scholarly journals DEVELOPMENT OF ARTERIAL HYPOTENSION IN PREMATURE INFANTS WITH EARLY ONSET BACTERIAL INFECTIONS: TOOLS OF CLINICAL PREDICATION

2019 ◽  
Vol 72 (5) ◽  
pp. 1068-1073
Author(s):  
Valeriy Pokhylko ◽  
Olena Kovalova ◽  
Yuliia Cherniavska ◽  
Svitlana Tsvirenko ◽  
Yuliia Klymchuk
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Blood Glucose ◽  
Diagnostic Criteria ◽  
Premature Infants ◽  
Early Onset ◽  
Bacterial Infections ◽  
Prognostic Model ◽  
Multiple Logistic Regression ◽  
Premature Babies

Introduction: The safe thresholds of blood pressure in preterm neonates are still unclear. The aim of our study was to substantiate the diagnostic criteria for the syndrome of arterial hypotension (AH) and indications for the appointment of hemodynamic support in premature infants with early onset bacterial infections. Materials and methods: A prospective cohort study was conducted. 2 experimental groups were formed –premature babies with early onset bacterial infections and AH (n = 58), and control group (n = 62), premature babies without AH. The subjects of the study were a number of risk factors. Simple and multiple logistic regression analyses were used. Results: In premature infants with AH, compared with those without AH, there are significantly lower values of stroke index of left ventricle (SILV), index of resistance (IR) of the middle cerebral artery, pH, significantly higher level of urea in serum and a higher proportion of children with hypoglycemia. Multiple logistic regression analysis was used to develop a clinical prognostic model for the AH-syndrome. Only prognostic model, which included SILV, blood pH and blood glucose, had high prognostic characteristics and the largest area under the ROC curve. Conclusions: The following diagnostic criteria can be used for the appointment of medical support for hemodynamics: the digital value of the level of mean blood pressure, expressed in mmHg, is less than the gestational age in weeks, and at least one of the following indicators –pH is less than 7.2, blood glucose level is less than 2.8 mmol/l, SILV is less than the normal ranges.

scholarly journals EFFECT OF ENOS GENE POLYMORPHISM ON THE COURSE OF EARLY ONSET BACTERIAL INFECTIONS IN PREMATURE INFANTS

2020 ◽  
Vol 73 (6) ◽  
pp. 1237-1240
Author(s):  
Yuliia I. Cherniavska ◽  
Valeriy I. Pokhylko ◽  
Tetiana K. Znamenska ◽  
Olga V. Vorobiova ◽  
Nataliia I. Hasiuk
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Gene Polymorphism ◽  
Premature Infants ◽  
Neonatal Sepsis ◽  
Bacterial Infections ◽  
Enos Gene ◽  
Premature Babies ◽  
Early Neonatal Sepsis

The aim of the study was to analyze the associations between 4a/4b polymorphism of the eNOS gene and impaired systemic hemodynamics in premature infants with early neonatal sepsis. Materials and methods: We conducted a prospective cohort study, which included 120 premature babies with early neonatal sepsis, in 57 children the course of the disease was accompanied by arterial hypotension (AH) and in 61 children – not. In children of both groups, genotyping was performed to determine 4a/4b polymorphism of the eNOS gene. Results: It was shown that the heart rate, blood pressure, hourly diuresis, the level of total nitrates and nitrites in the urine, as well as a number of echocardioscopic and dopplerometric indicators in children with different eNOS gene genotypes are not different. Conclusions: There is no effect of 4a/4b polymorphism of the eNOS gene on the occurrence of hemodynamic disturbances in premature infants with sepsis.

scholarly journals Association of Lipid Accumulation Product With Chronic Kidney Disease in Chinese Community Adults: A Report From the REACTION Study

2021 ◽  
Author(s):  
pijun yan ◽  
Yong Xu ◽  
Ying Miao ◽  
Qian Tang ◽  
Yuru Wu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Blood Glucose ◽  
Density Lipoprotein ◽  
Multiple Logistic Regression ◽  
Chinese Community ◽  
Lipid Accumulation Product ◽  
Increased Risk ◽  
The Relationship

