Anthropometric studies on the Turkish population--a historical review

Comprehensive evaluation of patients with primary hyperoxaluria type 1: A nationwide study

BACKGROUND

Primary hyperoxaluria type 1 (PH1) is characterized by increased endogenous oxalate production and deposition as calcium oxalate crystals. The main manifestations are nephrocalcinosis/nephrolithiasis, causing impaired kidney function. We aimed to evaluate the clinical characteristics and overall outcomes of paediatric PH1 patients in Turkey.

METHODS

This is a nationwide, multicentre, retrospective study evaluating all available paediatric PH1 patients from 15 different paediatric nephrology centres in Turkey. Detailed patient data was collected which included demographic, clinical and laboratory features. Patients were classified according to their age and characteristics at presentation: patients presenting in the first year of life with nephrocalcinosis/nephrolithiasis (infantile oxalosis, Group 1), cases with recurrent nephrolithiasis diagnosed during childhood (childhood-onset PH1, Group 2), and asymptomatic children diagnosed with family screening (Group 3).

RESULTS

Forty-eight patients had a mutation consistent with PH1. The most common mutation was c.971_972delTG (25%). Infantile oxalosis patients had more advanced chronic kidney disease (CKD) or kidney failure necessitating dialysis (76.9% vs. 45.5%). These patients had much worse clinical course and mortality rates seemed to be higher (23.1% vs. 13.6%). Patients with fatal outcomes were the ones with significant comorbidities, especially with cardiovascular involvement. Patients in Group 3 were followed with better outcomes, with no kidney failure or mortality.

CONCLUSION

PH1 is not an isolated kidney disease but a systemic disease. Family screening helps to preserve kidney function and prevent systemic complications. Despite all efforts made with traditional treatment methods including transplantation, our results show devastating outcomes or mortality.

Arterial Stiffness and Ambulatory Blood Pressure Measurements in Children With Familial Mediterranean Fever

Familial Mediterranean fever (FMF) is an autoinflammatory disease which may cause endothelial dysfunction and arterial stiffness. In this study, we evaluated patients with FMF in terms of arterial stiffness indicators and investigated whether there was any difference according to colchicine response. This is a single-center, prospective, case-control study conducted on pediatric patients with FMF. Patients were categorized into 2 groups: patients on colchicine monotherapy (group 1) and patients who used anti-interleukin-1 (IL-1) plus colchicine (group 2). Patient age, mutations in the MEFV gene, overall duration of treatments, and general characteristics of symptoms were recorded. Laboratory values in an attack-free period were noted. Pulse wave velocity (PWV) was measured in all patients. Erythrocyte sedimentation rate and C-reactive protein, nocturnal hypertension, and PWV were higher in group 2. Arterial stiffness develops due to subclinical inflammation in patients with FMF. It is more pronounced in colchicine-resistant patients.

Electrocardiographic measurements in children with pre-dialysis chronic kidney disease and undergoing kidney replacement therapy

Cardiovascular diseases are the main causes of morbidity in children with chronic kidney disease (CKD). Electrocardiography (ECG) can provide important information about cardiac functions and parameters associated with sudden cardiac death. This study aims to evaluate the potentially dangerous changes in CKD and kidney replacement therapies by ECG and to determine the value of ECG in predicting cardiovascular outcome compared with echocardiography. 101 patients with CKD were divided into subgroups according to treatment modalities as pre-dialysis CKD, hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (KTx). Differences in anthropometric measurements, laboratory results, blood pressures, ECG monitoring were compared within groups as well as with 40 healthy controls. Available echocardiographic findings were noted. In the patients, HD group had highest frequency of hypertension. ECG revealed prolonged QTc as more frequent (16.8% vs 0%, p = 0.006) and higher QTcD (56.7 ± 6.5 vs 39.9 ± 5.1 ms, p = 0.001) in the patients compared to controls, especially in dialysis patients, whereas lowest values were in KTx subgroup. Left ventricular (LV) hypertrophy (LVH) was more frequent (47.1%) in HD compared to other CKD subgroups in ECG (p = 0.052). Echocardiography also showed LV mass index as highest in HD and lowest in KTx (121.4 ± 55.7 vs 63.7 ± 18.3 g/m2, p = 0.000), with numerically highest LVH in HD (58.3%, p = 0.063).  Conclusion: ECG can be used to detect cardiovascular problems in patients with CKD, especially in HD. As ECG results were in line with echocardiography, patients with ECG abnormalities suggestive of LVH should be referred for echocardiographic assessment. What is Known: • Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhythmias and sudden cardiac death are major causes of morbidity and mortality in chronic kidney disease. • Electrocardiography has significant advantages in demonstrating cardiac functions in children because it is readily available, non-invasive and often non-experts can interpret the results. What is New: • The heart rate is higher, QTc is longer and QTcD is higher in dialysis patients and the prolonged QTc is more frequent in patients with underlying glomerular diseases. • Left ventricular hypertrophy is more common in HD patients and those with hypertension, hypercalcemia, anemia or glomerular etiology. The cardiovascular risky conditions are less frequent in the patients with kidney transplantation.

