Nocturnal non-dipping on 24-h Ambulatory Blood Pressure Monitoring in children and adolescents with obesity is associated with higher total cholesterol levels.

BACKGROUND: Few studies indicate the occurrence of abnormal nocturnal dipping of blood pressure (BP) in 35-50% of children and adolescents with obesity. The relation between that phenomenon and metabolic complications of obesity remains unclear. To evaluate the association between disorders of glucose and lipid metabolism, and nocturnal non-dipping in pediatric patients with obesity. METHODS: In 207 children (53.14% girls, mean age 14 (range 2-17), mean BMI Z-SCORE 4.38, range 2.07-10.74) standard 24-h Ambulatory Blood Pressure Monitoring was performed. Normal dipping was defined as a ≥ 10% decline in BP during the night. RESULTS: There were 106 (51.21%) cases of non-dippers. The mean 24-h nocturnal systolic BP (SBP) reduction (%) was 9.9 ± 5.5. The mean 24-h nocturnal diastolic BP (DBP) reduction (%) was 15.8 ± 8.5. There was a significant correlation between BMI Z-SCORE and mean day-time SBP (r = 0.14 P = .042). There are positive correlations between 24-h heart rate (beats/min) and BMI Z-SCORE (r = 0.15, P = .027), between fasting glucose and systolic BP Z-SCORE (r = 0.17, P = .03) and between mean diastolic BP and LDL cholesterol (r = 0.23, P = .004). Total cholesterol level was significantly higher in non-dippers (4.34 vs. 3.99 mmol/L, P = .034). There were no significant differences between non-dippers and dippers regarding fasting glucose (4.6 vs. 4.8 mmol/L), 120'post load glucose (5.7 vs. 5.9 mmol/L), insulin (19 vs. 20.2 µIU/mL), HOMA-IR (2.36 vs. 2.44), LDL cholesterol (2.64 vs. 2.51 mmol/L), HDL cholesterol (1.06 vs. 1.03 mmol/L) or triglycerides (1.36 vs. 1.34 mmol/L) levels. CONCLUSION: Nocturnal non-dipping is frequent in pediatric patients with obesity. It is associated with higher total cholesterol levels.

Comparison of eleven commonly used formulae for sonographic estimation of fetal weight in prediction of actual birth weight.

OBJECTIVES: The aim of the study is to compare the accuracy of 11 formulas in predicting fetal weight. MATERIAL AND METHODS: The study includes 1072 pregnant women of gestational age from 28 to 42 weeks, who gave birth between January and June 2017. Pregnant women were divided into five groups; group 1, where actual birth weight (ABW) was less than 2500 g, group 2, where ABW was between 2500-4000 g, group 3, where ABW was above 4000 g. Group 4 - newborns with birth weight under 10 percentile and group 5 - newborns with birth weight above 90 percentile. The accuracy of the estimated fetal weight (EFW) was assessed by calculating absolute percentage error (APE) and 'limits-of-agreement'. R Spearman correlation was utilized between EFW and ABW. RESULTS: The most accurate formula for group 1 is Hadlock3 (MAPE = 7.04%), the narrowest limits of agreement has Combs - [mean (SD): 99.41 g (269.57 g)]. For group 2, the lowest MAPE (5.43%) has Ott, the narrowest limits of agreement belongs to Combs - [mean (SD): -101.36 g (275.88 g)] . For group 3 is Hadlock3 (MAPE = 5.79%), the narrowest limits of agreement has Hadlock5 [mean (SD): -637.32 g (209.59 g)]. For group 4 is Combs (MAPE = 7.72%), the narrowest limits of agreement has Combs [mean (SD): 195.77 g (264.97 g)]. For gr oup 5 is Warsof2 (MAPE = 7.06%), the narrowest limits of agreement has Campbell [mean (SD): 227.81 g (299.26 g)]. CONCLUSIONS: Median of absolute percentage error is the most useful parameter to predict birth weight. Each group of fetuses needs different formula to predict the most accurate weight.