scholarly journals Evaluation of Hypertension, Proteinuria, and Abnormalities of Body Weight in Italian Adolescents Participating in the World Kidney Days

2020 ◽  
Vol 45 (2) ◽  
pp. 286-296 ◽  
Author(s):  
Yuri Battaglia ◽  
Pasquale Esposito ◽  
Salvatore Corrao ◽  
Luigi Russo ◽  
Alessandro Balducci ◽  
...  

Introduction: World Kidney Day (WKD) was promoted by the Italian Kidney Foundation and the Italian Society of Nephrology for raising awareness, detection, prevention, and treatment of kidney diseases. The Italian WKD focused on the “School Project” by screening students attending the fifth year of high school. The main goal of the “School Project” was to assess in healthy adolescents the presence of hypertension (HTN) and proteinuria; as well as to evaluate potential interrelations between overweight, obesity (both measured with different anthropometric methods), blood pressure (BP) levels, and proteinuria. The ancillary goal was to have an estimate of awareness on some nephrology topics. Methods: The study population consisted of 17- to 19-year-old students. HTN was defined as systolic BP (SBP) ≥140 mm Hg and/or diastolic BP (DBP) ≥90 mm Hg. Isolated systolic hypertension (ISH) was defined as SBP ≥140 mm Hg and DBP <90 mm Hg; isolated diastolic hypertension as SBP <140 mm Hg and DBP ≥90 mm Hg; systolic and diastolic hypertension as SBP ≥140 mm Hg and DBP ≥90 mm Hg; pre-hypertension as SBP >120 mm Hg but <140 mm Hg or DBP >80 mm Hg but <90 mm Hg; and optimal BP as SBP ≤120 mm Hg and DBP ≤80 mm Hg. Urine tests were performed with a dipstick; the subjects were regarded as proteinuric when the urine dipstick was positive (proteinuria ≥30 mg/dL). Body weight, height, and waist circumference (WC) were measured; body mass index (BMI), waist-to-height ratio (WHtR), and conicity index (Ci) were calculated. According to the BMI, the following classifications were adopted: underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), class-I obesity (30–34.9 kg/m2), class-II obesity (35–39.9 kg/m2), class-III obesity (≥40 kg/m2). Results: Data from 12,125 students (45.6% males) were evaluated. HTN was found in 1,349 participants (11.1%; 61.1% male), and ISH was present in 7.4%. Overweight (24.1%) and class-I (6%), -II (3.6%), and -III (1%) obesity were present in hypertensive participants. Compared to participants with normal BP, hypertensive participants had a higher BMI (p < 0.001), WC (p < 0.001), and WHtR (p < 0.001); whereas the Ci was not different (p = 0.527). Multivariate linear regression analysis showed that both WC and BMI were predictors of abnormal SBP and DBP (p < 0.001) both in males and females. Proteinuria was present in 14.8, 13.8, 14.7, and 14.7% of all normal weight, overweight, obese, and all subjects, respectively. In addition, no association was found between body weight, proteinuria, and BP. Conclusion: This study shows that overweight and obesity were significantly associated to HTN in Italian adolescents. BMI and WC were predictors of SBP and DBP. The occurrence of proteinuria was quite similar to that of HTN, but it was not associated with anthropometric indicators or HTN.

Author(s):  
Aysel Vehapoglu ◽  
Zeynep Ebru Cakın ◽  
Feyza Ustabas Kahraman ◽  
Mustafa Atilla Nursoy ◽  
Ali Toprak

