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Abstract

Background: The cause of the increased risk of hypertension in children born prematurely is still unclear. The aim of this study was to analyze the results of blood pressure monitoring and the levels of variety of kidney function markers at the 40–42 weeks postmenstrual age in children born prematurely and to compare them with the values obtained from full-term newborns. The analysis of the differences in the observed parameters could be used to assess the risk of developing hypertension in preterm infants in the following years of life.
Methodology: Prospective cohort study included 37 children born prematurely (<35 weeks of gesta-tion) and 20 full-term newborns. The 24-hour ambulatory blood pressure measurement, serum cystatin C and thrombomodulin levels, urine Neutrophil Gelatinase-Associated Lipocalin (NGAL) concentration, renal ultrasound and bioelectrical impedance were performed.
Results: Analysis of the blood pressure monitoring reveled lower values of diastolic (DBP) and mean blood pressure (MAP) in the preterm group (DBP: 47.69 ± 4.79 vs. 53.96 ± 5.3 mmHg; p <0.01; MAP 64 ± 6.7 vs. 68 ± 6 mmHg; p = 0.02), however the preterm children were significantly smaller at the time of evaluation. Moreover, the pulse pressure was significantly higher in the preterm group (44 ± 7.8 vs. 39.4 ± 5.7 mmHg; p = 0.017). In the preterm group serum cystatin C level was lower (1.397 ± 0.22 vs. 1.617 ± 0.22 mg/l; p <0.01) and NGAL urine concentration was higher (57 ± 84 vs. 15 ± 21 ng/ml; p = 0.04). There was substantial difference in body composition between groups - the total body water was lower in the preterm group (75.6 ± 13 vs. 82 ± 8%; p = 0.015).
Conclusion: At the predicted date of birth, preterm newborns show significant differences in blood pressure profile, body weight composition, and levels of cystatin C and NGAL compared to full-term babies.
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Authors and Affiliations

Maja Gilarska
1
Dagmara Wolińska
2
Przemko Kwinta
1

  1. Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Pediatrics, University Children Hospital, Kraków, Poland
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Abstract

B a c k g r o u n d a n d s t u d y a i m s: The aim of the study was to assess the usefulness of serum concentrations of YKL-40/ CHI3L1 (a 40-kilodalton glycoprotein also referred to as chitinase 3 like- 1 — CHI3L1) and PIIINP (N-terminal propeptide of type III procollagen), markers of fibrosis, in the monitoring of inflammatory processes and fibrosis in children with inflammatory bowel disease (IBD).

P a t i e n t s a n d m e t h o d s: In 60 patients (41 with Crohn’s disease (CD), 19 with ulcerative colitis (UC)) concentrations of investigated parameters were measured at baseline (day 0), after 3 and after 6–8 weeks of pharmacological treatment.

R e s u l t s: PIIINP concentrations were significantly higher in CD patients compared to UC (baseline results: median concentrations 1013.73 vs 78.30 ng/mL; P = 0.06 for the Kruskall-Wallis test; results at 6–8 weeks: 1076.48 vs 53.10 ng/mL, P = 0.01). Fibrosis was clearly present in patients with CD and its severity increased (reflected by both YKL-40/ CHI3L1 and PIIINP concentrations) in 6–8 weeks of follow up, regardless of the treatment used during that time. In patients with UC the levels of YKL-40/CHI3L1 and PIIINP were lower at baseline and further decreased after 6–8 weeks (median concentrations were respectively: 39.5 ng/mL vs 24.7 ng/mL and 78.3 ng/mL vs 53.1 ng/mL).

C o n c l u s i o n: Fibrosis was more severe in CD than in UC patients. The marker that more accurately reflected these differences was PIIINP.

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Authors and Affiliations

Stanisław Pieczarkowski
Kinga Kowalska-Duplaga
Przemko Kwinta
Andrzej Wędrychowicz
Przemysław Tomasik
Anna Stochel-Gaudyn
Krzysztof Fyderek

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