Abstract Background: Limited studies regarding the relationship between lipid accumulation product (LAP), a novel surrogate marker of visceral adiposity, and declined estimated glomerular filtration rate (eGFR) have yielded conflicting findings, and no report has demonstrated the relationship of LAP with chronic kidney disease (CKD), defined by lower eGFR and/or the presence of albuminuria. This study aimed to estimate the possible association between LAP and CKD in Chinese community adults. Method: This cross‐sectional study, drawn from the REACTION study, included 7072 participants aged ≥40 years in Luzhou city, Sichuan Province. LAP was determined based on a combination of waist circumference (WC) and fasting triglycerides (TG). CKD was defined as eGFR <60mL/min/1.73m² and/or presence of albuminuria [urinary albumin‐creatinine ratio (ACR) ≥30mg/g]. A multiple logistic regression model was performed to evaluate the possible association between LAP and CKD in Chinese community adults. Results: Participants with CKD had significantly higher LAP, age, WC, weight, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure (PP), TG, total cholesterol (TC), fasting blood glucose, 2 h postload blood glucose, glycated hemoglobin A1C, serum creatinine, urinary ACR, prevalence of obesity, type 2 diabetes mellitus, hypertension, myocardial infarction, coronary heart disease, peripheral arterial disease, cardiovascular disease (CVD), users of hypoglycemic drugs, and lower high density lipoprotein cholesterol, eGFR, and users of drinking (P<0.01 or P<0.05). Multiple logistic regression analysis demonstrated that LAP quartiles were positively associated with an increased risk of prevalent CKD (Q2: odds rate [OR]: 1.083, 95% confidence intervals [CI] 0.850-1.381; Q3: OR: 0.961, 95% CI 0.741-1.247; Q4: OR: 1.497, 95% CI 1.139-1.966, P for trend = 0.004) even after adjustment for potential confounding factors. Stratified analysis revealed that the associations of LAP quartiles with increased risk of prevalent CKD also occurred in people who were older, women, overweight, with hypertension, normal glucose tolerance, normal PP, low-density lipoprotein cholesterol < 3.4 mmol/L, without CVD events, no smoking and drinking. Conclusions: These findings suggest that LAP is significantly associated with increased risk of prevalent CKD in Chinese community adults, and may inform both public health recommendations and clinical practice.

HYPERGLYCEMIAAS AN INDEPENDENT RISK FACTOR FOR RETINOPATHY OF PREMATURITY (ROP): A COHORT STUDY

2021 ◽  
pp. 54-57
Author(s):  
Kali Shankar Das ◽  
Athokpam Poireiton ◽  
Niladri Sekhar Mandal ◽  
Samim Ahmed
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Blood Glucose ◽  
Premature Infants ◽  
Gestational Age ◽  
Independent Risk Factor ◽  
Logistic Regression Model ◽  
Bivariate Analysis ◽  
Premature Babies ◽  
Average Blood Glucose

OBJECTIVE: Retinopathy of prematurity (ROP) is a severe morbidity that can lead to blindness in premature babies. Neonatal hyperglycemia has been related to the growth of ROP in a variety of studies. However, there aren't many observational trials to show whether hyperglycemia is linked to ROP in the absence of other comorbidities. The aim of this research was to see if hyperglycemia in premature babies is linked to ROP in a different way. STUDY DESIGN: Premature infants (<1500 g or⩽ 32 weeks gestational age) were enrolled in a prospective longitudinal cohort study. All demographic, clinical and laboratory data were collected. Bedside whole-blood glucose concentration was measured every 8 hours daily for rst 7 , days of live. For any glucose reading <50 or>150 mg dl 1 serum sample was sent to the laboratory for conrmation. Hyperglycemia was dened as any blood glucose level⩾ 150 mg dl − 1. ROP patients were compared with non-ROP patients in a bivariate analysis. Variables signicantly associated with ROP were studied in a logistic regression model. RESULT:Atotal of 100 patients were enrolled with gestational age <32weeks and birth weight <1500g. Forty-eight patients (48%) were identied with hyperglycemia. On eye examination, 30 cases (30%) had ROP (19 with stage 1, 10 with stage 2 and 1 with stage 3). There were more cases of ROPin the hyperglycemia group compared with the euglycemia group (45.83% vs 15.38%, P = 0.007). Patients who developed ROP had signicantly higher maximum and average glucose concentrations when compared with non-ROP patients. Multiple factors have been associated with ROP on bivariate analysis, including gestational age, exposure to oxygen, respiratory support and poor weight gain. However, in a logistic regression model including all signicant variables, average blood glucose in the rst week of life was the factor independently associated with ROPwith an odds ratio of: 1.77 (95% condence interval: 1.08 to 2.86), P= 0.024 CONCLUSION: In a prospective cohort study of premature infants, elevated average blood glucose concentrations in the rst week of life is an independent risk factor associated with the development of ROP.

