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Toprak K, Özen K, Karataş M, Dursun A. Inflammation-based markers, especially the uric acid/albumin ratio, are associated with non-dipper pattern in newly diagnosed treatment-naive hypertensive patients. Blood Press Monit 2024; 29:221-231. [PMID: 38774974 DOI: 10.1097/mbp.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
OBJECTIVE Physiologically, at night, blood pressure (BP) is expected to decrease by at least 10% in hypertensive individuals. The absence of this decrease, called non-dipper hypertension, is associated with increased end-organ damage and cardiovascular mortality and morbidity in hypertensive individuals. It is known that increased inflammatory process plays an important role in the etiopathogenesis of non-dipper hypertension pattern. In recent years, it has been shown that inflammation-based markers (IBMs) obtained by combining various inflammation-related hematological and biochemical parameters in a single fraction have stronger predictive value than single inflammatory parameters. However, until now, there has not been a study investigating the relationship of these markers with dipper/non-dipper status in newly diagnosed hypertensive patients. METHODS Based on ambulatory BP monitoring, 217 dipper and 301 non-dipper naive hypertensive subjects were included in this study. All subjects' IBM values were compared between dipper and non-dipper hypertensive individuals. RESULTS IBMs [C-reactive protein/albumin ratio (CAR), monocyte/high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, systemic immune-inflammation index (SII), uric acid/albumin ratio (UAR)] were significantly higher in the non-dipper group. CAR, MHR, NLR, SII, and UAR were determined as independent predictors for non-dipper pattern ( P < 0.05, for all). Also, UAR's diagnostic performance for non-dipper pattern was found to be superior to other IBMs (area under the curve: 0.783, 95% confidence interval: 0.743-0.822; P < 0.001). CONCLUSION These findings suggest an association between elevated IBMs, particularly UAR, and the non-dipper hypertension pattern observed in our study.
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Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa
| | - Kaya Özen
- Department of Cardiology, Gazi Yaşargil Training and Research Hospital, Diyarbakir
| | - Mesut Karataş
- Department of Cardiology,Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul
| | - Ayten Dursun
- Nursing Department, Şanliurfa Provincial Health Directorate, Sanliurfa, Turkey
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Quan Y, Wang C, Wang L, Li G. Geriatric sarcopenia is associated with hypertension: A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2023; 25:808-816. [PMID: 37594142 PMCID: PMC10497027 DOI: 10.1111/jch.14714] [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: 05/12/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/19/2023]
Abstract
This meta-analysis aimed to explore the potential relationship between senile sarcopenia and hypertension in older people. A comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library, up to November 2022. Ten studies comprising 14 804 participants were enrolled. The odds ratio (OR) and 95% confidence interval (CI) was pooled to evaluate the correlation between sarcopenia and hypertension in older people utilizing a random-effects model. Subgroup and sensitivity analyses were then carried out to explore the potential sources of heterogeneity. The results revealed a substantial correlation between sarcopenia and hypertension among older people (OR = 1.39, 95% CI: 1.15-1.67, p < .01). Further subgroup analysis revealed an association between sarcopenic obesity and hypertension (OR = 1.49, 95% CI: 1.37-1.62, p < .01). In conclusions, our findings highlighted a significant relationship between sarcopenia and hypertension among older people, with sarcopenic obesity amplifying this risk.
