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1.
Article in English | WPRIM | ID: wpr-917048

ABSTRACT

Background@#The clinical features of pediatric rhabdomyolysis differ from those of the adults with rhabdomyolysis; however, multicenter studies are lacking. This study aimed to investigate the characteristics of pediatric rhabdomyolysis and reveal the risk factors for acute kidney injury (AKI) in such cases. @*Methods@#This retrospective study analyzed the medical records of children and adolescents diagnosed with rhabdomyolysis at 23 hospitals in South Korea between January 2007 and December 2016. @*Results@#Among 880 patients, those aged 3 to 5 years old composed the largest subgroup (19.4%), and all age subgroups were predominantly male. The incidence of AKI was 11.3%. Neurological disorders (53%) and infection (44%) were the most common underlying disorder and cause of rhabdomyolysis, respectively. The median age at diagnosis in the AKI subgroup was older than that in the non-AKI subgroup (12.2 years vs. 8.0 years). There were no significant differences in body mass index, myalgia, dark-colored urine, or the number of causal factors between the two AKI-status subgroups. The multivariate logistic regression model indicated that the following factors were independently associated with AKI: multiorgan failure, presence of an underlying disorder, strong positive urine occult blood, increased aspartate aminotransferase and uric acid levels, and reduced calcium levels. @*Conclusions@#Our study revealed characteristic clinical and laboratory features of rhabdomyolysis in a Korean pediatric population and highlighted the risk factors for AKI in these cases. Our findings will contribute to a greater understanding of pediatric rhabdomyolysis and may enable early intervention against rhabdomyolysis-induced AKI.

2.
Article in English | WPRIM | ID: wpr-903549

ABSTRACT

Background/Aims@#Functional dyspepsia is a disease involving a range of upper gastrointestinal symptoms derived from various pathophysiologies. Tablets containing a combination of rabeprazole and controlled-release (CR) mosapride were recently developed.To investigate a more effective treatment, this trial evaluated the efficacy and safety of UIC201609/UIC201610 as a preliminary study. @*Methods@#A multicenter, double-blind, randomized study was performed on 30 subjects. UIC201609/UIC201610 (combination of rabeprazole and CR mosapride) was the case group, and the two control groups were rabeprazole 10 mg once a day and mosapride 15 mg CR tablet once a day. As a primary efficacy endpoint of the study, the changes in the total score of eight items of the Nepean Dyspepsia Index-Korean version were analyzed at 2 weeks and 4 weeks. The outcomes regarding safety were collected. @*Results@#The total symptom score of Nepean Dyspepsia Index-Korean decreased in the rabeprazole single group (29.4±17.1), mosapride CR single group (33.4±15.6), and UIC201609/UIC201610 group (33.4±11.8) at 4 weeks without significant differences. On the other hand, the UIC201609/UIC201610 combination group showed more score reduction of pain in the upper abdomen, burning in the upper abdomen compared to each control group, but it did not reach statistical significance. No difference was found in safety analysis. @*Conclusions@#UIC201609/UIC201610 once daily showed some improvement in epigastric pain and dyspepsia in patients with functional dyspepsia, but there was no significance. Further study based on the advanced clinical trial design will be needed to confirm the efficacy of UIC201609/UIC201610 combination therapy in the future.

3.
Article in English | WPRIM | ID: wpr-903438

ABSTRACT

Primary vesicoureteral reflux is a common genetically determined condition that is associated with varying degrees of renal scarring and represents one of the main causes of chronic kidney disease in children. Usually vesicoureteral reflux is common in urinary tract infection patient under 5 years of age. However, we report a rare case of high-grade vesicoureteral reflux and chronic kidney disease in a 10-year-old boy who was referred to the pediatric department for incidentally detected asymptomatic bacteriuria. Our case demonstrated that high grade vesicoureteral reflux patient with reduced renal function, bladder and bowel dysfunction at presentation is more likely to progress to chronic kidney disease.