Abstract P128: Serum Lipid Levels at Adolescence can Predict Adult Dyslipidemia in South Korea - The Kangwha Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Jung H Lee ◽  
Hyeon C Kim ◽  
Dae R Kang ◽  
Il Suh
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Logistic Regression ◽  
South Korea ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Serum Lipid ◽  
Hdl Cholesterol ◽  
Multiple Logistic Regression ◽  
Auc Value

Introduction: Several studies have examined tracking pattern of lipid profile level during long follow-up periods in Western countries. However, there have been few such studies in East Asia. Hypothesis: We assessed the hypothesis that there exists tracking pattern of lipid profile level from adolescence to adulthood, and lipid measurements in adolescence can predict adult dyslipidemia in South Korea. Methods: The Kangwha Study was a community-based prospective cohort study that started in 1986 in Kangwha County, South Korea . A total of 400 participants (54% women) whose serum total cholesterol, triglyceride, and high density lipoprotein (HDL) cholesterol level were measured at least once during adolescence (1992-1996), and repeatedly measured at least once during adulthood (2005-2015) were enrolled in our study. Body mass index, waist circumstance, and blood pressure were measured at all measurements. Family history of cardiovascular disease, smoking history, and presence of adult dyslipidemia were checked at adulthood. The tracking pattern of lipid profile level was determined by tracking coefficients (low: <0.30; moderate: 0.30-0.59; moderately high: 0.60-0.89; high: ≥0.90). The tracking coefficients were calculated by Generalized Estimating Equation. The predictability of adult dyslipidemia was assessed by multiple logistic regression and area under curve (AUC) value. Additional analyses were performed to find out whether repeated lipid measurements during adolescence can enhance the predictability of adult dyslipidemia or not. Results: The presence of adult dyslipidemia was 26.3% (105 of 400). Mean age of study participants at enrollment is 13.8 years (SD, 1.6 years), and that at adulthood is 30.1 years (SD, 3.7 years). When adjusted for age, body mass index, waist circumstance, and blood pressure, the tracking coefficient of total cholesterol was 0.59 (95% confidence interval (CI), 0.54-0.63), that of triglyceride was 0.39 (95% CI, 0.28-0.49), and that of HDL cholesterol was 0.51 (95% CI, 0.46-0.55). The AUC value of our multiple logistic regression model on adult dyslipidemia without lipid profile levels at adolescence was 0.77 (95% CI, 0.72-0.83), and that with lipid profile levels at adolescence was 0.80 (95% CI, 0.75-0.85). P value for AUC comparison was significant (p=0.02). In additional analyses, using the average lipid profile levels in multiple lipid measurements at adolescence did not significantly improve the AUC value (p>0.09). Conclusion: In conclusion, moderate tracking patterns of serum lipid profile level were shown in this study. Serum lipid profile measurements at adolescence could help the prediction of adult dyslipidemia. The results of this study supported the need of lipid profile screening at adolescence.

scholarly journals Relationship between obesity indices and hypertension among middle-aged and elderly populations in Taiwan: a community-based, cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031660 ◽  
Author(s):  
Yen-An Lin ◽  
Ying-Jen Chen ◽  
Yu-Chung Tsao ◽  
Wei-Chung Yeh ◽  
Wen-Cheng Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Multiple Logistic Regression ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Elderly Populations ◽  
Obesity Indices ◽  
Northern Taiwan

ObjectiveObesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations in Taiwan.DesignCross-sectional observational study.SettingCommunity-based investigation in Guishan Township of northern Taiwan.ParticipantsA total of 396 people were recruited from a northern Taiwan community for a cross-sectional study. Anthropometrics and blood pressure were measured at the annual health exam. The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).Outcome measuresStatistical analyses, including Pearson’s correlation, multiple logistic regression and the area under ROC curves (AUCs) between HTN and anthropometric measurements, were used in this study.ResultsOf the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.ConclusionsWC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount.