Abstract Objectives It is unclear whether body weight status (underweight/normal weight/overweight/obese) is associated with allergic disease. Our objective was to investigate the relationship between body weight status (body mass index; BMI) and atopic allergic disease in prepubertal children, and to compare children with atopic allergic diseases with non atopic healthy children. Methods A prospective cross sectional study of 707 prepubertal children aged 3–10 years was performed; the participants were 278 atopic children with physician-diagnosed allergic disease (allergic rhinitis and asthma) (serum total IgE level >100 kU/l and eosinophilia >4%, or positivity to at least one allergen in skin test) and 429 non atopic healthy age- and sex-matched controls. Data were collected between December 2019 and November 2020 at the Pediatric General and Pediatric Allergy Outpatient Clinics of Bezmialem Vakıf University Hospital. Results Underweight was observed in 11.6% of all participants (10.8% of atopic children, 12.2% of healthy controls), and obesity in 14.9% of all participants (18.0% of atopic children, 12.8% of controls). Obese (OR 1.71; 95% CI: 1.08–2.71, p=0.021), and overweight status (OR 1.62; 95% CI: 1.06–2.50, p=0.026) were associated with an increased risk of atopic allergic disease compared to normal weight in pre-pubertal children. This association did not differ by gender. There was no relationship between underweight status and atopic allergic disease (OR 1.03; 95% CI: 0.63–1.68, p=0.894). Conclusions Overweight and obesity were associated with an increased risk of atopic allergic disease compared to normal weight among middle-income and high-income pre pubertal children living in Istanbul.


2021 ◽  
Author(s):  
Hwal Rim Jeong ◽  
Young Seok Shim

Abstract Objective: To investigate the associations between hematologic parameters and obesity in children and adolescents.Methods: A total of 7,997 subjects (4,259 boys, 3,738 girls) aged 10–18 years was enrolled and hematologic parameters, including WBC, RBC, Hb, Hct, and platelet levels, were recorded and compared against body mass index (BMI) classified into normal-weight, overweight, and obesity groups.Results : The obesity group had significantly higher mean levels of WBC (7.16 vs. 6.16 (x103/mm3), p<0.001), RBC (4.90 vs. 4.82 (x106/mm3), p<0.001), Hb (14.07 vs. 13.99 (g/dL), p<0.05), Hct (42.31 vs. 41.91 (%), p<0.001) and platelets (311.87 vs. 282.66 (x103/mm3), p<0.001) than the normal-weight group after adjusting for obesity and sex. BMI SDS was significantly positively associated with WBC (β=0.275, p<0.001), RBC (β=0.028, p<0.001), Hb (β=0.034, p<0.001), Hct (β=0.152, p<0.001), and platelets (β=8.372, p<0.001) after adjusting for age, sex, and possible socioeconomic confounders in a multiple linear regression analysis.Conclusion: Higher BMI is associated with elevated WBC, RBC, Hb, Hct and platelet counts in children and adolescents. Because higher hematologic parameters are potential risk factors for obesity-related morbidity, more attention should be paid to evaluating and interpreting hematologic parameters in children and adolescents with obesity


2016 ◽  
Vol 12 (3) ◽  
pp. 244-251 ◽  
Author(s):  
Deirdre K. Tobias ◽  
JoAnn E. Manson

The obesity paradox for survival among individuals with type 2 diabetes has been observed in some but not all studies. Conflicting evidence for the role of overweight and obesity in all-cause mortality may largely be a result of differences in study populations, epidemiological methods, and statistical analysis. For example, analyses among populations with long-term prevalent diabetes and the accrual of other chronic health conditions are more likely to observe that the sickest participants have lower body weights, and therefore, relative to normal weight, overweight and even obesity appear advantageous. Other mortality risk factors, such as smoking, also confound the relationship between body weight and survival, but this behavior varies widely in intensity and duration, making it difficult to assess and effectively adjust for in statistical models. Disentangling the potential sources of bias is imperative in understanding the relevance of excess body weight to mortality in diabetes. In this review, we summarize methodological considerations underlying the observed obesity paradox. Based on the available evidence, we conclude that the obesity paradox is likely an artifact of biases, and once these are accounted for, it is evident that compared with normal body weight, excess body weight is associated with a greater mortality risk.