4.
Article in Korean | WPRIM | ID: wpr-901191

ABSTRACT

Objective@#Triage in the emergency department is important as mistriage leads to inefficient use of resources. The Korean Triage and Acuity Scale (KTAS) was developed in 2012 and has been implemented in emergency departments nationwide since January 2016. The purpose of this study was to determine whether KTAS can predict resource use in a pediatric emergency center. @*Methods@#From October to December 2019, a retrospective analysis was conducted by a review of medical records. Demographic data, KTAS grades, Emergency Severity Index (ESI) as an indicator of resource utilization and details of the use of each resource were collected. Patients were divided into non-trauma and trauma groups. KTAS grades 1 and 2 were defined as the severe group, grade 3 was the moderate group, and grades 4 and 5 were defined as the mild group. We investigated whether triage using KTAS is related to resource utilization. @*Results@#In the non-trauma group, ESI, length of stay in the emergency department, and hospitalization were significantly correlated with the KTAS groups. In the trauma group, there was no significant difference between the moderate and mild groups in the above variables except for hospitalization. This was because there was no significant difference in sedation, procedure, and intravenous injection, in the trauma group. @*Conclusion@#The KTAS triage helped predict resource utilization in the non-trauma group, but not in the trauma group especially between the moderate and mild groups. Additional research will be needed to predict resource utilization in children with trauma.

5.
Article in English | WPRIM | ID: wpr-897482

ABSTRACT

Purpose@#The purpose of this study was to investigate the clinical outcomes of non-carbapenem treatment for urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) in young children. @*Methods@#We retrospectively reviewed the medical records of children under 2 years of age who were diagnosed and treated for UTIs caused by ESBL-producing E. coli from September 2014 to March 2020. @*Results@#Forty-three children under 2 years of age were treated with non-carbapenem antimicrobials for UTIs caused by ESBL-producing E. coli without bloodstream infections. The overall clinical and microbiological success rates for empirical antimicrobial treatment were 90.7% and 97.7%. Three of the patients (7.0%) experienced a relapse of UTI within a month. An in vitro susceptibility test showed that two patients were sensitive and one was resistant to the antimicrobial treatments. Furthermore, there were no significant differences in the time to defervescence, clinical success, microbiological success, and relapse rate between the susceptible (n=13) and non-susceptible groups (n=30). @*Conclusion@#In this study, the overall relapse rate of patients treated with non-carbapenem antimicrobials was 7.0%. The patients showed high success rates in the clinical and microbiological responses to the non-carbapenems regardless of the results of the in vitro antimicrobial susceptibility test. These results provide evidence that non-carbapenems may be viable alternative treatments for UTIs caused by ESBL-producing E. coli.

6.
Article in English | WPRIM | ID: wpr-895845

ABSTRACT

Background/Aims@#Functional dyspepsia is a disease involving a range of upper gastrointestinal symptoms derived from various pathophysiologies. Tablets containing a combination of rabeprazole and controlled-release (CR) mosapride were recently developed.To investigate a more effective treatment, this trial evaluated the efficacy and safety of UIC201609/UIC201610 as a preliminary study. @*Methods@#A multicenter, double-blind, randomized study was performed on 30 subjects. UIC201609/UIC201610 (combination of rabeprazole and CR mosapride) was the case group, and the two control groups were rabeprazole 10 mg once a day and mosapride 15 mg CR tablet once a day. As a primary efficacy endpoint of the study, the changes in the total score of eight items of the Nepean Dyspepsia Index-Korean version were analyzed at 2 weeks and 4 weeks. The outcomes regarding safety were collected. @*Results@#The total symptom score of Nepean Dyspepsia Index-Korean decreased in the rabeprazole single group (29.4±17.1), mosapride CR single group (33.4±15.6), and UIC201609/UIC201610 group (33.4±11.8) at 4 weeks without significant differences. On the other hand, the UIC201609/UIC201610 combination group showed more score reduction of pain in the upper abdomen, burning in the upper abdomen compared to each control group, but it did not reach statistical significance. No difference was found in safety analysis. @*Conclusions@#UIC201609/UIC201610 once daily showed some improvement in epigastric pain and dyspepsia in patients with functional dyspepsia, but there was no significance. Further study based on the advanced clinical trial design will be needed to confirm the efficacy of UIC201609/UIC201610 combination therapy in the future.

