Preoperative serum cortisone levels are associated with cognition in preschool-aged children with tetralogy of Fallot after corrective surgery: new evidence from human populations and mice.

BACKGROUND: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Children with TOF would be confronted with neurological impairment across their lifetime. Our study aimed to identify the risk factors for cerebral morphology changes and cognition in postoperative preschool-aged children with TOF. METHODS: We used mass spectrometry (MS) technology to assess the levels of serum metabolites, Wechsler preschool and primary scale of intelligence-Fourth edition (WPPSI-IV) index scores to evaluate neurodevelopmental levels and multimodal magnetic resonance imaging (MRI) to detect cortical morphological changes. RESULTS: Multiple linear regression showed that preoperative levels of serum cortisone were positively correlated with the gyrification index of the left inferior parietal gyrus in children with TOF and negatively related to their lower visual spaces index and nonverbal index. Meanwhile, preoperative SpO2 was negatively correlated with levels of serum cortisone after adjusting for all covariates. Furthermore, after intervening levels of cortisone in chronic hypoxic model mice, total brain volumes were reduced at both postnatal (P) 11.5 and P30 days. CONCLUSIONS: Our results suggest that preoperative serum cortisone levels could be used as a biomarker of neurodevelopmental impairment in children with TOF. Our study findings emphasized that preoperative levels of cortisone could influence cerebral development and cognition abilities in children with TOF.

Analysis of limb segments length and body proportion of southern Chinese children and adolescents.

AIM: This cross-sectional study was designed to characterize by age the ratios of limb segments length to height and extremities-trunk ratio and body proportions of southern Chinese children. METHODS: Data were collected from students (n = 4715) from five school, aged 6-17 years, in the city of Chongqing. Their standing height, sitting height, arm span, forearm length, upper arm length, leg length, lower leg length, and ratios of extremities to trunk length were determined. RESULTS: Sitting height, forearm length, upper arm length, arm span, and lower leg length were highly correlated with standing height (r > 0.9; P < 0.05). The ratio of extremities to trunk increased till about 13 years of age for both genders. CONCLUSIONS: The length of extremities and their ratio to sitting height reflect regular changes of growth in Chinese children as their age, and limb segments length is highly correlated with height.