2021 ◽  
Vol 50 (4) ◽  
pp. 85-96
Author(s):  
Marijana Jandrić-Kočić

Introduction/Aim: 41 million children under the age of 5 and 340 million children and adolescents aged 5 to 19 are overweight or obese. Obesity in children and adolescents is the most important predictor of high blood pressure. The aim of the study was to examine the incidence of overweight and obesity in primary school children aged 6 to 15 years, as well as to examine the incidence of prehypertension and hypertension in children who were overweight and obese. Method: The study included 85 of 86 children from the Primary School "Krupa na Uni". Data were collected with the help of a questionnaire, while body weight and blood pressure were measured. The chi-square test and t-test were used for the statistical analysis of data Results: The cross-sectional study included 85 children, 45 (52.9%) boys and 40 (47.1%) girls with an average age of 10.87 ± 2.70 years. Normal weight was found in 54 (63.5%) subjects, underweight in 12 (14.1%), overweight in 5 (5.9%), and obesity in 14 (16.5%). 76 (89.4%) subjects had normal blood pressure values, 5 (5.9%) prehypertensive state, and 4 (4.7%) arterial hypertension. There was no significant difference between younger and older children regarding their nutritional status (p=0.477) and blood pressure levels (p=0.453). Children who were overweight and obese had prehypertension and hypertension significantly more often (p˂0.001). Conclusion: Every fifth child was overweight or obese, while prehypertension or hypertension were found in every tenth child. The timely change of diet and physical activity could contribute to the regulation of body weight and the regulation of blood pressure, as well.


2021 ◽  
Vol 8 ◽  
Author(s):  
Hyeon Seok Hwang ◽  
Jin Sug Kim ◽  
Yang Gyun Kim ◽  
Yu Ho Lee ◽  
Dong-Young Lee ◽  
...  

Background: Neprilysin inhibition has demonstrated impressive benefits in heart failure treatment, and is the current focus of interest in cardiovascular (CV) and kidney diseases. However, the role of circulating neprilysin as a biomarker for CV events is unclear in hemodialysis (HD) patients.Methods: A total of 439 HD patients from the K-cohort were enrolled from June 2016 to April 2019. The plasma neprilysin level and echocardiographic findings at baseline were examined. The patients were prospectively followed up to assess the primary endpoint (composite of CV events and cardiac events).Results: Plasma neprilysin level was positively correlated with left ventricular (LV) mass index, LV end-systolic volume, and LV end-diastolic volume. Multivariate linear regression analysis revealed that neprilysin level was negatively correlated with LV ejection fraction (β = −2.14; p = 0.013). The cumulative event rate of the composite of CV events was significantly greater in neprilysin tertile 3 (p = 0.049). Neprilysin tertile 3 was also associated with an increased cumulative event rate of cardiac events (p = 0.016). In Cox regression analysis, neprilysin tertile 3 was associated with a 2.61-fold risk for the composite of CV events [95% confidence interval (CI), 1.37–4.97] and a 2.72-fold risk for cardiac events (95% CI, 1.33–5.56) after adjustment for multiple variables.Conclusions: Higher circulating neprilysin levels independently predicted the composite of CV events and cardiac events in HD patients. The results of this study suggest the importance of future studies on the effect of neprilysin inhibition in reducing CV events.


2019 ◽  
Vol 70 (2) ◽  
pp. 181-185
Author(s):  
Takanori Masuda ◽  
Takeshi Nakaura ◽  
Yoshinori Funama ◽  
Tomoyasu Sato ◽  
Tetsuya Nitta ◽  
...  

Introduction To evaluate the effect of sex, age, height, cardiac output (CO), total body weight (TBW), body surface area (BSA), and lean body weight (LBW) on vessel enhancement of the ascending aorta in pediatric chest computed tomography angiography (c-CTA). Materials and Methods This retrospective study received institutional review board approval; parental prior informed consent for inclusion was obtained for all patients. All 50 patients were examined using our routine protocol; iodine (600 mg/kg) was the contrast medium (CM). Unenhanced and contrast-enhanced scans were obtained. We calculated the CM volume per vessel enhancement and performed univariate and multivariate linear regression analysis of the relationship between CM volume per vessel enhancement and each of the body parameters. Results All patient characteristics were significantly related to CM volume per vessel enhancement ( P < .05). Multivariate linear regression analysis revealed a significant correlation between CM volume per vessel enhancement and TBW, BSA, and LBW, but not the patient sex, age, CO, and height. The LBW model for CM volume per vessel enhancement yielded the highest determination coefficient (R2 = .913) and the lowest Akaike Information Criterion (400.324). Conclusions Our findings support the delivery of an iodine dose adjusted to the LBW at c-CTA.