7.
Article in English | WPRIM | ID: wpr-895734

ABSTRACT

Primary vesicoureteral reflux is a common genetically determined condition that is associated with varying degrees of renal scarring and represents one of the main causes of chronic kidney disease in children. Usually vesicoureteral reflux is common in urinary tract infection patient under 5 years of age. However, we report a rare case of high-grade vesicoureteral reflux and chronic kidney disease in a 10-year-old boy who was referred to the pediatric department for incidentally detected asymptomatic bacteriuria. Our case demonstrated that high grade vesicoureteral reflux patient with reduced renal function, bladder and bowel dysfunction at presentation is more likely to progress to chronic kidney disease.

8.
Article in Korean | WPRIM | ID: wpr-893487

ABSTRACT

Objective@#Triage in the emergency department is important as mistriage leads to inefficient use of resources. The Korean Triage and Acuity Scale (KTAS) was developed in 2012 and has been implemented in emergency departments nationwide since January 2016. The purpose of this study was to determine whether KTAS can predict resource use in a pediatric emergency center. @*Methods@#From October to December 2019, a retrospective analysis was conducted by a review of medical records. Demographic data, KTAS grades, Emergency Severity Index (ESI) as an indicator of resource utilization and details of the use of each resource were collected. Patients were divided into non-trauma and trauma groups. KTAS grades 1 and 2 were defined as the severe group, grade 3 was the moderate group, and grades 4 and 5 were defined as the mild group. We investigated whether triage using KTAS is related to resource utilization. @*Results@#In the non-trauma group, ESI, length of stay in the emergency department, and hospitalization were significantly correlated with the KTAS groups. In the trauma group, there was no significant difference between the moderate and mild groups in the above variables except for hospitalization. This was because there was no significant difference in sedation, procedure, and intravenous injection, in the trauma group. @*Conclusion@#The KTAS triage helped predict resource utilization in the non-trauma group, but not in the trauma group especially between the moderate and mild groups. Additional research will be needed to predict resource utilization in children with trauma.

9.
Article in English | WPRIM | ID: wpr-889778

ABSTRACT

Purpose@#The purpose of this study was to investigate the clinical outcomes of non-carbapenem treatment for urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) in young children. @*Methods@#We retrospectively reviewed the medical records of children under 2 years of age who were diagnosed and treated for UTIs caused by ESBL-producing E. coli from September 2014 to March 2020. @*Results@#Forty-three children under 2 years of age were treated with non-carbapenem antimicrobials for UTIs caused by ESBL-producing E. coli without bloodstream infections. The overall clinical and microbiological success rates for empirical antimicrobial treatment were 90.7% and 97.7%. Three of the patients (7.0%) experienced a relapse of UTI within a month. An in vitro susceptibility test showed that two patients were sensitive and one was resistant to the antimicrobial treatments. Furthermore, there were no significant differences in the time to defervescence, clinical success, microbiological success, and relapse rate between the susceptible (n=13) and non-susceptible groups (n=30). @*Conclusion@#In this study, the overall relapse rate of patients treated with non-carbapenem antimicrobials was 7.0%. The patients showed high success rates in the clinical and microbiological responses to the non-carbapenems regardless of the results of the in vitro antimicrobial susceptibility test. These results provide evidence that non-carbapenems may be viable alternative treatments for UTIs caused by ESBL-producing E. coli.

