ABSTRACT
Objective:To explore the relationship between overweight and obesity, high blood pressure and left ventricular hypertrophy (LVH) in adolescents in Tangshan.Methods:Through cluster sampling, 1 023 adolescents aged 7-18 were selected from primary and secondary schools in Tangshan (January 2018 to January 2020). Questionnaire survey, blood pressure, weight, height measurement and ultrasound examination were performed. The incidence of LVH in 1 023 adolescents was statistically analyzed. 1 023 adolescents were divided into four groups according to whether they were overweight or obesity (overweight: weight for age Z score >2; obesity: height for age Z score >2) and whether blood pressure was high [high blood pressure: systolic blood pressure (SBP) or diastolic blood pressure (DBP)≥gender/age P 90 and <P 95; hypertension: SBP/DBP≥gender/age P 95]. The left ventricular mass index (LVMI) and the incidence of LVH were compared among different body weight and blood pressure. The relationship between overweight and obesity, high blood pressure and LVH was analyzed by multivariate logistic regression. Results:Among 1 023 adolescents, 98 were LVH and 925 were normal; the BMI, SBP, DBP, high blood pressure rate, and overweight and obesity rate in LVH group were significantly higher than normal group ( t=13.179, 3.239, 4.093; χ 2=12.998, 120.861, P<0.05). The LVMI level of each group increased with the increase of body weight and blood pressure ( P<0.05); the incidence of LVH in the overweight and obesity group with high blood pressure was significantly higher than that in the overweight and obesity group with normal blood pressure; the incidence of LVH was significantly higher in the overweight and obesity group with normal blood pressure was significantly higher than that in the high blood pressure and normal weight group ( P<0.05). Multivariate logistic regression analysis showed that compared with the normal blood pressure and weight groups, the risk of LVH increased significantly in the obesity and overweight group with high blood pressure and normal blood pressure [ OR (95% CI): 12.04(4.95-29.14), 14.32(5.66-36.26)], while the risk of LVH did not increase significantly in the high blood pressure and normal weight group [ OR (95% CI): 2.53(0.61-10.21)]. Conclusions:The adolescents in Tangshan area have a higher incidence of LVH. Simple high blood pressure will not increase the risk of LVH. However, overweight and obesity combined with high blood pressure can further increase the risk of LVH. We should actively prevent high blood pressure, control overweight and obesity, and reduce the risk of abnormal cardiac structure in adolescents.
ABSTRACT
Objective To investigate the prevalence,missed diagnosis rate and causes of acute kidney injury (AKI) in hospitalized children,and its impact on hospitalization cost,length of stay and outcome.Methods The data of children admitted in Children's Hospital Affiliated to Capital Institute of Pediatrics from December 1st to 31st 2014 were collected,and those whose serum creatinine (Scr) were measured at least two times were selected.Patients were diagnosed as AKI according to the diagnostic criteria of 2012 Kidney Disease:Improving Global Outcomes,then divided into AKI group and non-AKI group,the former of which was further divided into AKI1 group (Scr peak value in normal range) and AKI2 group (Scr peak value above normal range).The causes and impact of AKI on hospitalization cost,length of stay and outcome in different groups were compared and analyzed.Results (1) Among 921 patients with at least two Scr results,170 patients met with the diagnostic criteria of AKI,including 100 males and 70 females.There were 112(65.9％) in AKI stage 1,43(25.3％) in stage 2,and 15(8.8％) in stage 3.The overall prevalence of AKI was 18.5％.With only 7cases getting diagnosed,the diagnostic rate was 4.1％,while 95.9％ of patients missed diagnosis.(2)Among AKI patients,67 cases had pre-renal causes,103 cases had intra-renal causes and mixed factors.100(58.8％) cases got complete recovery,34(20.0％) cases recovered partially and 36(21.2％)cases did not improve,including 4 cases of death.(3) The prevalence of AKI among those below 1-year old was higher than children elder than 1-year (23.0％ vs 15.5％,P=0.004).The prevalence of AKI in surgical ward was higher than medical ward (30.7％ vs 15.8％,P ＜ 0.001).(4) Compared with those in non-AKI group,there was lower age [1.1(0.2,3.5) year vs 2.0(0.3,4.9) year] and higher hospitalization time[12.5(8.0,20.0) d vs 8.0(6.0,11.0) d],hospitalization costs [25 279.2(13 822.8,48 856.7) yuan vs 12 616.9(8680.1,19 345.1) yuan] and mortality (2.4％ vs 0.3％) in AKI group (all P ＜ 0.05).(5) There were 126 cases in AKL group and 44 cases in AKI2 group.The costs of hospitalization,outcome and mortality showed no difference between two groups (all P ＞ 0.05).The hospitalization time in AKI2 group was shorter than that in AKL group (P=0.038).Conclusions Among hospitalized children the missed diagnosis rate of AKI is high.Pre-renal factor is the main cause of AKI.Children younger than 1-year old are more susceptible to AKI.AKI children have lower age and higher hospitalization time,hospitalization costs and mortality than non-AKI children.The effect of Scr fluctuation within normal levels needs to be further studied.