Clinical and Experimental Pediatrics最新文献

{"title":"Need for national guidance regarding proactive care of infants born at 22-23 weeks' gestation.","authors":"Ga Won Jeon","doi":"10.3345/cep.2024.01277","DOIUrl":"10.3345/cep.2024.01277","url":null,"abstract":"<p><p>With recent rapid improvements in neonatal intensive care, the limit of viability has shifted downward to 22-23 weeks' gestation. The younger the gestational age of preterm infants, the higher the risk of survival despite severe neurodevelopmental impairments. For infants born at 22-23 weeks' gestation, the limit of viability, neurodevelopmental outcomes, and survival rates may be determined by the quality of proactive care. Owing to the high risk of severe neurodevelopmental impairment in 22-23 weeks' gestation, proactive care is sometimes withheld according to ethical or legal considerations, and there are significant differences in the provision of proactive care and survival rates across countries or institutions. Additionally, there are differing or even lacking guidelines regarding the care of these infants across countries and institutions. Japan and Sweden are countries with well-established national guidance and proactive care for infants born at 22-23 weeks' gestation, resulting in higher survival rates among them. In Korea, where there is an extreme shortage of neonatologists, maternal transfer before delivery at 22-23 weeks' gestation to high-activity regions with appropriate neonatal intensive care unit resources, such as adequate personnel and facilities similar to the centralized care model seen in Sweden, is crucial for improving the survival rates of infants born at 22-23 weeks' gestation. The survival of these infants largely depends on the quality of proactive care provided. This rate is not static and can be improved through proactive care based on national guidance and the implementation of enhanced neonatal intensive care practices, including centralization of care.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"53-61"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children?","authors":"Rungrat Sukharom, Prakarn Tovichien, Kanokporn Udomittipong, Pinyapach Tiamduangtawan, Wattanachai Chotinaiwattarakul","doi":"10.3345/cep.2024.00066","DOIUrl":"10.3345/cep.2024.00066","url":null,"abstract":"<p><strong>Background: </strong>Few studies have explored the polysomnographic features of children with obesity.</p><p><strong>Purpose: </strong>This study aimed to explore the demographic and polysomnographic features of obese children and determine whether body mass index (BMI) could predict severe obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>This cross-sectional study recruited obese children who underwent diagnostic polysomnography between January 2019 and March 2022. We explored demographic and anthropometric measures as well as polysomnographic abnormalities among them. We used receiver operating characteristic curves and logistic regression analyses to determine the optimal cutoff values of anthropometric variables for predicting severe OSA.</p><p><strong>Results: </strong>A total of 132 children with obesity (76.5% male; mean age, 12.5±3.2 years) were included. Severe OSA was identified in 64 children (48.5%). Desaturation was observed in 59.8%, while 23.5% had hyperarousal, 20.5% had sleep-related hypoventilation, 60.6% had positional OSA, 40.2% had rapid eye movement-related OSA, and 5.0% had obesity hypoventilation syndrome. Among them, BMI (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.05-1.17; P<0.001), neck circumference (OR, 1.15; 95% CI, 1.07-1.25; P<0.001), and waist circumference (OR, 1.04; 95% CI, 1.02- 1.07; P=0.001) were significantly associated with severe OSA. These findings suggest a cutoff BMI for predicting severe OSA of greater than 29.2 kg/m2 with 81.3% sensitivity and 48.5% specificity.</p><p><strong>Conclusion: </strong>Severe OSA is common in children with obesity; thus, we recommend screening children with obesity and a BMI greater than 29.2 kg/m2 for severe OSA.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"80-90"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbapenem resistance in gram-negative pathogens in an Iranian hospital: high prevalence of OXA-type carbapenemase genes.","authors":"Setareh Mamishi, Reihaneh Hosseinpour Sadeghi, Sadaf Sajedi Moghaddam, Babak Pourakbari, Shiva Poormohammadi, Maryam Sotoudeh Anvari, Shima Mahmoudi","doi":"10.3345/cep.2023.01774","DOIUrl":"10.3345/cep.2023.01774","url":null,"abstract":"<p><strong>Background: </strong>The widespread dissemination of carbapenem- resistant gram-negative bacteria poses a significant threat to global public health.</p><p><strong>Purpose: </strong>This study aimed to investigate the prevalence of carbapenem resistance in gram-negative bacteria isolated from patients at the Children's Medical Center Hospital, Tehran, Iran, to understand the molecular mechanisms underlying this resistance.</p><p><strong>Methods: </strong>During the period spanning from June 2019 to June 2020, 777 gram-negative bacterial strains were isolated. Antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute. Polymerase chain reaction was used to detect carbapenem resistance genes including bla OXA23, bla OXA24, bla OXA48, bla OXA51, bla OXA58, bla OXA143, bla KPC, bla IMP, bla VIM, and bla NDM.