scholarly journals Modelling of Risk Factors of Diabetes in United Arab Emirates (UAE)

2015 ◽  
Vol 1 (2) ◽  
pp. 28
Author(s):  
Suheer Haroun
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Blood Glucose ◽  
United Arab Emirates ◽  
Binary Logistic Regression ◽  
Sample Survey ◽  
Fresh Vegetables ◽  
Study Results

Objectives: The aim of this study was to model and determine factors influencing the risk of diabetes mellitus (DM) in the United Arab Emirates and to analyze data related to the topic. Methods: The study was carried out in UAE, using a questionnaire to out-patients in a medical clinic that contained socio-demographic characteristics and risk factors were used for data collection. Sample survey data analyzed using descriptive techniques, correlations, and binary logistic regression models. Binary logistic regression were performed to find the crude and adjusted odds ratio (OR) and 95% confidence interval (CI) was calculated to find the significance of the observed OR. A p-value ≤ 0.05 was considered statistically significant All Analysis was performed using SPSS and Microsoft excels. Results: study results showed that six main factors influence the risk of diabetes in UAE, which are, blood glucose, blood pressure, physical activity, waist size, gender and family history of diabetes. Marital status, smoking, and intake of fresh vegetables and fruits did not show any statistically significant association with risk of diabetes in UAE. Blood glucose is observed as the most statistically significant factor (for every one unit increase in blood glucose, the study expect a 5.422 increase in the risk of developing diabetes), at the meantime gender observed as the lowest statistically significant factor (if the respondent is male the probability of being diabetic is 0.809 percent) holding all other independent variables constant. Conclusion: Results of the present study will be one of use in planning primordial, primary and secondary measures of prevention at the community. Encouraging physical activity, controlling blood pressure and blood glucose may significantly decrease the risk of diabetes mortality; effective health education programs promoting regular exercise and effective advices may needed to reduce the burden of diabetes in UAE.

scholarly journals The Effects of Insulin Therapy on Mothers’ Blood Pressure and Weight in Women with Gestational Diabetes Mellitus

2021 ◽  
Author(s):  
Tiange Sun ◽  
Fanhua Meng ◽  
Shufei Zang ◽  
Yue Li ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Weight Gain ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Insulin Therapy ◽  
Gestational Hypertension ◽  
Short Term ◽  
Gestational Weight

Abstract BackgroundThe primary mechanism of gestational diabetes mellitus (GDM) was insulin resistance. Effects of insulin as the first - line medicine for GDM women was blurring. This work aims to investigate influences of insulin therapy on GDM mothers. MethodsThis retrospective cohort study recruited 616 GDM women with lifestyle intervention (diet and physician alone) and 92 GDM women with insulin therapy. Comparing the differences of variables (BMI, blood pressure, gestational weight gain, the incidence of macrosomia and so on) between GDM women with insulin and with lifestyle alone with univariate analysis. Employed paired sample test to evaluate the changes of BP from the time of intervention to one week before delivery, and used logistic regression to analyze the relationship between insulin therapy and gestational hypertension (GH).ResultsThere were no significant differences in delivery mode, newborn weight and the incidence of macrosomia between GDM women with insulin and with lifestyle alone. Insulin therapy slightly increased mothers’ weight despite there were no significant statistically differences in the rate of excessive weight gain comparing to the intervention of lifestyle alone which was attributed to short - term administration (about 12 weeks). In addition, the injection of insulin remarkably enhanced the incidence of gestational hypertension (GH). furthermore, the effect still existed after matching the time of insulin therapy, and from starting insulin usage to delivery systolic blood pressure significantly elevated 6mmHg (vs 4mmHg lifestyle alone, P = 0.529) and diastolic blood pressure 9mmHg (vs 5mmHg lifestyle alone, P = 0.032). Correlation analysis implied blood pressure near the delivery had significant positive correlation with BMI, 1 hour blood glucose, HbA1c, area under the blood glucose curve and gestational weight gain. Logistic regression analysis with enter selection confirmed that insulin therapy was an independent risk factor for the development of GH.ConclusionsThis work suggested that insulin therapy for short - term usage might slightly increase mothers’ weight, but had the marked risk of raising mothers’ BP, especially DBP.

scholarly journals Is insulin an independent predictor of mortality in hemodialysis patients?