Occurrence, bioconcentration, and human health risks of pharmaceuticals in biota in the Sea of Marmara, Türkiye

The presence, bioconcentration, and health risk via seafood consumption of 11 pharmaceutical compounds belonging to different therapeutic groups (anti-inflammatory, antiepileptic, lipid regulators, and hormones) were investigated in the muscle tissues of fish and the meat of shrimp in the Sea of Marmara. Six biota species (Merlangius merlangus, Trachurus meditterraneus, Serranus hepatus, Pomatomus saltatrix, Parapenaeus longirostris, Spratus sprattus) were collected from the five stations in October and April 2019. Ultrasonic extraction method followed by solid phase extraction was used for extraction of pharmaceutical compounds from biota samples and then analyzed using high-performance liquid chromatography. Of the 11 compounds, 10 were detected in biota species. Ibuprofen was the most frequently detected pharmaceutical in the biota tissues at high concentrations (<3.0-1225 ng/g, dw). The other widely detected compounds were fenoprofen (<3.6-323 ng/g, dw), gemfibrozil (<3.2-480 ng/g, dw), 17α-ethynylestradiol (<2.0-462 ng/g, dw), and carbamazepine (<7.6-222 ng/g, dw). The bioconcentration factors of the selected pharmaceuticals calculated in various aquatic organisms ranged from 9 to 2324 L/kg. The estimated daily intakes of anti-inflammatories, antiepileptics, lipid regulators, and hormones via seafood consumption were 0.37-568, 1.1-324, 8.5-197, 3-340 ng/kg bw. Day, respectively. Based on hazard quotients, estrone, 17β-estradiol, and 17α-ethynylestradiol may pose a health risk to humans through the consumption of this seafood.

The effect of COVID-19 restriction on metabolic syndrome in primary hypertension

BACKGROUND

Primary hypertension (HT) has been increasingly reported in parallel to the increase in the prevalence of obesity in children, both of which are important components of metabolic syndrome. The aim of this study was to investigate the effects of COVID-19 restrictions, which are believed to induce lifestyle changes and physical inactivity, on the parameters of metabolic syndrome in children with primary hypertension.

METHODS

This was an observational, pre-post study conducted on pediatric patients with primary HT. The first phase of the study was the period prior to when COVID-19 restrictions were put in place in Turkey, and the second phase was up to the date when the restrictions were lifted. Anthropometric and blood pressure measurements, laboratory tests, and hypertensive-mediated organ damage at both phases of the study were compared.

RESULTS

Severe restrictions due to the COVID-19 pandemic were associated with an increase in mean ± standard deviation body mass index (BMI) (26.4 ± 7.3 vs. 27.2 ± 7.1, P = 0.002), antihypertensive drug use (n = 53 (57.6%) vs. n = 59 (64.1%), P < 0.0001), fasting blood glucose level (89.4 ± 12.6 vs. 94.1 ± 14.2, P = 0.013), and a borderline elevation in total cholesterol (21 [22.8%] vs. 28 [30.4%], P < 0.0001). These increases negatively affected end organs, with an increased frequency of interventricular septum hypertrophy (n = 12 [13%] vs. n = 17 [18.5%], P = 0.031).

CONCLUSIONS

COVID-19 restrictions were associated with an increased risk of parameters associated with metabolic syndrome in patients with primary hypertension. Physicians should carefully monitor the weight, blood pressure, fasting plasma glucose level, and total cholesterol levels in patients during periods of movement/activity restrictions such as during the COVID-19 pandemic.

Biomarkers of airway and systemic inflammation in obese asthmatic paediatric patients

BACKGROUND

It is thought that airway inflammation is more common in obese asthmatic patients because inflammation is harder to control and does not respond well to glucocorticoid treatment.

OBJECTIVE

This study's aim was to investigate the effect of obesity on airway and systemic inflammation in children with asthma and to identify the biomarkers that play a role in this inflammation.

METHODS

The study included patients aged 6-16 years who were diagnosed with asthma in the paediatric allergy outpatient clinic of Bagcilar Training and Research Hospital in Turkey. Complete blood count parameters were compared between three groups: obese asthmatic (n=43), obese non-asthmatic (n=45), and non-obese non-asthmatic (control group, n=30). Levels of high-sensitive CRP (hs-CRP), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), and matrix metalloproteinase-9 (MMP-9), and 25(OH)-vitamin D were compared between the groups.

