Blood Pressure In Girls Research Articles

Obstructive Sleep Apnea in Pediatrics and Adolescent Women: A Systematic Review of Sex-Based Differences Between Girls and Boys

Background/Objectives: Obstructive sleep apnea (OSA) is marked by repetitive occurrences of upper airway (UA) obstruction during sleep. Morbidities impacting the metabolic, cardiovascular (CV) and neurological systems are correlated with OSA. Only a few studies have described the existence of different characteristics depending on sex and, to date, the girl phenotype in OSA pediatrics is not well known. The objective of this systematic review is to identify the specific phenotype of OSA in pediatric and adolescent females compared to males. Methods: A systematic review was performed. The terms “pediatric sleep apnea” and “sex differences” were used to look for publications using PubMed, the Cochrane Library and Web of Science. Inclusion criteria: (1) peer-reviewed journal articles written in English; (2) investigations conducted on individuals diagnosed with OSA; and (3) investigations providing information about sex differences. Exclusion criteria: (1) studies carried out with individuals aged 18 years and older; (2) studies involving a sample size of fewer than 10 patients; and (3) editorials, letters and case reports. Results: Fifteen studies were included and classified in sections related to sex-based differences. Conclusions: Limited information related to sex-based OSA differences in the pediatric population exists. These differences are conditioned by hormonal status, and are minimal in the premenarcheal period. Moreover, adolescent women present a lower prevalence of obesity and craniofacial alterations, lower OSA severity related to higher UA area and earlier tonsil regression. Hyperactivity is more frequent in boys. Some studies pointed to a higher risk of high diastolic blood pressure in girls than in boys.

Early exposure to mercury and cardiovascular function of seven-year old children in Guadeloupe (French West Indies)

BackgroundThe cardiotoxicity of prenatal exposure to mercury has been suggested in populations having regular contaminated seafood intake, though replications in the literature are inconsistent. MethodsThe Timoun Mother-Child Cohort Study was set up in Guadeloupe, an island in the Caribbean Sea where seafood consumption is regular. At seven years of age, 592 children underwent a medical examination, including cardiac function assessment. Blood pressure (BP) was taken using an automated blood pressure monitor, heart rate variability (HRV, 9 parameters) and electrocardiogram (ECG) characteristics (QT, T-wave parameters) were measured using Holter cardiac monitoring during the examination. Total mercury concentrations were measured in cord blood at birth (median = 6.6 μg/L, N = 399) and in the children's blood at age 7 (median = 1.7 μg/L, N = 310). Adjusted linear and non-linear modelling was used to study the association of each cardiac parameter with prenatal and childhood exposures. Sensitivity analyses included co-exposures to lead and cadmium, adjustment for maternal seafood consumption, selenium and polyunsaturated fatty acids (n3-PUFAs), and for sporting activity. ResultsHigher prenatal mercury was associated with higher systolic BP at 7 years of age (βlog2 = 1.02; 95% Confidence Interval (CI) = 0.10, 1.19). In boys, intermediate prenatal exposure was associated with reduced overall HRV and parasympathetic activity, and longer QT was observed with increasing prenatal mercury (βlog2 = 4.02; CI = 0.48, 7.56). In girls, HRV tended to increase linearly with prenatal exposure, and no association was observed with QT-wave related parameters. Mercury exposure at 7 years was associated with decreased BP in girls (βlog2 = −1.13; CI = −2.22, −0.004 for diastolic BP). In boys, the low/high-frequency (LF/HF) ratio increased for intermediate levels of exposure. ConclusionOur study suggests sex-specific and non-monotonic modifications in some cardiac health parameters following prenatal exposure to mercury in pre-pubertal children from an insular fish-consuming population.

Blood pressure in girls with central precocious puberty receiving GnRH analogue therapy.