2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Leticia Elizondo-Montemayor ◽  
Christian Silva-Platas ◽  
Alejandro Torres-Quintanilla ◽  
Carlos Rodríguez-López ◽  
Guillermo U. Ruiz-Esparza ◽  
...  

The correlations between irisin levels, physical activity, and anthropometric measurements have been extensively described in adults with considerable controversy, but little evidence about these relationships has been found in children. The objective of this study is to correlate the plasma levels of irisin in underweight, normal weight, overweight, and obese children with anthropometric parameters and physical activity levels. A cross-sample of 40 children was divided into the following groups on the basis of body mass index (BMI) percentile. The correlations of plasma irisin levels with physical activity, anthropometric, and metabolic measurements were determined. Plasma irisin levels (ng/mL) were lower for the underweight group (164.2 ± 5.95) than for the normal weight and obese groups (182.8 ± 5.58;p<0.05). Irisin levels correlated positively with BMI percentile (0.387), waist circumference (0.373), and fat-free mass (0.353;p<0.05), but not with body muscle mass (−0.027). After a multiple linear regression analysis, only BMI percentile (0.564;p<0.008) showed a positive correlation with irisin. Our results indicated no association with metabolic parameters. A negative correlation with physical activity was observed. Interrelationships among body components might influence irisin levels in children.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2062
Author(s):  
Annica Franziska Dörsam ◽  
Alisa Weiland ◽  
Helene Sauer ◽  
Katrin Elisabeth Giel ◽  
Nanette Stroebele-Benschop ◽  
...  

Purpose: The influence of dishware on portion size perception in children and adolescents is inconclusive. This study investigated how children and adolescents with both obesity and a normal weight perceived portion size in different sized and shaped dishware items. Methods: The study included 60 children and adolescents with overweight and obesity (OBE) and 27 children and adolescents with normal weight (NW) aged from 9 to 17 years. The participants estimated quantities in three pairs of drinking glasses, one pair of bowls and two pairs of plates which varied in size and shape. The children were instructed to state intuitively which portion they would choose for big or small thirst/hunger. Thereafter they were asked to determine the exact amount by answering which dishware item contained the larger/smaller portion (cognitive evaluation). Results: There were no substantial differences in the intuitive evaluation of portion sizes between OBE and NW. During the cognitive evaluation, OBE estimated the amount of water in the glasses more correctly compared to NW (61% vs. 43%; p = 0.008); OBE estimated the amount of lentils in the bowls and on the plates significantly less correctly (39%) compared to NW (56%; p = 0.013). Conclusions: Habit formation and environmental stimuli might play a greater role in estimating food amounts in dishware than the child’s and adolescent’s body weight.


2020 ◽  
pp. 11-15
Author(s):  
K. B. Pokusaeva ◽  
A. S. Krivenko ◽  
N. Yu. Katkova ◽  
V. N. Pokusaeva ◽  
A. S. Vakhrushin

