Waist-to-height ratio as a measure of abdominal obesity in southern Chinese and European children and adolescents.

BACKGROUND: Waist-to-height ratio (WHtR), with a 0.5 threshold (WHtR0.5), is regarded as a simple age- and gender-independent criterion of abdominal obesity (AO) and a better predictor than the 90th percentile of waist circumference (WCP90). OBJECTIVE: An analysis of gender and ethnic differences of WHtR and other AO indices between children and adolescents from southern China (HK: Hong-Kong, China) and Europe (LD: Lódz, Poland). SUBJECTS: Two large cross-sectional surveys of children and adolescents aged 7-19 years, one from LD (13 172) and one from HK (14 566). METHODS: The percentile and standardized values of WHtR and other parameters (WC, body mass index (BMI)) were assessed using the LMS method. The WHtR values corresponding to WCP90 and to the BMI definition of global obesity (BMIP95) were evaluated with the polynomial regression model. The compliance of the AO prevalence data, obtained with two criteria (WCP90 vs WHtR0.5) was analyzed using Cohen's kappa index (κC). RESULTS: The WHtR data of Polish subjects were generally higher than those of their HK peers, and the ethic differences increased with age. The WHtR values of HK boys showed a stronger relationship with BMI z-score. WHtR corresponding to WCP90 assumed values <0.5. An application of Cohen's kappa coefficient (κC) to Polish subjects showed either 'substantial' (κC>0.6) or 'almost perfect' (κC>0.8) agreement in the AO prevalence for both criteria (WCP90 and WHtR0.5). For these criteria, either 'fair' (κC <0.4) or 'moderate' (κC<0.6) AO consistency ratings were observed among HK girls. In HK boys, a significant difference in the prevalence of AO was observed, independent of the criterion used. CONCLUSIONS: Our results provide further evidence of the need for developing ethnic-specific WC charts and for recommending that a WHtR cutoff of 0.5 may not be appropriate to predict cardiometabolic risk in children of different ethnic groups.

Frequency of under- and overweight among children and adolescents during the economic transition in Poland.

The aim of this study is to examine the prevalence of underweight, overweight and obesity, using International Obesity Task Force (IOTF) criteria, in four cohorts of children and adolescents living in Poland in different economic eras: communist economy (1977/1978), crisis of the 1980s (1987/1988), political and economic transformation (1992/1994) and the free market economy (2002/2004). Analysis was conducted on a database including 10,934 records for children of the age 7-18 years. In Poland, in the last 26 years of economic and political transformations, the epidemic of obesity was not noticed but the growing incidence of children and adolescents with body mass deficit was observed (p<0.0001) (20.2% of girls in 2002/2004 vs. 11.0% in 1977/1978 and 12.1% of boys in 2002/2004 vs. 7.2% in 1977/1978). Lower parental education and a higher number of children in a family resulted in a higher prevalence of underweight (odds ratio [OR] fluctuated from 1.26 to 1.63). The social effects of the political transformation in Poland significantly affected families with low socio-economic status (SES), and especially more eco-sensitive boys. This result is opposite to the trends observed in Western countries and makes an important contribution to the current knowledge of the course of further changes in weight-to-height ratio at a global scale.

[Nephropathy in the course of inflammatory connective tissue diseases]. / Nefropatia w przebiegu zapalnych chorób tkanki lacznej.

The aim of the study was to assess the frequency of renal complications and also evaluation of renal efficiency with regard to sex and age in children with inflammatory connective tissue diseases. The examination embraced 18 children out of 5657 hospitalised in 19991-1998 in Military University School of Medicine-Dpt of Pediatrics suffering from inflammatory connective tissue diseases, which constitutes 0.32%. They found the following number of isolated cases: 9 cases of juvenile chronic arthritis (JCA), 6 cases of rheumatic fever (RF), and 3 cases of systemic lupus erythematosus (SLE). There were 9 girls and 9 boys. The most frequent symptom of kidneys affection was erythrocyturia. Due to chronic course, reccurrence and the possibility of further complications, children with inflammatory connective tissue diseases, after discharging from hospital, should stay under the care of rheumatological outpatient clinic.