Case reports show hypertension in children treated with GnRH analogues for central precocious puberty (CPP). However, relevant data on blood pressure are scarce. We aimed to evaluate blood pressure (BP) among girls with idiopathic CPP and early-onset puberty before and during GnRH analogue therapy; and to examine associations of blood pressure with clinical parameters. For this retrospective longitudinal cohort study, demographic, anthropometric, clinical, and laboratory data were collected from electronic files. The study group included 112 girls with idiopathic CPP or early-onset puberty followed in a tertiary pediatric endocrinology institute, and a control group of 37 healthy pre-pubertal girls. The main outcome measures were BP percentile, before, and during treatment with GnRH analogue. At baseline, similar proportions of the study and control groups had BP values>90th percentile: 64 (53 %) and 17 (46 %), respectively (p=0.57). The mean systolic and diastolic BP percentiles measured under treatment remained unchanged. In the study group, baseline BP>90th percentile compared to normal baseline BP was associated with lower birthweight and a higher body mass index-standard deviation score: 2,821 ± 622 vs. 3,108 ± 485 g and 1.0 ± 0.7 vs. 0.70 ± 0.8, respectively, p=0.01 for both. GnRH analogue therapy for precocious or early puberty was not associated with increased blood pressure. The stability of mean blood pressure percentile during treatment is reassuring.

The state of the cardiovascular system in female students after use of different doses of caffeine

Our article is devoted to the study of the state of the cardiovascular system in female students after the use of different doses of caffeine. Drinking 200 mg of coffee leads to a significant increase in heart rhythm and diastolic blood pressure in girls. The maximum values of heart rate (HR) and blood pressure are reached 1 hour after caffeine intake. Thus, in this case, reported is an increase in the heart rhythm by 12.7% (P ˂ 0.05), a rise in the high blood pressure by 8.8% and that in the low blood pressure level by 12.0% (P ˂ 0.05), as compared to the respective initial values thereof. After drinking 100 mg of coffee, there are no significant changes in the indicators of the cardiovascular system performance recorded: an increase in the heart rate after 1 hour has been reported to be 9.5%, a rise in the systolic blood pressure (BPs) has reached 5.0% and that in the diastolic one (BPd) 6.4%, as compared with the values of the reference group. The use of different doses of caffeine does not lead to significant changes in the duration of the waves and segments on the electrocardiogram. 3 and 6 hours after drinking coffee, the indicators of the cardiovascular system are gradually decreasing, approaching their respective initial values.

Prenatal exposure to mixtures of phthalates and phenols and body mass index and blood pressure in Spanish preadolescents

BackgroundPregnant women are simultaneously exposed to several non-persistent endocrine-disrupting chemicals, which may influence the risk of childhood obesity and cardiovascular diseases later in life. Previous prospective studies have mostly examined single-chemical effects, with inconsistent findings. We assessed the association between prenatal exposure to phthalates and phenols, individually and as a mixture, and body mass index (BMI) and blood pressure (BP) in preadolescents. MethodsWe used data from the Spanish INMA birth cohort study (n = 1,015), where the 1st and 3rd- trimester maternal urinary concentrations of eight phthalate metabolites and six phenols were quantified. At 11 years of age, we calculated BMI z-scores and measured systolic and diastolic BP. We estimated individual chemical effects with linear mixed models and joint effects of the chemical mixture with hierarchical Bayesian kernel machine regression (BKMR). Analyses were stratified by sex and by puberty status. ResultsIn single-exposure models, benzophenone-3 (BP3) was nonmonotonically associated with higher BMI z-score (e.g. Quartile (Q) 3: β = 0.23 [95% CI = 0.03, 0.44] vs Q1) and higher diastolic BP (Q2: β = 1.27 [0.00, 2.53] mmHg vs Q1). Methyl paraben (MEPA) was associated with lower systolic BP (Q4: β = −1.67 [−3.31, −0.04] mmHg vs Q1). No consistent associations were observed for the other compounds. Results from the BKMR confirmed the single-exposure results and showed similar patterns of associations, with BP3 having the highest importance in the mixture models, especially among preadolescents who reached puberty status. No overall mixture effect was found, except for a tendency of higher BMI z-score and lower systolic BP in girls. ConclusionsPrenatal exposure to UV-filter BP3 may be associated with higher BMI and diastolic BP during preadolescence, but there is little evidence for an overall phthalate and phenol mixture effect.