10.
Gut and Liver ; : 53-60, 2021.
Article in English | WPRIM | ID: wpr-874567

ABSTRACT

Background/Aims@#Favorable outcomes of potassium-competitive acid blocker (PCAB)-containing eradication therapy have been reported. In fact, tegoprazan, a recently developed PCAB, was presumed to show good eradication efficacy even for resistant Helicobacter pylori. We aimed to investigate the anti-H. pylori efficacy of tegoprazan compared with that of vonoprazan. @*Methods@#A total of 220 resistant clinical H. pylori isolates were utilized. The anti-H. pylori efficacy of PCABs was determined by evaluating the minimum inhibitory concentrations (MICs) of clarithromycin, fluoroquinolone, metronidazole, and amoxicillin in combination with vonoprazan or tegoprazan by the agar dilution method. The impact of the mutations responsible for resistance development, such as 23S rRNA, gyrA, rdxA, frxA, and pbp1 mutations, was also analyzed. @*Results@#H. pylori growth was significantly inhibited in a medium containing 1 μg/mL clarithromy-cin with tegoprazan (128 μg/mL). The MICs of clarithromycin (46.3%), fluoroquinolone (46.7%), metronidazole (55.6%), and amoxicillin (34.5%) against resistant H. pylori isolates improved after tegoprazan administration. Tegoprazan demonstrated more frequent susceptibility acquisitionwith metronidazole than with vonoprazan (20.6% vs 4.7%, p=0.014). However, there were nosignificant differences depending on the mutational status of each antimicrobial agent. @*Conclusions@#Tegoprazan administration may improve the susceptibility of antimicrobial-resistant H. pylori, independent of acid suppression.

11.
Article | WPRIM | ID: wpr-837290

ABSTRACT

Background/Aims@#Fluoroquinolone-containing triple eradication therapy could be considered an alternative regimen for the second- line treatment of Helicobacter pylori infection. This study aimed to investigate the changes in the eradication efficacy of fluoroquinolone- containing triple therapy from 2003 to 2018 in Korea. @*Materials and Methods@#Patients with a history of first-line eradication therapy failure were consecutively enrolled at Seoul National University Bundang Hospital from 2003 to 2018. All patients took moxifloxacin-containing triple therapy as the second-line eradication therapy. The treatment regimen comprised a three-drug combination comprising a proton pump inhibitor, amoxicillin, and moxifloxacin. Data on age, sex, endoscopic diagnosis, eradication results, compliance, and adverse outcomes were acquired and analyzed. @*Results@#In total, 824 participants were enrolled during the study period, of whom, 46 were lost to follow-up. Finally, 778 participants were included in the per-protocol (PP) analysis, of whom, 72.1% received moxifloxacin-containing triple therapy for 14 days. The eradication rate of moxifloxacin-containing triple therapy was 72.1% (594/824) in the intention-to-treat analysis and 76.3% (594/778) in the PP analysis. A decline in eradication efficacy was observed, especially in the PP analysis (P=0.046). Diarrhea was the most commonly observed adverse event, accounting for 19.6% (41/209) of recorded adverse events. @*Conclusions@#Moxifloxacin-containing triple therapy has shown suboptimal eradication efficacy as the second-line eradication therapy. In addition, there is a concern that eradication rate will decrease due to increase in antimicrobial resistance.

12.
Article | WPRIM | ID: wpr-837192

ABSTRACT

Idiopathic renal hypouricemia is a hereditary disease characterized by abnormally high renal uric acid clearance. A defect in the SLC22A12 genes, which encodes the renal uric acid transporter, URAT1, is the known major causes of this disorder. Most patients are clinically silent, but exercise-induced acute kidney injury, urolithiasis or hematuria may develop. The patient presented with azotemia, decreased urine output and abdominal pain without vigorous exercise past history. He was diagnosed with rapidly progressive glomerulonephritis at admission, but low serum uric acid level was persisted. Since the diagnosis of the patient was familial renal hypouricemia, we performed sequence analysis of the SLC22A12 gene in all family members. We report a case of 17-year-old boy with severe acute kidney injury with familial renal hypouricemia confirmed by genotyping of SLC22A12 .