RESULTS

No statistically significant differences were observed in 25(OH)-vitamin D, NGAL, OPN, hs-CRP, and MMP-9 levels between groups. There was a statistically significant negative correlation between FEV1/FVC and NGAL and MMP-9.

CONCLUSION

This is the first study to investigate levels of hs-CRP, NGAL, OPN, MMP-9, and 25(OH)-vitamin D in obese asthmatic children. Larger studies with sputum and BAL examinations are required to determine the potential of biomarkers for identifying inflammation in obese asthmatic children.

Static Anthropometric Characteristics of Bangladeshi Vehicle Driver: A Case Study

Background. Inappropriate design of sitting furniture and working equipment causes the serious musculoskeletal injuries and various pains as well as reducing working efficiency. Uncomfortable sitting posture in prolonged driving in Bangladesh is an issue to be solved immediately. Therefore, anthropometric databank of user population is significantly essential for the suitable dimensional design for avoiding these remarkable problems. Methods. This study analyses the anthropometric data of the Bangladeshi male vehicle driver aged between 30 and 60 years. A total of 210 Bangladeshi healthy drivers are considered for 15 anthropometric measurements and compared with the similar anthropometrics of other nationalities. Results. The mean stature and sitting height erect of Bangladeshi driver are 1645 mm and 843 mm, respectively. The mean of body mass index (BMI) of the drivers is 26.09 kg/m(2), which indicates that the drivers are overweight. The mean stature of Bangladeshi driver is 17 mm shorter than the driver of Korea and 115 mm shorter than the driver of Iran. Conclusion. There are substantial differences between the body dimensions of Bangladeshi driver and similar dimensions of other countries. In comparison, Bangladeshi driver is found to be the shortest compared with the sample of other nationalities.

Anthropometric evaluation of cockpit designs

The objective of this research is to evaluate all the critical reaches in a cockpit and determine the visual sufficiency of a cockpit to accommodate 90% of potential pilots. While mismatches of measurements with cockpit dimensions are revealed, proposals are made to improve cockpit ergonomics. Regression models were generated to predict and assure adequate exterior vision. Mean, lower and upper control limits of all measurements were found acceptable except eye level. There are very strong positive relationships between stature and eye level (R(2) = 0.972, p < 0.01), and eye level and visual angle (R(2) = 0.994, p < 0.01). Display panel height should be at least 1.645 × SD smaller than the eye level mean or seating adjustment limits in height may be changed. In general, cockpit design is acceptable in terms of fit/reach accommodation for pilots, except eye level and visual variables that could be solved by better seat adjustments.

Total cholesterol-to-high-density lipoprotein cholesterol ratio predicts high-sensitivity C-reactive protein levels in Turkish children

BACKGROUND

High-sensitivity C-reactive protein (hs-CRP) is a biomarker of continued long-term systemic inflammation and cardiovascular (CV) risk.

OBJECTIVE

To analyze the association of hs-CRP levels with CV risk factors in healthy school children.

METHODS

The study sample was derived from a survey on the prevalence of CV risk factors (dyslipidemia, obesity, high blood pressure, and insulin resistance in school children. Along with anthropometry, hs-CRP levels, lipids, glucose levels, and insulin levels were measured.

RESULTS

Ninety-one male (12.5 ± 3.4 years) and 77 female students (12.7 ± 3.4; P = .624) were included. Median (interquartile range) hs-CRP levels were similar among boys and girls (0.4 [1.2] vs 0.5 [0.7]; P = .928). Risk factors such as obesity (16%), high triglycerides (20%), low high-density lipoprotein cholesterol (HDL-C, 16%), and elevated blood pressure (25%) were commonly observed in study participants. Gender-stratified analysis displayed that insulin resistance (18 [19.8%] vs 3 [3.9%]; P = .002) and high triglycerides (26 [28.6%] vs 8 [10.4%]; P = .003) were more commonly observed among boys compared with girls. hs-CRP levels correlated positively with cardiometabolic risk factors such as waist circumference (boys) and total cholesterol (TC)-to-HDL-C ratio. Linear regression analysis displayed that among the covariates of age, body mass index, and glucose, TC-to-HDL-C ratio was the most significant determinant of hs-CRP levels (P = .004).

CONCLUSION

Cardiometabolic risk factors such as TC-to-HDL-C ratio correlate with hs-CRP levels in children and adolescents. Long-term prospective studies are needed to confirm the association between hs-CRP and cardiometabolic risk in children.