Family history of arterial hypertension and central adiposity: impact on blood pressure in schoolchildren

BackgroundA family history of arterial hypertension is an important risk factor for arterial hypertension. This study aimed to verify the mediating role of high central adiposity in the relationship between family history of arterial hypertension and blood pressure in schoolchildren. MethodsCross-sectional study with 118 schoolchildren of both sexes aged between 11 and 17 years. Weight, height, waist circumference and body mass index z score were verified. Somatic maturation was predicted by age for peak growth velocity. The family history of arterial hypertension was verified and defined as hypertensive schoolchildren with systolic blood pressure or diastolic blood pressure. Mediation analysis was used with linear regression models applied by PROCESS macro for SPSS (version 22.0), with significance p < 0.05.ResultsIt was observed that 34.7% of the students have family history of arterial hypertension, 36% of the girls and 44.2% of the boys have arterial hypertension. In girls, the relationship between waist circumference and systolic blood pressure was direct (β = 0.535 p = 0.005), and those with a family history of arterial hypertension and who had a waist circumference greater than those without a family history of arterial hypertension was significant (β = -5,437 p = 0.009). Likewise, the relationship between family history of arterial hypertension and systolic blood pressure was attenuated when waist circumference was included in the model (β = -5.544; p = 0.103), indicating waist circumference as a mediator with an influence percentage of 19%. For boys, waist circumference is not a mediator of the relationship between family history of arterial hypertension and blood pressure.ConclusionsElevated central adiposity was a mediator of the relationship between family history of arterial hypertension and high blood pressure in girls, indicating the importance of family health strategies in the prevention and management of arterial hypertension in children and adolescents.

Association between body composition and blood pressure in normal-weight Chinese children and adolescents

BackgroundThe aim of this study was to assess the associations of body fat distribution and lean body mass (LBM) with blood pressure (BP) in normal-weight Chinese children and adolescents.MethodsA total of 898 normal-weight Chinese children and adolescents, aged 10–18 years, were included this cross-sectional study via a cluster sampling method. The bioelectrical impedance analysis (BIA) was used to measure body composition. The participants were measured for blood pressure (BP) using a calibrated electronic sphygmomanometer according to the standard method by the "American Hypertension Education Project Working Group".ResultsBody composition was related to abnormal BP in normal-weight children and adolescents. After the model adjusted for age, smoking, and drinking, regression analysis showed that fat mass percentage (FMP) was negatively associated with abnormal BP, while LBM was positively associated with abnormal BP in boys(P < 0.05). Whereas FMP and visceral fat level (VFL) were positively associated with abnormal BP in girls (P < 0.05).ConclusionsThere are sex differences in the relationships between total body fat, visceral fat and lean body mass with abnormal BP in normal-weight youths. Therefore, it is of great significance to pay attention to the relative influence of the body composition of the boys and girls in the prevention and treatment of hypertension in youths.

Fitness, Food, and Biomarkers: Characterizing Body Composition in 19,634 Early Adolescents.

Adolescent obesity persists as a major concern, especially in Central and Eastern Europe, yet evidence gaps exist regarding the pivotal early adolescent years. Our objective was to provide a comprehensive picture using a holistic approach of measured anthropometry in early adolescence, including body composition, cardiorespiratory fitness (CRF), and reported lifestyle characteristics. We aimed to elucidate potential sex/gender differences throughout and associations to biomarkers of disease risk for obese adolescents. Methods: Trained nurses measured 19,634 early adolescents (12–14-year-olds), we collected parental reports, and, for obese adolescents, fasting blood samples in four major Polish cities using a cross-sectional developmental design. Results: 24.7% boys and 18.6% girls were overweight/obese, and 2886 had BMI ≥ 90th percentile. With increasing age, there was greater risk of obesity among boys (p for trend = 0.001) and a decreasing risk of thinness for girls (p for trend = 0.01). Contrary to debate, we found BMI (continuous) was a useful indicator of measured fat mass (FM). There were 38.6% with CRF in the range of poor/very poor and was accounted for primarily by FM in boys, rather than BMI, and systolic blood pressure in girls. Boys, in comparison to girls, engaged more in sports (t = 127.26, p < 0.0001) and consumed more fast food (t = 188.57, p < 0.0001) and sugar-sweetened beverages (167.46, p < 0.0001). Uric acid, a potential marker for prediabetes, was strongly related to BMI in the obese subsample for both boys and girls. Obese girls showed signs of undernutrition. Conclusion: these findings show that overweight/obesity is by far a larger public health problem than thinness in early adolescence and is characterized differentially by sex/gender. Moreover, poor CRF in this age, which may contribute to life course obesity and disease, highlights the need for integrated and personalized intervention strategies taking sex/gender into account.

Clinical assessment of blood pressure in 60 girls with Turner syndrome compared to 1888 healthy Danish girls.

