Characteristics of amino acid metabolism in preterm infants in Guangxi, China / 中国当代儿科杂志

OBJECTIVES@#To study the characteristics of amino acid metabolism in preterm infants in Guangxi, China.@*METHODS@#A retrospective analysis was performed on the medical data of 30 757 neonates who underwent the screening for inherited metabolic diseases and had negative results in Guangxi Neonatal Disease Screening Center from 2018 to 2020. Among these neonates, there were 28 611 normal full-term infants (control group) and 2 146 preterm infants (preterm birth group). According to gestational age, the preterm infants were further divided into four groups: very preterm (n=209), moderately preterm (n=307), and late preterm group (n=1 630). According to birth weight, they were divided into three groups: very low birth weight group (n=161), low birth weight group (n=1 085), and normal birth weight group (n=900). According to blood collection time, they were divided into three groups: 3-7 days group (n=1 664), 8-14 days group (n=314) and 15-28 days group (n=168). Tandem mass spectrometry was performed to measure the levels of 11 amino acids in dried blood spots, which were then compared between groups.@*RESULTS@#After adjustment for confounding factors, there were significant differences in the levels of 11 amino acids among different gestational age groups (P<0.05), and significant differences were observed in the levels of the 11 amino acids between the control group and the various preterm groups (except for citrulline and methionine in the late preterm group). There were significant differences in the levels of 11 amino acids among different birth weight groups (P<0.05). Except for ornithine, there were significant differences in the levels of other amino acids among the different blood collection time groups (P<0.05).@*CONCLUSIONS@#Gestational age, birth weight and blood collection time all affect amino acid metabolism in preterm infants in Guangxi, China. This provides a basis for the laboratory to establish the reference standard and clinical interpretation of blood amino acid levels in preterm infants, and to improve the nutritional metabolism of preterm infants.

Relationship between body mass index and sexual development in Chinese children / 中华儿科杂志

Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.

Prevalence of hypertension and relationship between hypertension and obesity in children and adolescents in Nanning of Guangxi Province / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of hypertension and the relationship between hypertension and obesity in children and adolescents aged 6-18 years in Nanning, Guangxi Province, China.</p><p><b>METHODS</b>A stratified cluster random sampling method was adopted in Nanning to select 7 893 children and adolescents aged 6-18 years as research subjects. Questionnaire surveys were conducted, and blood pressure, height, weight, and other indicators of growth and development were measured.</p><p><b>RESULTS</b>An increasing trend with age for both systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed. Detection rates of hypertension, high SBP (HSBP) and high DBP (HDBP) were 6.58%, 4.02% and 3.81%, respectively. The detection rates of hypertension and HSBP in boys were significantly higher than in girls (P<0.05). The detection rates of hypertension in normal, overweight and obesity groups were 3.87%, 9.84% and 19.23%, respectively. The obesity group showed the highest detection rates for hypertension, HSBP and HDBP, followed by the overweight group and normal group. Compared with that in the normal group, the odds ratios (95% CI) for hypertension in the overweight and obesity groups were 2.71 (1.69-5.96) and 5.91 (3.46-7.63), respectively. Blood pressure showed a positive correlation with age, height, weight and BMI (P<0.01).</p><p><b>CONCLUSIONS</b>The present study provides with the current information and characteristics of blood pressure of children and adolescents aged 6-18 years in Nanning, Guangxi. Blood pressure is correlated with gender, age, height, weight and BMI. Obesity is positively correlated with the prevalence of hypertension and the risk of hypertension increases with body weight.</p>

