 3.19; 95% confidence interval, 2.80-3.63) were risk factors for hypertension (all P<0.001). When stratified by sex, the results confirmed that WC and body mass index predicted the development of hypertension in both men and women but not skinfold thickness in women. CONCLUSIONS Body mass index and WC were independent risk factors for hypertension, but skinfold thickness was a poor marker of body fat and could not be used to predict hypertension.
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Affiliation(s)
- Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuan Liang
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Senshuang Zheng
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuan Wang
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Ability of Nontraditional Risk Factors and Inflammatory Biomarkers for Cardiovascular Disease to Identify High Cardiometabolic Risk in Adolescents: Results From the LabMed Physical Activity Study. J Adolesc Health 2018; 62:320-326. [PMID: 29174876 DOI: 10.1016/j.jadohealth.2017.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/25/2017] [Accepted: 09/14/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE Then objective of this study was to evaluate the ability of several nontraditional cardiometabolic and inflammatory biomarkers in identifying high cardiometabolic risk in adolescents. METHODS A cross-sectional study was conducted with 529 Portuguese adolescents (267 girls) aged 14.3 ± 1.7 years. A clustered cardiometabolic risk score (body fat percentage, systolic blood pressure, ratio of total cholesterol to high-density lipoprotein cholesterol, triglycerides, homeostatic model assessment of insulin resistance, and negative values of cardiorespiratory fitness) was computed. The nontraditional cardiometabolic biomarkers assessed were complement factors (C3 and C4), C-reactive protein (CRP), fibrinogen, leptin, white blood cells (WBCs), albumin, interleukin-6, and a clustered score of inflammatory biomarkers (InflaScore) (C3, C4, CRP, fibrinogen, and leptin). RESULTS Receiver operating characteristic curves analyses showed that C3, C4, CRP, fibrinogen, leptin, and the InflaScore were able to present discriminatory ability in identifying an unfavorable cardiometabolic profile in both girls and boys (p <.01 for all). Logistic regression analyses showed that C3, C4, CRP, fibrinogen, leptin, the InflaScore (in both sexes), and WBC (boys) were associated with high cardiometabolic risk, independent of age, pubertal stage, socioeconomic status, or adherence to a Mediterranean diet (p <.05 for all). CONCLUSIONS C3, C4, CRP, fibrinogen, and leptin were associated with high cardiometabolic risk in both sexes and WBC in boys. In addition, the clustered inflammatory biomarkers seem to have a better diagnostic accuracy in identifying an unfavorable cardiometabolic profile than single biomarkers. Such biomarkers may have utility in motivating health professionals, public health workers, and adolescents' families toward lifestyle changes, improving prevention efforts early in life.
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48
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Agostinis-Sobrinho C, Ruiz JR, Moreira C, Abreu S, Lopes L, Oliveira-Santos J, Mota J, Santos R. Cardiorespiratory Fitness and Blood Pressure: A Longitudinal Analysis. J Pediatr 2018; 192:130-135. [PMID: 29246334 DOI: 10.1016/j.jpeds.2017.09.055] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/18/2017] [Accepted: 09/21/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine the association between cardiorespiratory fitness and cardiovascular indices 2 years later, and to determine whether changes in cardiorespiratory fitness are associated with cardiovascular indices at a 2-year follow-up in adolescents. STUDY DESIGN The sample comprised 734 adolescents (349 girls) aged 12-18 years followed for 3 years from the LabMed Physical Activity Study. Cardiorespiratory fitness was assessed by the 20-meter shuttle run test. Height, weight, waist circumference, and resting blood pressure (BP) were measured according to standard procedures. RESULTS Regression analyses showed a significant inverse association between cardiorespiratory fitness at baseline and systolic BP (B = -0.126; P = .047) and rate pressure product (B = -29.94; P = .016), at follow-up after adjustments for age, sex, height, pubertal stage, socioeconomic status, and waist circumference. Significant differences were found between cardiorespiratory fitness groups (fit vs unfit) at baseline and systolic BP and rate pressure product at follow-up (P < .05 for all). Analysis of covariance showed a significant association between cardiorespiratory fitness changes and systolic BP (P = .024) and rate pressure product (P = .014), after adjustment for age, sex, height, pubertal status, socioeconomic status, and waist circumference. CONCLUSIONS Changes in cardiorespiratory fitness during adolescence were associated with cardiovascular indices over a 2-year period. Adolescents with persistently low levels of cardiorespiratory fitness exhibited the highest levels of systolic BP and rate pressure product.
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Affiliation(s)
- César Agostinis-Sobrinho
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
| | - Jonatan R Ruiz
- PROFITH Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Sandra Abreu
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - José Oliveira-Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal; Early Start Research Institute, Faculty of Social Sciences, School of Education. University of Wollongong, Wollongong, Australia
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Aleali AM, Latifi SM, Rashidi H, Payami SP, Sabet A. Prevalence of hypertension and prehypertension in adolescence in Ahvaz, Iran. Diabetes Metab Syndr 2017; 11 Suppl 2:S547-S550. [PMID: 28420576 DOI: 10.1016/j.dsx.2017.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/05/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND High blood pressure is a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. OBJECTIVES The aim of this study was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. PATIENTS AND METHODS This descriptive analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran). A questionnaire include: height, weight, and body mass index, systolic and diastolic blood pressures filled for each participant. Blood pressure was measured twice for each person. For the diagnosis of hypertension, the fourth report of the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Health Institute of United States was used. RESULTS Total participants of the study were 1707children and adolescents including 922 boys (54%) and 785 girls (46%). The prevalence of high blood pressure was 1.7% (2.5% in boys and 0.8%). The prevalence of pre-hypertension was 9%(7.6% in boys, 10.6% in girls). The mean systolic and diastolic blood pressures increased with increasing body mass index. CONCLUSIONS The prevalence of high blood pressure was found to be lower than other studies in our country. The prevalence of the high blood pressure in boys was significantly higher than girls. This study, like other studies showed high correlation between being overweight and an increase in systolic and diastolic blood pressure.
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Affiliation(s)
- Armaghan Moravej Aleali
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Seyed Mahmoud Latifi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran.
| | - Homeira Rashidi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Seyed Peyman Payami
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Azar Sabet
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
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Gooding HC, Brown CA, Wisk LE. Investing in our future: The importance of ambulatory visits to achieving blood pressure control in young adults. J Clin Hypertens (Greenwich) 2017; 19:1298-1300. [PMID: 28942600 DOI: 10.1111/jch.13100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Holly C Gooding
- Division of Adolescent and Young Adult Medicine Boston Children's Hospital, Boston, MA, USA
| | - Courtney A Brown
- Division of Adolescent and Young Adult Medicine Boston Children's Hospital, Boston, MA, USA
| | - Lauren E Wisk
- Division of Adolescent and Young Adult Medicine Boston Children's Hospital, Boston, MA, USA
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