Hypertension contributes to increased risk of cardiovascular disease in patients with Turner syndrome (TS). Our objective was to evaluate blood pressure (BP) in girls with TS followed longitudinally through childhood and adolescence compared to a newly established BP reference material. Cohort study with data collected from 1991 to 2019 consisting of a population-based reference cohort and a group of girls with TS followed at a single tertiary centre. Reference population of 1888 healthy girls with 4890 BP recordings and 60 girls with TS with 365 BP recordings. Difference in diastolic BP (DBP) and systolic BP (SBP), expressed in standard deviation scores (SDS), between girls with TS and the reference population, unadjusted and adjusted for BMI. Difference in BP (SDS) between TS subgroups (karyotype, oestrogen treatment, cardiac diagnosis). The girls with TS had significantly higher DBP (mean ± SD, 0.72 SDS ± 0.95; p < .001) and SBP (0.53 SDS ± 1.11; p = .001) than the reference population. Adjusted for BMI, girls with TS had significantly higher DBP (mean ± SE, 0.71 SDS ± 0.12; p < .001) but not SBP (0.17 SDS ± 0.16; p = .29). There was no significant difference in DBP (median, IQR: 0.97 SDS, 0.30-1.58 vs. 0.76 SDS, 0.10-1.20; p = .31) or SBP (0.51 SDS, 0.15-1.30 vs. 0.57 SDS, -0.30 to 1.05; p = .67) between individuals with or without a cardiac diagnosis. In the TS population, 55% (31/56) had at least one BP recording above the hypertension threshold. Our findings indicate that standardised longitudinal routine monitoring of BP in girls with TS already in childhood is of utmost importance.

Diagnostic accuracy of anthropometric indices for discriminating elevated blood pressure in pediatric population: a systematic review and a meta-analysis

BackgroundChildhood obesity is more likely to increase the chance of many adult health problems. Numerous studies have shown obese children to be more prone to elevated blood pressure (BP) and hypertension. It is important to identify an obesity anthropometric index with good discriminatory power for them in pediatric population.MethodsMEDLINE/PubMed, Web of Science, and Cochrane databases were retrieved comprehensively for eligible studies on childhood obesity and hypertension/elevated BP through June 2021. The systematic review and meta-analysis of studies used receiver operating characteristics (ROC) curves for evaluating the discriminatory power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in distinguishing children with elevated BP and hypertension.Results21 cross-sectional studies involving 177,943 children and 3–19 years of age were included in our study. Meta-analysis showed that the pooled area under the reporting receiver-operating characteristic curves (AUC) and 95% confidence intervals (CIs) for BMI, WC, and WHtR to detect hypertension of boys were 0.68 (0.64, 0.72), 0.69 (0.64, 0.74), 0.67 (0.63, 0.71), for elevated BP, the pooled AUCs and 95% CIs were 0.67 (0.61, 0.73), 0.65 (0.58, 0.73), 0.65 (0.61, 0.71). The pooled AUCs and 95% CIs for BMI, WC and WHtR of predicting hypertension were 0.70 (0.66, 0.75), 0.69 (0.64, 0.75), 0.67 (0.63, 0.72) in girls, the pooled AUCs and 95% CIs of predicting elevated BP were 0.63 (0.61, 0.65), 0.62 (0.60, 0.65), 0.62 (0.60, 0.64) respectively. There was no anthropometric index was statistically superior in identifying hypertension and elevated BP, however, the accuracy of BMI predicting hypertension was significantly higher than elevated BP in girls (P < 0.05). The subgroup analysis for the comparison of BMI, WC and WHtR was performed, no significant difference in predicting hypertension and elevated BP in pediatric population.ConclusionsThis systematic review showed that no anthropometric index was superior in identifying hypertension and elevated BP in pediatric population. While compared with predicting elevated BP, all the indicators showed superiority in predicting hypertension in children, the difference was especially obvious in girls. A better anthropometric index should be explored to predict children’s early blood pressure abnormalities.