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Affiliation(s)
- Yawen Quan
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
- Graduate School of Hebei Medical UniversityShijiazhuangHebeiChina
| | - Chang Wang
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
- Graduate School of North China University of TechnologyTangshanHebeiChina
| | - Linfeng Wang
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
- Graduate School of Hebei North CollegeZhangjiakouHebeiChina
| | - Gang Li
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
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Buksińska-Lisik M, Kwasiborski PJ, Ryczek R, Lisik W, Mamcarz A. Ambulatory Blood Pressure Monitoring as a Useful Tool in the Cardiological Assessment of Pancreas Transplant Recipients with Type 1 Diabetes. Diagnostics (Basel) 2023; 13:2724. [PMID: 37685261 PMCID: PMC10487007 DOI: 10.3390/diagnostics13172724] [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: 05/30/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Having the appropriate tools to identify pancreas recipients most susceptible to coronary artery disease (CAD) is crucial for pretransplant cardiological assessment. The aim of this study is to evaluate the association between blood pressure (BP) indices provided by ambulatory blood pressure monitoring (ABPM) and the prevalence of CAD in pancreas transplant candidates with type 1 diabetes (T1D). This prospective cross-sectional study included adult T1D patients referred for pretransplant cardiological assessment in our center. The study population included 86 participants with a median age of 40 (35-46) years. In multivariate logistic regression analyses, after adjusting for potential confounding factors, higher 24 h BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.063, 95% CI 1.023-1.105, p = 0.002/OR = 1.075, 95% CI 1.003-1.153, p = 0.042/OR = 1.091, 95 CI 1.037-1.147, p = 0.001, respectively) and higher daytime BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.069, 95% CI 1.027-1.113, p = 0.001/OR = 1.077, 95% CI 1.002-1.157, p = 0.043/OR = 1.11, 95% CI 1.051-1.172, p = 0.0002, respectively) were independently and significantly associated with the prevalence of CAD. Daytime pulse pressure was the strongest indicator of the prevalence of CAD among all analyzed ABPM parameters. ABPM can be used as a valuable tool to identify pancreas recipients who are most susceptible to CAD. We suggest the inclusion of ABPM in pretransplant cardiac screening in type 1 diabetes patients eligible for pancreas transplantation.
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Affiliation(s)
- Małgorzata Buksińska-Lisik
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 2 Bursztynowa St., 04-749 Warsaw, Poland
- Department of Cardiology and Internal Medicine, Multidisciplinary Hospital Warsaw Miedzylesie, 2 Bursztynowa St., 04-749 Warsaw, Poland
| | - Przemysław Jerzy Kwasiborski
- Department of Cardiology and Internal Medicine, Multidisciplinary Hospital Warsaw Miedzylesie, 2 Bursztynowa St., 04-749 Warsaw, Poland
| | - Robert Ryczek
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 128 Szaserów St., 04-141 Warsaw, Poland
| | - Wojciech Lisik
- Department of General and Transplantation Surgery, The Medical University of Warsaw, 59 Nowogrodzka St., 02-006 Warsaw, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 2 Bursztynowa St., 04-749 Warsaw, Poland
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Xing E, Wan C. Prevalence of and factors associated with sarcopenia among elderly individuals with hypertension. J Int Med Res 2022; 50:3000605221110490. [PMID: 35822256 PMCID: PMC9284226 DOI: 10.1177/03000605221110490] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Sarcopenia is a major health problem in community-dwelling elderly
individuals. Hypertension is postulated to aggravate sarcopenia. The present
study was performed to estimate the prevalence of and factors associated
with sarcopenia among elderly individuals with hypertension. Methods This study involved 165 Chinese individuals with hypertension aged ≥60 years
who were evaluated for sarcopenia using the Asian Working Group for
Sarcopenia criteria. Data on their sociodemographic information, physical
illnesses, and clinical and functional status were collected. Results The overall prevalence of sarcopenia among elderly individuals with
hypertension was 20.2%. The factors significantly associated with sarcopenia
were an age of ≥70 years (adjusted odds ratio (OR), 3.01; 95% confidence
interval (CI), 1.17–5.39), diabetes (OR, 4.45; 95% CI, 1.32–11.16),
osteoporosis (OR, 2.52; 95% CI, 1.13–5.37), drinking (OR, 3.28; 95% CI,
1.26–7.85), and a body mass index of 24.0 to 27.9 kg/m2 (OR,
0.74; 95% CI, 0.59–0.91). Conclusions This study revealed a very high prevalence of sarcopenia among elderly
individuals with hypertension (20.2%). Sarcopenia may be associated with
advanced age, drinking, diabetes, the body mass index, and osteoporosis. The
longitudinal relationship between clinic visits and sarcopenia should be
further evaluated.