13.
Article | WPRIM | ID: wpr-834906

ABSTRACT

Objective@#Tsutsugamushi disease is a febrile illness caused by tick bites. Delay in making the diagnosis and treatment cause an increase of the frequency of complications and mortality. The aim of this study was to determine quick sequential organ failure assessment (qSOFA) to predict the clinical outcome of scrub typhus patients in emergency departments. @*Methods@#This was a retrospective, observational study of patients with tsutsugamushi disease and who presented to the emergency department of an urban hospital and a rural tertiary hospital between January 2013 and December 2018. The demographic and laboratory data was collected through a chart review. Statistical analysis was performed by dividing the patients into the general ward admission group (general ward) and the intensive care unit admission group (ICU). @*Results@#Age, Acute Physiology and Chronic Health Evaluation II (APACHE) II score and laboratory tests such as pH, leukocyte count, C-reactive protein, and procalcitonin also showed significant differences between the general ward and ICU groups on the univariable logistic regression analysis, but only the qSOFA score among the variables showed a significant difference on the multivariate logistic regression analysis (P=0.014). @*Conclusion@#The qSOFA score will be a prompt and useful tool for predicting the prognosis of patients with tsutsugamushi disease in the emergency department.

14.
Article | WPRIM | ID: wpr-834905

ABSTRACT

Objective@#Serious bacterial infection (SBI) is a common disease among infants, and it is associated with high morbidity and mortality. Making the diagnosis of SBI is challenging and measurement of various biomarkers is useful. This study examined the utility of lactate at an emergency department for diagnosing SBI patients. @*Methods@#This was a retrospective, observational study of febrile infants less than 90 days old presenting to the emergency department of a tertiary hospital between September 2014 and August 2017. The demographic and laboratory data was collected through a chart review. @*Results@#Laboratory tests such as the white blood cell count, C-reactive protein (CRP), procalcitonin, and lactate showed significant differences on the Student-T test and the Mann Whitney-U test. Multivariabe logistic regression test was done using the variables with significant differences. CRP (P=0.037; odds ratio, 1.01), procalcitonin (P=0.011; odds ratio, 1.02) and lactate (P=0.001; odds ratio, 2.38) shows significant correlation. @*Conclusion@#For febrile infants at the emergency department, the measurement of lactate is expected to be a useful tool to diagnose serious bacterial infection.

15.
Korean Circulation Journal ; : 1167-1180, 2019.
Article in English | WPRIM | ID: wpr-759422

ABSTRACT

BACKGROUND AND OBJECTIVES: Hypertension is becoming one of the most common health conditions in children and adolescents due to increasing childhood obesity. We aimed to provide the auscultatory blood pressure (BP) normative reference values for Korean non-overweight children and adolescents. METHODS: BP measurements in children and adolescents aged 10 to 18 years were performed in the Korean National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016. BP was measured using a mercury sphygmomanometer. Sex-, age- and height-specific systolic BP (SBP) and diastolic BP (DBP) percentiles were calculated in the non-overweight children (n=10,442). We used the General Additive Model for Location Scale and Shape method to calculate BP percentiles. RESULTS: The 50th, 90th, 95th, and 99th percentiles of SBP and DBP tables and graphs of non-overweight children and adolescents aged 10 to 18 years were presented by age and height percentiles. We found that the SBP and DBP at the 95th percentile were well correlated with height. The BP tables presented by height contained BP values from 124 cm to 190 cm for boys and from 120 cm to 178 cm for girls. Boys had higher SBP and DBP. CONCLUSIONS: We provided the sex-, age- and height-specific auscultatory BP values using the KNHANES big data. These may be useful in diagnosis and treatment of hypertension in Korean children and adolescents.


Subject(s)
Adolescent , Auscultation , Blood Pressure , Child , Diagnosis , Female , Humans , Hypertension , Korea , Methods , Nutrition Surveys , Pediatric Obesity , Reference Values , Sphygmomanometers
16.
Article in Korean | WPRIM | ID: wpr-761575