Morphofunctional characteristics of the heart of adolescent girls who have dynamic physical activity

Summary. The article presents the study of the morphofunctional indicators of the heart in adolescent girls who go in for dynamic sports, and their comparison with the indicators of physically inactive peers. Purpose – to determine the features of physical development and morphofunctional indicators of the cardiovascular system in girls 15-17 years old who are engaged in dynamic sports. Materials and methods. 16 girls aged 15-17 years were examined, who had been involved in dynamic sports for a least two years: half of them engaged in basketball and sports dancing, as well as athletics, badminton, football, tennis, swimming, kickboxing. The comparison group consisted of 18 phisically inactive female peers. The examination included an assessment of the state of health, physical activity, anthropometry. The morphofunctional characteristics of the heart were determined using echocardiography (ECHO-CG + Doppler ECHO-CG). Results. The average indicators of the physical development of female athletes did not differ from those of physically inactive girls. 32% of girls in the first group had high growth. Systolic blood pressure in girls of the first group was higher than SBP in hypodynamic girls (p ˂ 0.05), but was within the normal values. Female athletes had significantly larger interventricular septal thickness, systolic size and volume of the left ventricle, myocardial mass and left ventricular ejection fraction than physically inactive girls (p ˂ 0.05). Conclusions. 1. Dynamic sports affect the physical development of adolecsent girls, 32% of them are tall. 2. In girls aged 15-17 who have been involved in dynamic sports for at least two years, there are changes in the morphological and functional characteristics of the heart. This is accompanied by increased systolic function of the left ventricle. These changes are adaptive, which have arisen as a result of regular physical activity. But it is possible that they may also be the initial signs of heart remodeling. 3. Medical supervision of girls with sports loads should include an assessment of the morpho-functional parameters of the heart using an annual instrumental examination. Preserving the health of a sports girls, along with ensuring the development of her physical data and achieving sports success, is the most important task for the joint work of a doctor and a sports coach.

Effects of Screen Time and Season on Cardiovascular System Indicators in Primary Schoolchildren

Indicators of the cardiovascular system, including heart rate (HR) and blood pressure (BP) variability parameters, were analyzed in primary school students with different computer screen times. The study included 4084 students of grades 1–4 (age 7–12 years) from 66 Moscow schools. The screen time at school and out of school was assessed by teachers, based on the national Sanitary Rules and Regulations: 0, no screen time; 1, screen time matching hygienic standards; 2, screen time at least twice greater than recommended. Physiological examinations were carried out by spiroarteriocardiorhythmography with a face mask, the conditions corresponding to the functional stress test (mild hypercapnia/hypoxia). Testing took place in spring and autumn (independent samples). Statistical data processing was performed using nonparametric criteria. It was revealed that the introduction of computer technologies in school lessons within the limits of hygienic standards was accompanied by an increase, within the normal range, of systolic BP in girls at the end of grade 2 and 4 and in boys at the beginning and end of grade 4. Screen time at least twice higher than the hygienic standard did not have an additional effect on BP, but provoked shifts in the function of autonomic regulation. Boys were more sensitive to the influence of this environmental factor. Their pattern of seasonal variability in total power (TP) of the HR variability spectrum was reversed compared to that of children who did not use computers at school; i.e., higher TP values were observed in spring. In grade 4, the process was accompanied by an increase in spontaneous arterial baroreflex sensitivity and a decrease in the relative power of the LF range in the variability spectrum of systolic BP. The changes were assumed to reflect the adaptive response to changes in educational environment.

Особенности системы кровообращения детей 8–17 лет разной этнической принадлежности, проживающих в условиях Ханты-Мансийского автономного округа – Югры

The research involved 479 schoolchildren living on the territory of the Khanty-Mansi Autonomous Okrug – Yugra (KMAO – Yugra). Two groups were singled out: the Khanty and 1st and 2nd generation descendants of newcomers. The following parameters were studied: blood pressure, heart rate, double product, and index of functional changes; the frequency of deviations from standard values was identified. In addition, the dominant type of circulation was determined. The analysis of the children’s circulatory system parameters revealed some ethnicity-related features. It was established that Khanty children have higher aerobic capacity of the cardiovascular system and lower blood pressure than newcomers’ descendants. Blood pressure deviations from the norm (high blood pressure in girls and arterial hypertension in boys) were statistically more common in newcomers’ descendants. Virtually one in two children had heart rate exceeding the normal values. Moreover, we observed increased stress of the cardiovascular system in the group of newcomers’ descendants (in girls aged 12–15 and boys aged 14–17 years) which was indicated by higher values of double product and index of functional changes. Hyperkinetic type of circulation was predominant in both groups, being, however, more frequent in Khanty children. The revealed features of the cardiovascular system in children of different ethnic groups living in KMAO – Yugra highlight the importance of developing regional and ethnic standards for an objective evaluation of children’s health. For citation: Govorukhina A.A., Kon’kova K.S. Features of the Circulatory System in 8–17-Year-Old Children of Different Ethnic Groups Living in the Khanty-Mansi Autonomous Okrug – Yugra. Journal of Medical and Biological Research, 2021, vol. 9, no. 2, pp. 126–137. DOI: 10.37482/2687-1491-Z050