</p><p><strong>Results: </strong>Among the total bacterial isolates, 141 (18.1%) exhibited carbapenem resistance. Escherichia coli was the most prevalent (57.4%), followed by Klebsiella pneumoniae (11.3%), and Acinetobacter baumannii (10.6%). Other notable contributors included Enterobacter spp. (5.7%), Salmonella spp. (3.5%), and Stenotrophomonas maltophilia (2.8%). Citrobacter spp., Proteus mirabilis, and Pseudomonas aeruginosa contributed to the distributions of 2, 1, and 3 isolates, respectively. Notably, bla OXA48 showed the highest prevalence (33%), followed by bla OXA143 and bla OXA5 8 (27% and 24%, respectively). In addition, bla OXA24 was present in 11% of the total isolates, bla OXA23 in 10%, and bla NDM in 10%, whereas bla KPC, bla VIM, and bla IMP were not detected.</p><p><strong>Conclusion: </strong>Our study highlights the prevalence of carbapenemase- producing gram-negative isolates among pediatric patients. Notable resistance patterns, especially in K. pneumoniae and E. coli, underline the urgent need for proactive interventions, including appropriate antibiotic prescription practices and strengthening of antibiotic stewardship programs.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"65-72"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What we should know about pediatric heart failure: children are not small adults.","authors":"Ja-Kyoung Yoon","doi":"10.3345/cep.2023.01130","DOIUrl":"10.3345/cep.2023.01130","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"62-64"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of leuprolide acetate versus triptorelin pamoate administered every 3 months for treatment of central precocious puberty.","authors":"Thanaporn Thaneetrakool, Suphab Aroonparkmongkol, Nattakarn Numsriskulrat, Vichit Supornsilchai, Suttipong Wacharasindhu, Khomsak Srilanchakon","doi":"10.3345/cep.2024.00822","DOIUrl":"10.3345/cep.2024.00822","url":null,"abstract":"<p><strong>Background: </strong>Central precocious puberty (CPP) is typically treated with gonadotropin-releasing hormone (GnRH) agonists. Although numerous GnRH agonist variants are available, limited research has compared the efficacy of leuprolide acetate and triptorelin pamoate administered at 3-month intervals.</p><p><strong>Purpose: </strong>This study aimed to assess the efficacy of CPP treatment with triptorelin pamoate and leuprolide acetate administered at 3-month intervals.</p><p><strong>Methods: </strong>This retrospective cohort study included 116 girls with CPP: 71 treated with leuprolide acetate every 3 months and 45 treated with triptorelin pamoate every 3 months. Anthropometric measurements were compared before and after therapy. At 6 months after the therapy, luteinizing hormone (LH) suppression was evaluated.</p><p><strong>Results: </strong>When administered every 3 months, leuprolide acetate and triptorelin pamoate significantly suppressed LH. The predicted adult height (PAH) and degree of bone age advancement at the end of treatment were comparable.</p><p><strong>Conclusion: </strong>Treatment with leuprolide acetate and triptorelin pamoate every 3 months did not have significantly different effects on LH suppression or PAH.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"91-96"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential roles of IL-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis.","authors":"Emilly Henrique Dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Karen Alessandra Rodrigues, Ronaldo Arkader, Thelma Suely Okay","doi":"10.3345/cep.2024.01543","DOIUrl":"https://doi.org/10.3345/cep.2024.01543","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing and predicting neonatal sepsis is challenging because of its nonspecific symptoms, lack of diagnostic criteria consensus, and absence of early, sensitive, and specific diagnostic laboratory tests.</p><p><strong>Purpose: </strong>To evaluate the diagnostic and prognostic potential of adrenomedullin (ADM), interleukin-6 (IL-6), and C-reactive protein (CRP) in late-onset neonatal sepsis (LOS).</p><p><strong>Methods: </strong>We studied 53 neonates with culture-proven LOS by sampling at admission and on antibiotic treatment days 3 and 7. These data were compared with those of 22 healthy full-term controls sampled on day 3 before hospital discharge. Survivors and non-survivors in the sepsis group were analyzed separately.</p><p><strong>Results: </strong>Coagulase-negative Staphylococcus was the most commonly detected pathogen. ADM (cutoff, 0.5 ng/mL) and CRP (cutoff, <5 mg/L) values aligned with manufacturer recommendations, while IL-6 levels (cutoff, 10 pg/mL) were higher than expected, likely due to labor stress. The median biomarker levels significantly distinguished neonates with sepsis from controls (p < 0.0001) at all time points with ADM and IL-6 levels elevated at admission, indicating their potential as early diagnostic markers. CRP level was diagnostically useful starting on day 3. Prognostically, IL-6 (p < 0.001) and ADM (p < 0.05) differentiated survivors from non-survivors; however, only IL-6 consistently predicted mortality at all time points (area under the curve [AUC] > 0.90). ADM and CRP levels showed poor prognostic value (AUC < 0.70). ADM and IL-6 demonstrated strong diagnostic utility in early LOS, whereas CRP became relevant later. IL-6 was the only reliable biomarker for predicting mortality, supporting its integration into clinical protocols. Combining IL-6 with CRP may enhance early detection and management, potentially improving neonatal outcomes.