[Nephropathy in the course of Schönlein-Henoch purpura]. / Nefropatia w przebiegu plamicy Schönleina-Henocha.

The aim of the study was to assess the frequency of renal complications and also evaluation of renal efficiency with regard to sex and age in children with Schonlein-Henoch purpura. 31 children with Schonlein-Henoch disease out of 5004 hospitalised in 6 years time (1994-1999) in Mil. Medical University-Dpt of Pediatrics, underwent the examination, which is 0.62% of all patients. The group of analysed cases consisted of 19 girls (61.3%) and 12 boys (38.7%). 15 of them had changes in kidneys, which constitutes 48.4%. The average age of examined children was 9.1 years. In the most cases upper respiratory tract infections preceded symptoms of the Schonlein-Henoch purpura. The most often complications found in the course of the Schonlein-Henoch purpura were renal ones. The most numerous renal complications affected children between 7 and 9 years of age. Because of chronic and insidious course of the disease, children, after discharging from hospital should stay under specialistic medical care.

[Application of computer base standards to pediatrics practice]. / Wykorzystanie komputerowej bazy norm pediatrycznych w praktyce.

The computer base of medical standards to aid of pediatric diagnostic has been presented. The base include of anthropometric data (height and mass of body, some of circumferences, thickness of skinfolds etc.), analytical data (lipids) and also some of hemodynamic parameters (blood pressure). The programme allows graphical presentation of data as a percentile charts and also archives data. The basic of construction of computer base and examples of application has been presented.

[Cyclic vomiting with ketosis as a cause of acute kidney dysfunction: own clinical experience]. / Wymioty cykliczne z ketonemia jako przyczyna ostrych zaburzen czynnosci nerek--obserwacje wlasne.

The aim of the study was to evaluate renal activity during cyclic vomiting with ketosis. The clinical material was obtained from 50 cases of children hospitalized in Department of Pediatrics Military Medical University within 1993-1999 what makes about 1% of all patients. The examined group consisted of 26 boys (52%) and 24 girls (48%). Three of the children were repeatedly hospitalized (3 to 8 times) because of acetonemic vomiting. The special attention during the laboratory studies was paid to evaluation of renal activity. Vomiting with ketosis were associated with temporary kidneys acute dysfunction in 46% of cases. In 98% of cases the parenteral hydration was necessary. Ketonemic vomiting with kidneys dysfunction was observed mainly with the children in pre-school age.

Impact of cardiovascular reactions using the impedance cardiography method in borderline hypertension.

This paper evaluates the hemodynamics of 30 young men, aged 17-19 years, with borderline hypertension (BHT) and 29 normotensive (NT) patients within the same age range. The study has been carried out using the impedance cardiography method at rest and under passive orthostatic test, cold test, and hyperventilation test. In the BHT patients, the following features have been observed: increased values of the cardiac index (CI), stroke volume index (SVI), mean blood pressure (MBP), and left ventricle work index (LVWI), as well as the accompanying normal values of the total peripheral resistance index (TPRI). The reactions of the cardiovascular systems during the functional tests are similar in both tested groups; however, they are most clearly distinct in the BHT patients, where the differences are statistically significant. This may support the argument that the activity of the adrenergic system in this group in intensified.

A computer aided venous occlusion plethysmography.

A computer aided set of equipment for impedance plethysmographic research has been presented. A simple linear model of blood circulation in a limb has been used. A comparative analysis of blood circulation parameters in lower extremities has been carried out manually as well as calculated automatically. Parameters such as the limb blood flow Qo, the tissue blood flow qo, maximum volume change (venous capacitance, VC), the venous outflow time constant Tv and the venous outflow index were automatically and traditionally calculated on the basis of curve lines recorded on thermal recorder. A high linear correlation has been observed between parameters calculated manually and with computer-aided techniques. The results obtained confirm the usefulness of the linear model of blood circulation in a limb for pressures occurring under the conditions of vein occlusion.