ASSOCIATION BETWEEN BODY FAT DISTRIBUTION AND BLOOD PRESSURE IN NORMAL-WEIGHT CHINESE CHILDREN AND ADOLESCENTS

Objective: Body fat distribution is commonly considered as playing a significant role in blood pressure (BP), whether normal-weight children and adolescents whose body fat distribution confer BP risk that remains uncertain. Aim of this study was to assess the associations of body fat distribution with BP risk in normal-weight Chinese children and adolescents. Design and method: A cross-sectional study consisted of 898 normal-weight children and adolescents aged 10–18 years from China. Participants were selected using a cluster sampling method and underwent bioelectrical impedance analysis (BIA) for body fat distribution indexes. Results: Body fat distribution was related with an increased risk for BP in normal-weight children and adolescents. After adjustment for gender and age, visceral fat level(VFL) was positively associated with abnormal BP (OR:1.109 95%CI, 1.016–1.210; P &lt; 0.05), and the same result also found when including fat mass percentage(FMP; P &lt; 0.05). FMP, VFL and VFL/FMP ratio showed a positively association with abnormal BP in girls after adjustment for age, respectively (OR:1.08; 95%CI, 1.03–1.13; P &lt; 0.01)(OR:1.22; 95%CI, 1.07–1.38; P &lt; 0.01)(OR:1.08; 95%CI, 1.01–1.14; P &lt; 0.05). However, when both FMP and VFL were adjusted for age, FMP but not VFL negatively associated with abnormal BP in boys (OR:0.94; 95%CI,0.88–1.00; P &lt; 0.05), and the same result also found when additional including VFL/FMP ratio in the same model(P &lt; 0.05). Conclusions: The body fat distribution (especially visceral fat) is associated with abnormal BP in normal-weight children and adolescents, especially in girls. Therefore, attention should be paid to the relative effect of body fat distribution (especially visceral fat) on BP in the prevention and treatment of hypertension in youths.

Associations of cardiorespiratory fitness and obesity parameters with blood pressure: fitness and fatness in youth Latin-American ethnic minority

ABSTRACT Background: In spite of wide international evidence about cardiorespiratory fitness (CRF) and adiposity in association with cardiovascular disease, there is poor evidence about this relationship in schoolchildren of ethnic minorities. Aim: To examine the relationship between CRF and body composition on blood pressure (BP) in a sample of ethnic minority schoolchildren from three Latin-American countries. Material and methods: A descriptive cross sectional study of total n = 3866, mean age 12.5 (2.7) y [girls n = 1997, mean age 12.8 (2.8) y; boys n = 1869, mean age 12.2 (2.7) y] schoolchildren from three Latin-American countries (Colombia, Brazil, Chile). Main outcomes were CRF, body mass index (BMI), waist circumference, body fat percentage (%BF), and BP (systolic SB, diastolic BP, and mean arterial pressure (MAP). Results: In both sex, and after adjusting for covariates (age and ethnicity group), negative CRF by O2peak levels were associated with a higher body fatness parameters (BMI, WC, WHtR and %BF p<0.001), and blood pressure measures (systolic BP, diastolic BP, and MAP; p<0.001). A lower CRF (by O2peak) was associated with a higher BP in girls (systolic SB −0.15; −5.10 (0.30), diastolic BP −0.14; −4.43 (0.23), and MAP −0.15; −4.93 (0.26) at p<0.001), and boys (systolic SB −0.02; −0.85 (0.32), DB −0.07; −2.23 (0.23), and MAP−0.06; −1.89 (0.25 at p<0.001). There was a significant association between a ‘high-CRF + low-%BF’ with a lower systolic SB diff = − 9.6 [0.7], diastolic BP diff= − 11.0 [0.6]; and MAP level diff = − 10.6 [0.6] all p<0.001). There was a significant association between a ‘high-CRF + low-BMI’ with a lower systolic diff = − 10.3 [1.1], diastolic diff = − 11.2 [1.1], and MAP diff = − 10.9 [1.0] all p<0.001. Conclusion: A lower CRF is associated with a higher body fatness parameters, and higher BP levels in Latin-American ethnic schoolchildren. Abbreviators: %BF: Percentage of Body fat; BIA: Bioelectric impedance analysis; BMI: Body mass index; BP: Blood pressure; CRF: Cardiorespiratory fitness; CVD: Cardiovascular disease; LDL-cholesterol: SD: Standard deviation; WC: Waist circumference; WHtR: Waist-height to ratio; O2max: Maximal oxygen consumption; O2peak: Peak of oxygen consumption

