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Oliveira MDS, Gonçalves FCLDSP, de Lira PIC, Filho SLVN, Eickmann SH, Lima MDC. Birthweight, postnatal growth and blood pressure in adolescents of low socioeconomic condition: a cohort study in Northeast Brazil. J Pediatr (Rio J) 2023; 99:391-398. [PMID: 36758624 PMCID: PMC10373154 DOI: 10.1016/j.jped.2023.01.003] [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: 09/23/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE To verify the influence of low birth weight and rapid postnatal weight gain and associated factors on blood pressure in adolescence in a population of low socioeconomic status, considering that injuries occur in the perinatal period can be predictors of future metabolic changes and are still poorly explored. METHODS A cohort study was carried out with 208 adolescents, 78 born with low weight and 130 born with appropriate weight. The infants were followed up during the first six postnatal months and reassessed at 8 and 18 years of age. The independent variables were birthweight and postnatal weight gain. Rapid postnatal weight gain was defined when above 0.67 z score. The co-variables were sex, maternal height and family income at birth, nutritional status at eight years old, socioeconomic conditions, nutritional status, fat mass index, and physical activity level at 18 years. The outcome variable was blood pressure at 18 years old. The bivariate and multivariable logistic regression analysis were realized and p < 0,05 was considered significant. RESULTS The proportion of adolescents with elevated blood pressure was 37.5%. The multivariable logistic regression analysis showed the variables independently associated with a higher chance of elevated blood pressure in adolescence were rapid postnatal weight gain (OR = 2.74; 95% CI 1.22-6.14; p = 0.014), male sex (OR = 4.15; 95% CI 1.66-10.38; p = 0.002) and being physically active (OR = 2.70; 95% CI 1.08-6.74; p = 0.034). CONCLUSIONS The rapid postnatal weight gain was a predictor for elevated blood pressure in adolescence, independently of other factors.
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Affiliation(s)
| | | | - Pedro Israel Cabral de Lira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Recife, PE, Brazil; London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | | | - Sophie Helena Eickmann
- Universidade Federal de Pernambuco, Nutrição, Recife, PE, Brazil; Departamento Materno-Infantil, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Marilia de Carvalho Lima
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom; Departamento Materno-Infantil, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Zhou Y, Li J, Ma Y, Tang M, Yuan X, Shen L. Elevated serum uric acid is associated with the risk of advanced staging and vascular involvement in patients with hepatoblastoma: a 14-year retrospective study. Front Oncol 2023; 13:1144349. [PMID: 37124543 PMCID: PMC10140562 DOI: 10.3389/fonc.2023.1144349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/30/2023] [Indexed: 05/02/2023] Open
Abstract
Background Uric acid is the end product of the purine metabolism pathway, and has been linked to cancer risks and prognosis, but its relationship with hepatoblastoma (HB) remains unclear. This study aims to investigate the association between serum uric acid (SUA) and the advanced tumor staging and unfavorable extra-parenchymal tumor characteristics in patients with HB. Methods This study enrolled pediatric patients from Xinhua Hospital between 2007 to 2021. A total of 101 participants with newly diagnosed HB were recruited in the study. PRETreatment EXTent of disease (PRETEXT)/PostTreatment Extent of disease (POSTTEXT) staging were evaluated at diagnosis and following neoadjuvant chemotherapy (NAC). Adjusted smoothing spline plots, subgroup analysis and multivariate logistic regression analysis were conducted to estimate the association of different levels of SUA with the advanced tumor staging and present annotation factors. Results In accordance with SUA tertiles, those patients with higher pretreatment SUA levels showed increased percentages of PRETEXT group IV, vessel involvement and multifocality of tumors. After fully adjustment with the confounding factors, SUA was positively associated with advanced PRETEXT stage IV (OR: 1.72, 95%CI 1.15-2.57, p=0.0080), as well as vascular invasion (OR: 1.29, 95%CI 1.01-1.64, p=0.0396). Compared with the lowest SUA concentration tertile, the highest tertile were independently associated with vessel involvement of tumor in all of the adjusted models. Following NAC, SUA levels were significantly reduced in response to the downstaging of tumors. SUA remained positively associated with advanced POSTTEXT staging and vessel involvement in adjusted models. Patients with highest tertile of posttreatment SUA showed worse 5-year EFS and OS. Conclusion Elevated SUA were associated with an increased occurrence of advanced PRETEXT/POSTTEXT staging and unfavorable vessel involvement at diagnosis and following NAC in patients with HB. High posttreatment SUA reflected poor tumor responses to NAC. This study linked SUA, a non-invasive laboratory test, with tumor staging and risk prediction for HB.