ABSTRACT

BACKGROUND/AIMS: The incidence of gastric cancer (GC) in Korea is very high compared to that in other countries. The aim of this study was to investigate the trends of GC in patients for over 16 years. MATERIALS AND METHODS: A total of 1,227 patients with GC were prospectively enrolled at Seoul National University Bundang Hospital between 2003 and 2018. Age, sex, histologic type (Lauren classification), and Helicobacter pylori (H. pylori) infection status were compared between three periods (2003~2007, 2008~2012, and 2013~2018). H. pylori infection status was evaluated based on histology, rapid urease test, culture, serology, and history of H. pylori eradication. Patients with severe atrophy or intestinal metaplasia based on histology were assumed to have previous H. pylori infection. RESULTS: Most patients with GC underwent endoscopic mucosal resection/endoscopic submucosal dissection or another type of surgery. Early GC (EGC) and advanced GC (AGC) were detected in 769 (62.7%) and 458 (37.3%) patients, respectively, and intestinal and diffuse types were detected in 714 (58.2%) and 485 (39.5%) patients, respectively. The prevalence of EGC increased from 54.0% (252/467) to 63.5% (359/565) to 81.0% (158/195) in 2003~2007, 2008~2012, and 2013~2018, respectively. The prevalence of H. pylori-positive GC decreased from 93.4% (436/467) to 88.5% (500/565) to 82.1% (160/195) during these three periods, respectively (P<0.001). Multivariate logistic analysis showed that diffuse-type GC was continuously more prevalent in those who were younger than 50 years, who were female, and who harbored the predominant AGC type. CONCLUSIONS: Over 16 years, the prevalence of EGC increased with a decrease in H. pylori infection rate. Diffuse-type GC was continuously more common in young and female patients.


Subject(s)
Atrophy , Female , Helicobacter pylori , Humans , Incidence , Korea , Metaplasia , Prevalence , Prospective Studies , Seoul , Stomach Neoplasms , Urease
17.
Article in English | WPRIM | ID: wpr-719358

ABSTRACT

Pseudohypoaldosteronism (PHA) in infants is manifested by presence of hyperkalemia, hyponatremia, and metabolic acidosis. At initial stages, PAH is generally suspected as congenital adrenal hyperplasia. Transient PHA has been reported in infants with urinary tract infection and urinary tract malformation. We report a case of 5-month-old infant with failure to thrive and finally diagnosed with transient PHA due to urinary tract infection with vesicoureteral reflux.


Subject(s)
Acidosis , Adrenal Hyperplasia, Congenital , Failure to Thrive , Humans , Hyperkalemia , Hyponatremia , Infant , Pseudohypoaldosteronism , Urinary Tract , Urinary Tract Infections , Vesico-Ureteral Reflux
18.
Korean Circulation Journal ; : 1167-1180, 2019.
Article in English | WPRIM | ID: wpr-917254

ABSTRACT

BACKGROUND AND OBJECTIVES@#Hypertension is becoming one of the most common health conditions in children and adolescents due to increasing childhood obesity. We aimed to provide the auscultatory blood pressure (BP) normative reference values for Korean non-overweight children and adolescents.@*METHODS@#BP measurements in children and adolescents aged 10 to 18 years were performed in the Korean National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016. BP was measured using a mercury sphygmomanometer. Sex-, age- and height-specific systolic BP (SBP) and diastolic BP (DBP) percentiles were calculated in the non-overweight children (n=10,442). We used the General Additive Model for Location Scale and Shape method to calculate BP percentiles.@*RESULTS@#The 50th, 90th, 95th, and 99th percentiles of SBP and DBP tables and graphs of non-overweight children and adolescents aged 10 to 18 years were presented by age and height percentiles. We found that the SBP and DBP at the 95th percentile were well correlated with height. The BP tables presented by height contained BP values from 124 cm to 190 cm for boys and from 120 cm to 178 cm for girls. Boys had higher SBP and DBP.@*CONCLUSIONS@#We provided the sex-, age- and height-specific auscultatory BP values using the KNHANES big data. These may be useful in diagnosis and treatment of hypertension in Korean children and adolescents.