Combined phthalates exposure in pregnancy and increased children’s blood pressure at age 4 to 6 years

PDS 63: Chemicals and metals: health effects, Exhibition Hall (PDS), Ground floor, August 27, 2019, 10:30 AM - 12:00 PM Background: Developmental exposure to endocrine disrupting chemicals, such as phthalates, may contribute to poorer metabolic health in childhood; however, there is limited previous research with inconsistent findings. We developed a Bayesian mixture approach to examine the association of combinations of urinary phthalate metabolites as a complex mixture with children’s blood pressure (BP) using a large prospective cohort of Mexican mother-child pairs. Methods: We analyzed data from 529 mother-child dyads participating in the Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) study for which prenatal urinary phthalate metabolites and children’s BP at age 4-6 years were available. We quantified urinary concentrations of 15 phthalate metabolites in spot samples collected from the 2nd and 3rd trimesters, and corrected concentrations for specific gravity. Our Bayesian mixture approach identifies both the linear association of each trimester mixture exposure with childhood BP and the contribution of each mixture component to the overall association. Covariates included maternal education and body mass index at 2nd trimester. Children’s BP percentiles were calculated based on age, sex, and height. Additional models were stratified by sex. Results: We identified no association between phthalate metabolites and child BP overall. However, when stratified by sex, a complex mixture predominantly composed of eight phthalate metabolites [mono-2-ethyl-5-carboxypentyl (mECPP), mono-carboxyisononyl (MCNP), mono-2-ethyl-5-hydroxyhexyl (MEHHP), mono-2-ethylhexyl (MEHP), monoethyl (MEP2), mono-isobutyl (MiBP), mono-hydroxybutyl (MHBP), mono-hydroxy-isobutyl (MHiBP)] assessed in the 3rd trimester was associated with increased systolic BP among girls 4-6 years old (β=0.08; 95%CrI: 0.00; 0.16). No association was identified between SBP and the same mixture during 2nd trimester (β=0.01; 95%CrI: -0.07; 0.10). Conclusion: Our findings suggest that early life exposure to select phthalates may increase BP in girls as early as 4-6 years of life. Long-term follow-up will increase our understanding of whether these subtle early life changes may influence later life cardiometabolic trajectories.

Serum γ-glutamyltransferase level and metabolic syndrome in children and adolescents: Korean National Health and Nutrition Examination Survey.

Aims/IntroductionSerum γ‐glutamyltransferase (GGT) is positively related to cardiometabolic diseases, such as type 2 diabetes mellitus, hypertension and metabolic syndrome (MetS), in adult populations. Our aim was to investigate whether serum GGT is independently associated with MetS and its components in a nationally representative sample of Korean children and adolescents.Materials and MethodsThe study included data from 1,618 participants (867 boys, 751 girls) aged 10–18 years from the 2010–2011 Korean National Health and Nutrition Examination Survey. MetS was diagnosed by the 2007 International Diabetes Federation criteria for children and adolescents. Participants were stratified using a cut‐off value of the 75th percentile of serum GGT levels (19 IU/L for boys, 15 IU/L for girls). The odds ratios and 95% confidence intervals for MetS and its components were determined with multiple logistic regression analyses.ResultsThe mean values of most cardiometabolic variables were significantly higher in the upper stratum. Except for low high‐density lipoprotein cholesterol in boys and elevated blood pressure in girls, participants in the upper GGT stratum had significantly higher odds of MetS and its components than those in the lower stratum. The multivariate‐adjusted odds ratios for MetS for the upper stratum were 5.79 (95% confidence interval 1.21–27.02) in boys and 6.20 (95% confidence interval 1.71–22.47) in girls, after adjusting for age, household income and residential area.ConclusionsSerum GGT was positively associated with MetS and its components in Korean children and adolescents. Serum GGT could be a useful measure for identifying children and adolescents with MetS.