Pulmonary surfactant associated gene variants in mixed ethnic population of Han and Zhuang / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the prevalence of pulmonary surfactant associated pathway genes functional variants in Chinese population.</p><p><b>METHOD</b>Using a cohort of 258 mixed ethnic population of Han and Zhuang, we pooled DNA samples from 146 term male infants and 112 term female infants and then used an Ill umina next generation sequencing platform to perform the complete exonic resequencing in 6 target genes:surfactant protein-B (SFTPB), surfactant protein-C (SFTPC), ATP-binding cassette transporter A3 (ABCA3), lysophospholipid acyltransferase 1 (LPCAT1), choline phosphotransferase 1 (CHPT1), phosphate cytidylyltransferase 1, choline, beta (PCYT1B). Collapsing methods was used to determine the functional allele frequency.</p><p><b>RESULT</b>(1) Altogether, 128 variants were found, including 44 synonymous variants, 66 nonsynonymous variants and 18 insertions-deletions. Of these, 28 variants were predicted to alter protein function. Two of these variants were seen twice, the rest variants were only seen once, for a total of 30 functional alleles; (2) ABCA3 had the most functional variants in both male and female groups with the minor allele frequencies of 0.014 (1.4%) and 0.04 (4%), respectively. The total functional allele frequencies of 6 genes were 0.041 (4.1%) and 0.08 (8%) in the two groups, respectively (P = 0.06).</p><p><b>CONCLUSION</b>(1) Functional variants in pulmonary surfactant associated pathway genes are present in the mixed Han-Zhuang population. (2) ABCA3 contained the most functional variants suggesting that ABCA3 could contribute significantly to neonatal respiratory distress syndrome and other lung disease.</p>

Relationship between alanine aminotransferase and overweight or obesity in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the association of alanine aminotransferase (ALT) with overweight or obesity in children.</p><p><b>METHODS</b>A total of 2889 healthy children and 702 overweight or obese children aged from 7 to 18 years who had received a physical examination were enrolled. Height, body weight, waist circumference, and blood pressure were measured, and the biochemical indicators including blood glucose, blood lipids, ALT, and insulin were detected. The insulin resistance index were calculated.</p><p><b>RESULTS</b>The ALT level was significantly higher in boys than in girls. Along with the increase of BMI, the ALT level increased in the normal, overweight, and obese groups in both boys and girls. ALT was correlated with BMI, waist circumference, triglyceride, and insulin resistance index. Among the overweight or obese children, the boys with the increased ALT level had higher BMI, waist circumference, blood pressure, triglyceride, low density lipoprotein and insulin resistance index than the boys with normal ALT level (P<0.05); the girls with the increased ALT level had higher waist circumference, blood pressure and insulin resistance index and lower high density lipoprotein than the girls with normal ALT level (P<0.05).</p><p><b>CONCLUSIONS</b>ALT is correlated with overweight and obesity and metabolic disorders caused by overweight and obesity such as dyslipidemia and insulin resistance.</p>

Epidemiological study on the association between obesity with metabolic syndrome in obese children and adolescents of Nanning city, Guangxi / 中华流行病学杂志

Objective To investigate the association between obesity and prevalence of metabolic syndrome (MS) with its associated risk factors,in children and adolescents.Methods A stratified random sampling method was used to select 7893 students from 6 to 18 years of age from 14 out of 396 primary and secondary schools in Nanning city.All the students had undergone physical examination and blood tests including the following risk factors related to metabolic syndrome:fasting blood glucose (FBG),total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),alanine amino shift enzyme (ALT),aspartic acid amine shift enzyme (AST) and fasting insulin (FINS).The homeostasis model assessment insulin resistance index (HOMA-IR) was also measured.Results (1) The prevalence rate of MS in normal group was 0.57％.In both the overweight and obesity groups,the prevalence rates of MS were 4.53％ and 26.80％,respectively.(2) These indices in obesity group were higher than other two groups (P＜0.05).The result of overweight group was higher than normal group (P＜0.05).(3) Waist circumference(OR=1.087,95％CI:1.033-1.143 ),SBP ( OR=1.073,95％CI:1.032-1.116),FBG (OR=1.394,95％CI:1.568-3.423),TG (OR=3.213,95％CI:1.410-7.319) and HDL-C (OR=0.001,95％CI:0.000-0.012)were detecting indices which had statistically significant with MS in binary logistic regression analysis.Conclusion Metabolic syndrome and obesity were closely related in children and adolescents while its prevalence and risk factors increased with the severity of obesity.