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Affiliation(s)
- Enwang Xing
- Department of Rehabilitation Medicine, Tianjin Medical
University, Tianjin, China
- Department of Rehabilitation Medicine, Tianjin Port Hospital,
Tianjin, China
| | - Chunxiao Wan
- Department of Rehabilitation Medicine, Tianjin Medical
University, Tianjin, China
- Department of Rehabilitation Medicine, Tianjin Medical
University General Hospital, Tianjin, China
- Chunxiao Wan, Department of Rehabilitation
Medicine, Tianjin Medical University General Hospital, 154 Anshan Road, Heping
District, Tianjin 300041, China.
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Relation between nocturnal decline in blood pressure and choroidal thickness: a comparative analysis in dipper vs. non-dipper hypertensive patients. Blood Press Monit 2021; 26:176-182. [PMID: 33252363 DOI: 10.1097/mbp.0000000000000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare choroidal thickness (ChT) and echocardiographical changes in patients with dipper and non-dipper systemic arterial hypertension (HT). METHODS Patients with HT were evaluated in two groups according to the 24-hour ambulatory BP monitoring. Compared to day-time values, those whose night-time SBP decreased ≥10% were defined as dippers, and those whose SBP decreased <10% were defined as non-dippers. Transthoracic echocardiography was conducted in all patients. ChT and central macular thickness were measured with spectral-domain optical coherence tomography. ChT was obtained at the subfoveal, 1500 µm nasal and temporal to the fovea. RESULTS Thirty non-dipper (18 females and 12 males) and 23 dipper (16 females and seven males) hypertensive patients were recruited. Sex distribution and the mean age were similar between the groups (P = 0.472; P = 0.12). Disease duration was longer in the non-dipper group (8 ± 3.39 vs. 4.96 ± 1.19 years, P = 0.001). The non-dipper group had lower ChT in subfoveal and temporal locations (P = 0.02 and 0.03, respectively) and higher left atrial volume index (LAVI) and pulmonary valve maximum flow (PV-max; P < 0.001). The night-time SBP was negatively correlated with ChT (P = 0.048) and positive correlated with LAVI and PV-max (P < 0.05). However those correlations were not significant when were controlled by the possible confounding factors as disease duration, age and gender. CONCLUSION Non-dipper HT patients may have thinner choroid than dippers due to longer duration of HT and higher ambulatory BP levels.
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Burgos-Alonso N, Ruiz Arzalluz MV, Garcia-Alvarez A, Fernandez-Fernandez de Quincoces D, Grandes G. Reproducibility study of nocturnal blood pressure dipping in patients with high cardiovascular risk. J Clin Hypertens (Greenwich) 2021; 23:1041-1050. [PMID: 33591600 PMCID: PMC8678773 DOI: 10.1111/jch.14222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/09/2021] [Accepted: 01/25/2021] [Indexed: 12/31/2022]
Abstract
It has been shown that in most people there is a physiological reduction in blood pressure during nighttime sleep, it falling by approximately 10% compared to daytime values (dippers). On the other hand, in some people, there is no nighttime reduction (non‐dippers). Various studies have found an association between being a non‐dipper and a higher risk of cardiovascular disease, but few have assessed whether the nocturnal pattern is maintained over time. From the database of the TAHPS study, data were available on 225 patients, each of whom underwent 24‐hour ambulatory blood pressure monitoring (ABPM) on four occasions over a period of 5 months. We studied the reproducibility of the nocturnal BP dipping pattern with mixed linear analysis and also calculated the concordance in the classification of patients as dippers or non‐dippers. The intraclass correlation coefficients between the different ABPM recordings were 0.482 and 0.467 for systolic and diastolic blood pressure, respectively. Two‐thirds (67%) and 70% of the patients classified, respectively, as dippers or non‐dippers based on systolic and diastolic blood pressure readings in the first ABPM recording were found to have the same classification based on the subsequent recordings. We conclude that the reproducibility of nocturnal dipping patterns and concordance of dipper vs non‐dipper status in individual patients is modest and therefore that we should be cautious about recommending treatments or interventions based on these patterns.