Increased high molecular weight adiponectin, but decreased total adiponectin and kisspeptin, in central precocious puberty compared with aged-matched prepubertal girls.

The aim of the present study was to compare serum leptin, kisspeptin, total adiponectin, high molecular weight (HMW) adiponectin and neuropeptide Y (NPY) levels between girls with central precocious puberty (CPP; n=26, 7-9.5 years old) and age-matched controls (n=29) including or excluding obese girls. Leptin and NPY levels were comparable between CPP and control girls. Kisspeptin levels were lower in the CPP than control group, and were positively correlated with oestrogen in the control group and with systolic and diastolic blood pressure in the CPP group. Kisspeptin levels were negatively correlated with FSH and LH in the CPP group. Total adiponectin levels were lower in CPP than control girls, and were negatively correlated with Tanner stage and body mass index, but positively correlated with the quantitative insulin sensitivity check index in the control group. HMW adiponectin was higher in the CPP than control group, and was positively correlated with Tanner stage and LH in all girls. Total adiponectin had a strong positive correlation with HMW adiponectin in the CPP group (r=0.915) compared with the control group (r=0.371). In conclusion, kisspeptin may be associated with increased oestrogen in prepubertal girls, but with increased blood pressure in girls with CPP. In girls entering puberty, HMW adiponectin was increased and associated with reproductive parameters. Based on these observations, HMW adiponectin probably plays an essential role in the initiation of puberty and is a candidate marker for the prediction of CPP.

Corrigendum to: Increased high molecular weight adiponectin, but decreased total adiponectin and kisspeptin, in central precocious puberty compared with aged-matched prepubertal girls.

The aim of the present study was to compare serum leptin, kisspeptin, total adiponectin, high molecular weight (HMW) adiponectin and neuropeptide Y (NPY) levels between girls with central precocious puberty (CPP; n=26, 7-9.5 years old) and age-matched controls (n=29) including or excluding obese girls. Leptin and NPY levels were comparable between CPP and control girls. Kisspeptin levels were lower in the CPP than control group, and were positively correlated with oestrogen in the control group and with systolic and diastolic blood pressure in the CPP group. Kisspeptin levels were negatively correlated with FSH and LH in the CPP group. Total adiponectin levels were lower in CPP than control girls, and were negatively correlated with Tanner stage and body mass index, but positively correlated with the quantitative insulin sensitivity check index in the control group. HMW adiponectin was higher in the CPP than control group, and was positively correlated with Tanner stage and LH in all girls. Total adiponectin had a strong positive correlation with HMW adiponectin in the CPP group (r=0.915) compared with the control group (r=0.371). In conclusion, kisspeptin may be associated with increased oestrogen in prepubertal girls, but with increased blood pressure in girls with CPP. In girls entering puberty, HMW adiponectin was increased and associated with reproductive parameters. Based on these observations, HMW adiponectin probably plays an essential role in the initiation of puberty and is a candidate marker for the prediction of CPP.

Pilot Study of Blood Pressure in Girls With Turner Syndrome: An Awareness Gap, Clinical Associations, and New Hypotheses.

Cardiovascular disease is the major factor that reduces lifespan in Turner syndrome. High blood pressure (BP) is common in Turner syndrome and is the most easily treatable cardiovascular risk factor. We studied the prevalence of elevated screening systemic BP, awareness of the problem, and its clinical associations in a large group of girls attending the annual meeting of the Turner Syndrome Society of the United States. Among 168 girls aged 2 to 17 years, 42% had elevated screening BP (systolic and diastolic), yet only 8% reported a previous diagnosis of hypertension. History of aortic coarctation repair (17%) was positively associated with elevated systolic BP (52% versus 32%; P<0.05). Elevated systolic BP was positively associated with obesity (56% versus 31%; P<0.05). Because the prevalence of obesity in the studied population was similar to Center for Disease Control published data for obesity in all girls and the prevalence of increased BP is approximately twice that of the general population, the Turner syndrome phenotype/genotype probably includes an intrinsic risk for hypertension. Obesity and repaired aortic coarctation increase this risk further. There seems to be a BP awareness gap in girls with Turner syndrome. Because girls living with Turner syndrome are a sensitized population for hypertension, further study may provide clues to genetic factors leading to a better understanding of essential hypertension in the general population.