2004 ◽  
Vol 23 (1) ◽  
pp. 43-49
Author(s):  
Zorica Rasic-Milutinovic ◽  
Gordana Perunicic ◽  
Steva Pljesa ◽  
Vanja Ristic ◽  
Gordana Ristic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Cardiovascular Mortality ◽  
Serum Proteins ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
C Peptide ◽  
Lipids And Lipoproteins

Reduced insulin sensitivity is present in patients with end-stage renal failure (ERF). It has been established in general population that insulin resistance is a cardiovascular risk factor. The present study examines the potential effect of insulin action and secretion on over-all and cardiovascular mortality in non-diabetic haemodialysis (HD) patients. Sixty two patents (age 52.5 ? 10.3 year) on maintenance haemodialysis (5.4 ? 3.1 year) were recruited in June, 1994 and were followed-up over a 5-year period. At the end of the study we had two those who survived and those who died: survivals and deaths. All basic clinical indicators (age, gender, duration of dialysis prior to entry into the study, blood pressure, serum proteins, albumins, lipids and lipoproteins, urea, creatinine, dialysis dose defined by Kt/V, protein catabolic rate-nPCR, glucose, insulin, C peptide, IR-HOMA and % b- HOMA) were screened for a significant relation to outcome by univariante logistic regression models. Multiple logistic regression analysis was used to evaluate potentional independent predictors of death. Patients of both groups, survivals (n=42) and deaths (n=20), had a comparable duration of HD before the study, and as to blood pressure, serum proteins, albumines, lipids and lipoproteins A and B 100, lipoprotein (a), glucose, glycosylated haemoglobin, and Kt/V there were no significant differences. Patients who died were significantly older, and they had lower values of urea, creatinine, insulin, C-peptide and nPCR. Multiple logistic regression analysis indicated that only insulin and nPCR were significantly and independently associated with all-cause mortality and cardiovascular mortality, and age was an important confounding factor. These results suggest that we need an early procedure to preserve beta-cell function, besides positive nitrogen balance, to reduce cardiovascular and over-all mortality in haemodialysis patients.

scholarly journals Prevalence of Nephropathy with Evaluation of HbA1c Level and other Associated Risk Factors in Type 2 Diabetic Patients in a Tertiary Level Hospital

KYAMC Journal ◽  
2017 ◽  
Vol 8 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Sayama Hoque ◽  
MA Muttalib ◽  
Md Imtiajul Islam ◽  
Parvin Akter Khanam ◽  
Nasrin Akter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Diabetic Nephropathy ◽  
Blood Glucose ◽  
Univariate Analysis ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Background: Diabetes is the leading cause of chronic kidney disease which ultimately results end-stage renal disease (ESRD).Objectives: The purpose of the study was to explore the factors influencing or related to the development of the diabetic nephropathy with specific concern to the HbA1c (glycosylated hemoglobin) levels.Methods: Four hundred type 2 diabetic patients (male 166 and female 234) were studied and were evaluated for the presence of nephropathy through the review of their registered diabetic guide book. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's ttest,?2-test and logistic regression analysis to determine and quantify the association of diabetic nephropathy with various risk factors specially HbA1c.Results: The prevalence of nephropathy was 24.0%; male 27.1%, female 21.8%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of nephropathy (15.8 vs 22.8 vs 30.7%; ?2 = 8.590, p = .013). Logistic regression models of univariate analysis showed that the risk of nephropathy was strongly increased at the HbA1c categories 8% (OR = 2.35; 95% CI: 1.30-4.25). Advanced age (OR = 3.8; 95% CI: 2.21-6.53), longer duration of diabetes (OR = 4.05; 95% CI: 2.31-7.10), lacking of physical exercise (OR = 1.93; 95% CI: 1.20-3.10), presence of hypertension (OR = 4.62; 95% CI: 2.42-8.83), fasting blood glucose (OR = 1.139; 95% CI: 1.054-1.231), blood glucose 2 hours after breakfast (OR = 1.088; 95% CI: 1.028-1.152), systolic blood pressure (OR = 1.049; 95% CI: 1.030-1.069) and diastolic blood pressure (OR = 1.061; 95% CI: 1.026-1.097) had significant association with nephropathy.Conclusion: HbA1c categories >7.0% is an important risk factor for the development of nephropathy.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 21-26

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