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Affiliation(s)
- Natalia Burgos-Alonso
- Primary Care Research Unit of Bizkaia, BioCruces Bizkaia Health Research Institute, Bilbao, Spain.,Preventive Medicine and Public Health Department, Faculty of Medicine and Nursery. University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Maria Victoria Ruiz Arzalluz
- Primary Care Research Unit of Bizkaia, BioCruces Bizkaia Health Research Institute, Bilbao, Spain.,Tolosaldea Health Region, Basque Health Service (Osakidetza), Bilbao, Spain
| | - Arturo Garcia-Alvarez
- Primary Care Research Unit of Bizkaia, BioCruces Bizkaia Health Research Institute, Bilbao, Spain
| | | | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, BioCruces Bizkaia Health Research Institute, Bilbao, Spain
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Patterns of Circadian Variation in 24-Hour Ambulatory Blood Pressure, Heart Rate, and Sympathetic Tone Correlate with Cardiovascular Disease Risk: A Cluster Analysis. Cardiovasc Ther 2020; 2020:4354759. [PMID: 33042223 PMCID: PMC7528127 DOI: 10.1155/2020/4354759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022] Open
Abstract
To investigate whether specific time series patterns for blood pressure (BP), heart rate (HR), and sympathetic tone are associated with metabolic factors and the 10-year risk of atherosclerotic cardiovascular disease (ASCVD). A total of 989 patients who underwent simultaneous 24-hour ambulatory BP and Holter electrocardiogram monitoring were enrolled. The patients were categorized into sixteen groups according to their circadian patterns using the consensus clustering analysis method. Metabolic factors, including cholesterol profiles and apolipoprotein, were compared. The 10-year ASCVD risk was estimated based on the Framingham risk model. Overall, 16 significant associations were found between the clinical variables and cluster groups. Age was commonly associated with all clusters in systolic BP (SBP), diastolic BP (DBP), HR, and sympathetic tone. Metabolic indicators, including diabetes, body mass index, total cholesterol, high-density lipoprotein, and apolipoprotein, were associated with the four sympathetic tone clusters. In the crude analysis, the ASCVD risk increased incrementally from clusters 1 to 4 across SBP, DBP, HR, and sympathetic tone. After adjustment for multiple variables, however, only sympathetic tone clusters 3 and 4 showed a significantly high proportion of patients at high risk (≥7.5%) of 10-year ASCVD (odds ratio (OR) = 5.90, 95% confidential interval (CI) = 1.27-27.46, and P value = 0.024 and OR = 15.28, 95% CI = 3.59-65.11, and P value < 0.001, respectively). Time series patterns of BP, HR, and sympathetic tone can serve as an indicator of aging. Circadian variations in sympathetic tone can provide prognostic information about patient metabolic profiles and indicate future ASCVD risk.