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Affiliation(s)
- Yunlan Zhou
- Department of Clinical Laboratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Faculty of Medical Laboratory Science, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinning Li
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanhui Ma
- Department of Clinical Laboratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Faculty of Medical Laboratory Science, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengjie Tang
- Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Yuan
- Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Lisong Shen, ; Xiaojun Yuan,
| | - Lisong Shen
- Department of Clinical Laboratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Faculty of Medical Laboratory Science, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Artificial Intelligence Medicine, Shanghai Academy of Experimental Medicine, Shanghai, China
- *Correspondence: Lisong Shen, ; Xiaojun Yuan,
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Sivasubramanian R, Meyers KE. Hypertension in Children and Adolescents with Turner Syndrome (TS), Neurofibromatosis 1 (NF1), and Williams Syndrome (WS). Curr Hypertens Rep 2021; 23:18. [PMID: 33779870 DOI: 10.1007/s11906-021-01136-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Turner syndrome (TS), neurofibromatosis type 1(NF1), and William Syndrome (WS) are 3 genetic conditions that are all associated with a substantial increase in risk of hypertension. In this review, we focus on factors leading to hypertension and on clinical manifestations and management of hypertension in children and adolescents with these genetic conditions RECENT FINDINGS: In most instances, hypertension is secondary. There is a high prevalence of masked hypertension in TS; however, the extent to which control of the BP helps reduce the risk of aortic dissection/aneurysm in TS is not yet fully elucidated. Vasculopathies are the least emphasized but most important manifestation of NF1. Of note, routine screening for pheochromocytoma in NFI is not recommended as it is not cost-effective. Cardiovascular complications are the major cause of death in patients with WBS. ABPM identifies patients without overt aortic or renovascular narrowing. Antihypertensive agents such as ARBs that have direct vascular wall effects and agents that inhibit oxidative stress (minoxidil) should be considered, even in those who do not exhibit overt hypertension. Elevated blood pressure in children and adolescence manifests early with end-organ changes and when left untreated, increases risk for premature onset of cardiovascular disease. Vigilant monitoring of the blood pressure is recommended. Accurate early diagnosis and management of hypertension will delay or prevent target organ damage and ensure a healthier transition to adulthood among children afflicted with these conditions.
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Affiliation(s)
- Ramya Sivasubramanian
- Division of Pediatric Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, 9th Floor Beurger Building, 3405 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Kevin E Meyers
- Division of Pediatric Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania, 9th Floor Beurger Building, 3405 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
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Paszynska E, Dmitrzak-Weglarz M, Ostalska-Nowicka D, Nowicki M, Gawriolek M, Zachwieja J. Association of Oral Status and Early Primary Hypertension Biomarkers among Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217981. [PMID: 33143057 PMCID: PMC7662220 DOI: 10.3390/ijerph17217981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
The aim of this case-control study was the evaluation of the association between biomarkers of early primary arterial hypertension (HA) and oral diseases among children and adolescents. Material and methods. Subjects suspected of primary HA (n = 180) underwent a complex evaluation of their vascular status: blood pressure, heart rate, vascular stiffness, sympathetic activity in a 24 h ambulatory examination, followed by measurement of serum uric acid (UA), cystatin C, and creatinine. This procedure allowed the identification of children with primary (n = 58) and secondary HA (n = 74), as well as of children with normal arterial blood pressure, who served as a control group (n = 48). All subjects with secondary HA were excluded from further investigation. Oral examination included the measurement of caries intensity (using the decayed, missing, filled index for permanent teeth DMFT /primary teeth dmft), bacterial plaque (by the plaque control record index, PCR%), and gingivitis (by the bleeding on probing index, BOP%). For statistical analysis, a linear regression model and Spearman rank correlation were used. Results. UA, cystatin C, and creatinine were not altered in the HA group. However, the number of decayed permanent teeth (DT) and the DMFT, PCR%, and BOP% indexes were significantly higher in the primary HA group compared to the control group (p = 0.0006; p = 0.02; p = 0.0009; p = 0.003). Our results are not sufficient to prove the important role of caries and gingival inflammation in the modulation of HA symptoms, although they prove the association of oral diseases with primary HA symptoms. This may indicate future strategies for preventive measures for hypertensive children and adolescents.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
- Correspondence:
| | - Monika Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (D.O.-N.); (J.Z.)
| | - Michal Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland;
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (D.O.-N.); (J.Z.)
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