19.
Article in English | WPRIM | ID: wpr-765659

ABSTRACT

OBJECTIVE: Fatty liver is associated with insulin resistance-related diseases, such as dyslipidemia, obesity, and type 2 diabetes. The aim of this study was to evaluate the association of dyslipidemia with fatty liver and assess the differences in these associations according to the degree of hepatic steatosis. METHODS: A total of 2,462 subjects (1,679 men and 783 women) who underwent a comprehensive health check-up (including abdominal computed tomography) from January 2010 to December 2013 were enrolled at Samsung Changwon Hospital Healthcare Center. The liver attenuation index (LAI), defined as the difference between mean hepatic and splenic attenuation, was used to assess the degree of hepatic steatosis. An LAI below 5 Hounsfield units was defined as fatty liver. RESULTS: We found that 32.2% of the study subjects had fatty liver. Serum low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG), and fasting blood glucose concentrations and glycated hemoglobin (HbA1c percentage) were significant greater in the fatty liver group compared with the non-fatty liver group, while serum high-density lipoprotein cholesterol (HDL-C) was significantly lower in the fatty liver group. Subjects with fatty liver had 1.7-fold greater risk of dyslipidemia than those without fatty liver after adjusting for age, sex, body mass index (BMI), and HbA1c. When individuals with fatty liver were analyzed by tertiles of LAI values, LDL-C, TG, fasting glucose, BMI, and HbA1c concentrations increased while HDL-C decreased with decreasing LAI tertiles. Compared with LAI tertile 3, the risk for dyslipidemia significantly increased with adjusted odds ratios of 1.42, and 1.81 in tertiles 2 and 1, respectively. CONCLUSION: Fatty liver was significantly associated with dyslipidemia and this association varied according to the degree of hepatic steatosis.


Subject(s)
Blood Glucose , Body Mass Index , Cholesterol , Delivery of Health Care , Dyslipidemias , Fasting , Fatty Liver , Glucose , Glycated Hemoglobin A , Humans , Insulin , Korea , Lipoproteins , Liver , Male , Obesity , Odds Ratio , Tomography, Spiral Computed , Triglycerides
20.
Article in English | WPRIM | ID: wpr-765011

ABSTRACT

BACKGROUND: Hypertension is one of the major causes of chronic diseases. The effect on high blood pressure (BP) with fetal growth restriction is now well-established. Recent studies suggest that a reduced number of nephrons programmed during the intrauterine period contribute to a subsequently elevated BP, due to a permanent nephron deficit. However, few studies have examined this in children. We investigated the effects of low birth weight (LBW) and preterm birth on the renal function markers related to a high BP in childhood. METHODS: We used data from 304 children aged 7–12 years who participated in the 2014 Ewha Birth and Growth Cohort survey in Korea. We assessed the serum uric acid, cystatin C, blood urea nitrogen (BUN), creatinine levels, and the estimated glomerular filtration rate (eGFR) in childhood. Anthropometric characteristics, BP in childhood, birth weight and gestational age were collected. RESULTS: The serum uric acid was significantly higher in LBW children (4.0 mg/dL) than in normal birth weight children (3.7 mg/dL). The cystatin C levels were highest among children who were very preterm (0.89 mg/dL) compared with those who were not (preterm, 0.84 mg/dL; normal, 0.81 mg/dL), although the result was only borderline significant (P for trend = 0.06). Decreased birth weight was found to be significantly associated with an increased serum BUN level in childhood. In the analysis of the effects of renal function on BP, subjects with an eGFR lower than the median value had a significantly higher diastolic BP in childhood (difference = 2.4 mmHg; P < 0.05). CONCLUSION: These findings suggest that LBW and preterm birth are risk factors for increased serum levels of renal function markers in childhood. Reduced eGFR levels were significantly associated with elevated diastolic BP in childhood. It is necessary to identify vulnerable individuals during their life and intervene appropriately to reduce the risk of an increased BP in the future.


Subject(s)
Birth Weight , Blood Pressure , Blood Urea Nitrogen , Child , Chronic Disease , Cohort Studies , Creatinine , Cystatin C , Fetal Development , Gestational Age , Glomerular Filtration Rate , Humans , Hypertension , Infant, Low Birth Weight , Infant, Newborn , Korea , Nephrons , Parturition , Premature Birth , Renal Insufficiency , Risk Factors , Uric Acid
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