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Zhu Y, Chen X, Geng S, Li Q, Yuan H, Zhou X, Li H, Li J, Jiang H. Association between ambulatory blood pressure variability and frailty among older hypertensive patients. J Clin Hypertens (Greenwich) 2020; 22:1703-1712. [PMID: 32857914 PMCID: PMC7589330 DOI: 10.1111/jch.13986] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/30/2020] [Accepted: 07/05/2020] [Indexed: 12/14/2022]
Abstract
Frailty and hypertension often coexist and are increasingly prevalent with advancing age. Although hypertension is independently associated with frailty, whether high blood pressure variability affecting frailty is unclear. In this retrospective study, we consecutively enrolled elderly patients with essential hypertension undergoing 24-hour ABPM. The frailty was assessed by a 38-item frailty index. The parameters of blood pressure variability of ABPM, including ARV, coefficient of CV, SD, and weighed SD were calculated. Ordinal logistic regression was used to investigate the association between blood pressure variability and frailty. A total of 242 hypertensive patients were recruited and divided into the frail group, pre-frail group, and non-frail group. The overall magnitudes of BP variability, assessed by ARV, CV, SD, and weighed SD, were significantly greater in patients with frailty than those with pre-frailty and non-frailty. With adjustment for covariates, ARV of 24-hour, diurnal, and nocturnal SBP were independently associated with frailty (24 hours, OR: 2.48, 95% CI: 2.01-3.07; daytime, OR: 1.83, 95% CI: 1.60-2.10; nighttime, OR: 1.19, 95% CI: 1.12-1.27). The CV of 24-hour, diurnal, and nocturnal SBP was independently associated with frailty in the study (24 hours, OR: 1.2, 95% CI: 1.05-3.07; daytime, OR: 1.19, 95% CI: 1.05-1.34; nighttime, OR: 1.13, 95% CI: 1.03-1.24). For SD and weighed SD, only 24-hour systolic SD was independent risk factor associated with frailty (OR: 1.12, 95% CI: 1.01-1.23). The greater blood pressure variability of SBP, particular ARV and CV, were independent risk factors associated with higher-order frailty status. Longitudinal studies are needed to investigate the causality associations between hypertension and frailty.
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Affiliation(s)
- Yingqian Zhu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xin Chen
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - ShaSha Geng
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - QingQing Li
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huixiao Yuan
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xi Zhou
- Department of General Medicine, Shanghai East Hospital Ji'an Hospital, Ji'an, China
| | - Huan Li
- Department of General Medicine, Shanghai East Hospital Ji'an Hospital, Ji'an, China
| | - Jinglan Li
- Department of General Medicine, Shanghai East Hospital Ji'an Hospital, Ji'an, China
| | - Hua Jiang
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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Arkoumani M, Papadopoulou-Marketou N, Nicolaides NC, Kanaka-Gantenbein C, Tentolouris N, Papassotiriou I. The clinical impact of growth differentiation factor-15 in heart disease: A 2019 update. Crit Rev Clin Lab Sci 2019; 57:114-125. [PMID: 31663791 DOI: 10.1080/10408363.2019.1678565] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Growth differentiation factor-15 (GDF-15), also known as macrophage inhibitory cytokine-1 (MIC-1) or non-steroidal anti-inflammatory drug-activated gene (NAG-1) has been identified as a biomarker of response to treatment and prognosis in cardiovascular diseases. GDF-15 is a member of the transforming growth factor-β superfamily and is involved in several pathological conditions such as inflammation, cancer, cardiovascular, pulmonary and renal diseases. Cardiac myocytes produce and secrete GDF-15 in response to oxidative stress, stimulation with angiotensin II or proinflammatory cytokines, ischemia, and mechanical stretch. Other cellular sources of GDF-15 production are macrophages, vascular smooth muscle cells, endothelial cells, and adipocytes, which secrete GDF-15 in response to oxidative or metabolic stress or stimulation of proinflammatory cytokines. GDF-15 is induced in hypertrophic and dilated cardiomyopathy after volume overload, ischemia, and heart failure. GDF-15 can be used as a marker of prognosis in patients with cardiovascular disorders, in combination with conventional prognostic factors, such as N-terminal pro B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT).
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Affiliation(s)
- Maria Arkoumani
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece.,First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Nektaria Papadopoulou-Marketou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece.,First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Nicolas C Nicolaides
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, "Laiko" General Hospital, Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
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