Aim. To evaluate the effects of maternal pre-pregnancy body weight and excessive gestational weight gain (GWG) on the risk of different subtypes of preeclampsia (PE).Methods. A cohort study of 289 pregnant women: 41 with early-onset (less than 34 weeks) preeclampsia (EPE), 76 with late-onset (more than 34 weeks) preeclampsia (LPE) and 172 normotensive women (control). Associations between anthropometric indicators (pre-pregnancy BMI, GWG, fat mass in the 1st, 2nd, 3rd trimesters, on the 2–3rd day after birth) and risk of PE and its subtypes were evaluated.Results. Pre-pregnancy body weight (r = 0.36; р = 0.000) and BMI (r = 0.38; р = 0.000) moderately increased risk of PE. GWG had independent risk of developing PE (r = 0.46; р = 0.000). Women with excessive GWG had an increased risk of PE in normal BMI (RR = 2.2; р = 0.019), in overweigh (RR = 2.7; р = 0.028), in obese (ОР = 5.2; р = 0.000). The risk of developing preeclampsia increased in normal weight with GWG more than 500 g per week in the 2nd trimester (р = 0.000) and more than 400 g per week in the 3d trimester (р = 0.000), total GWG more than 16.5 kg increased risk of preeclampsia in 3.4-fold (ОР = 3.4; р = 0.001). Overweight and obesity had an increased risk of late-onset preeclampsia (RR = 4.9; р = 0.000). No association was found for early-onset preeclampsia (p > 0.050). Gestational metabolic disorders were independent risk of LPE: weekly GWG and the per cent of fat mass in normal weight pregnant women with LPE were significantly higher compared to the women with EPE and control. The per cent of fat mass in the 1st trimester in PPE (23.90 ± 4.40 %) exceeded control (20.50 ± 4.30 %; р = 0.003) and EPE (21.20 ± 3.65 %; р = 0.008) groups. Differences were aggravated during pregnancy (р < 0.050).Conclusions. Pre-pregnancy overweight and obesity, excessive GWG and gain of fatty mass were an independent risk of developing PE with synergistic negative effect. Pre-pregnancy and gestational lipid dismetabolism were associated with LPE. Our results suggested that no correlation between pre-pregnancy BMI, GWG, fatty mass and risk of EPE.


2021 ◽  
Author(s):  
Na Tang ◽  
Jian Ma ◽  
Rongqin Tao ◽  
Zhijun Chen ◽  
Yide Yang ◽  
...  

Abstract Background:Body mass index(BMI) is a commonly used international standard to measure body fat or thinness and health,and dyslipidemia is the metabolic abnormalities of lipoprotein in the human body,which are often considered have associated with high blood pressure.In this study,we explored the relationship between BMI or dyslipidemia and the risk of hypertension and further verified the possible interacting influences of BMI with dyslipidemia on the risk of hypertension.The aim is to explore the possible risk factors of hypertension and to provide scientific basis for the prevention and treatment of hypertension.Methods:Eligible subjects were selected from a cross-sectional survey in Changsha City, and we collected relevant data and clinical indicators for each participant.Body mass index(BMI) was calculated as weight (kg)/height2 (m2),and divided into four categories according to the Chinese standard.Dyslipidemia is defined according to Chinese guideline.The following indicators were used to assess the interaction effects:(1)Relative excess risk due to interaction (RERI);(2)Attributable proportion due to interaction(AP);(3)Synergy index (SI). SPSS software was used for statistical analysis.Results:A total of 2740 eligible participants were enrolled in the cross-sectional study, of which 765 subjects (27.9%) were diagnosed with hypertension.Multivariate Logistic model showed that overweight or obese subjects had a significantly higher risk of hypertension than normal weight people, and low body weight was a protective factor for hypertension(OR:0.52,95%CI:0.29-0.93).People with dyslipidemia have a higher risk of hypertension than those with normal lipids(OR:3.05,95%CI:2.36-3.90). In addition,there was a significant interaction between overweight or obesity and dyslipidemia(overweight:RERI(1.91,95%CI 0.17-3.66),AP(0.40,95%CI 0.14-0.66),SI (2.03,95%CI 1.11-3.74) and obesity:RERI (2.20,95%CI 1.01-3.40), AP (0.38,95%CI 0.18-0.58),SI (1.84,95%CI 1.18-2.89), while no interaction was found between low body weight and dyslipidemia.Conclusion:Low body weight is an independent protective factor for hypertension, but overweight,obesity and dyslipidemia are risk factors for hypertension,and dyslipidemia significantly shared interactions with overweight and obesity that influenced the risk of hypertension.


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