</p><p><strong>Conclusion: </strong>IL-6 is a robust biomarker for the early diagnosis and prognosis of LOS. Incorporating IL-6 into clinical practice with CRP could improve early neonatal LOS diagnosis and patient outcomes.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in understanding pathophysiology of nonnutritional stunting in very preterm infants.","authors":"Eduardo Cuestas, Alina Rizzotti","doi":"10.3345/cep.2024.01354","DOIUrl":"https://doi.org/10.3345/cep.2024.01354","url":null,"abstract":"<p><p>Very preterm infants (VPIs) often experience extrauterine growth failure. Therefore, aggressive nutritional management of VPIs is recommended with the goal of achieving the postnatal growth of an equivalent fetus. However, VPIs frequently present postnatal length growth restriction at term-corrected age that remains lower than the standard weight and have greater fat mass and lower lean and bone mass than term-born infants. This condition differs from the classic pattern of infant undernutrition defined as a significantly lower weight for a given length. Moreover, it suggests that non-nutritional factors play a key role in length growth restriction. While weight faltering has been extensively studied, the significance of length growth failure in VPIs has only recently emerged. The non-nutritional factors underlying poor length growth in VPIs are currently not fully understood. In this review, we address recent advances in our understanding of the pathophysiology of length growth restriction, which has been identified as a major predictor of adverse neurodevelopmental and cognitive outcomes in VPIs. First, we review the short- and long-term consequences of poor length growth in VPIs; next, we highlight the effects of non-nutritional factors on postnatal length growth with focus on sustained neonatal inflammation; and finally, we discuss hypothesis and future lines of research attempting to understand the complex inflammatory-endocrine interactions and pathophysiological changes during early postnatal life, appropriately guide and apply clinical strategies aimed at optimizing length growth of VPIs, and identify evidence of the associations between sustained neonatal inflammation, stunting, and long-term health risks and the potential implications thereof.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enteric pathogens implicated in acute infectious diarrhea among young children in resource-limited region with rapidly growing population: a hospital-based cross-sectional study.","authors":"Aseel Al-Mashahedah, Randa Dhahi","doi":"10.3345/cep.2024.01333","DOIUrl":"https://doi.org/10.3345/cep.2024.01333","url":null,"abstract":"<p><strong>Background: </strong>Acute infectious diarrhea is among the leading causes of morbidity and mortality worldwide, particularly in developing countries and among children younger than 5 years of age.</p><p><strong>Purpose: </strong>To determine the causative microorganisms in diarrhea and elucidate their epidemiological trajectory among children younger than 5 years of age to establish successful preventive measures.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in Al-Musayyib District, Babil Governorate, Iraq, using data from January 2023 to January 2024 provided by the information system of Ibn Saif Children's Hospital and Al-Musayyib General Hospital. Data from 300 children under 5 years of age with infectious diarrhea were collected to determine the causative pathogens. Patient data including sex, age, treatment, and post-treatment clinical condition, were collected from the hospital archive and analyzed.</p><p><strong>Results: </strong>Overall, 56% of males and 44% of females had diarrhea. The 1-2-year age group was the most susceptible to diarrhea (33.3%). This rate gradually decreased with age, reaching 9.9% in the 4-5-year age group. Furthermore, bacteria were the causative organisms in 43% of cases, followed by viruses, parasites, and fungi at 24.7%, 12%, and 7.7%, respectively. Mixed infections were detected in 12.6%. Post-treatment, 89.7% of patients completely recovered, 8% experienced physiological disorders, and 2.3% died.</p><p><strong>Conclusion: </strong>Bacteria were the most common causative organisms of infectious diarrhea among children younger than 5 years of age. Children in the 1-2-year age group were the most commonly affected. This study highlights that diarrhea continues to threaten the lives and well-being of children.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, biochemical, and genetic study of TACE/TNF-α/ACE signaling pathway in pediatric COVID-19 infection.","authors":"Ahmed El-Abd Ahmed, Sawsan M A Abuhamdah, Mohammed H Hassan, Nagwan I Rashwan, Eman A Abd-Elmawgood, Haggagy Mansour, Hoda S Sherkawy, Shymaa G Rizk","doi":"10.3345/cep.2024.00941","DOIUrl":"10.3345/cep.2024.00941","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients infected with coronavirus disease 2019 (COVID-19) have unique clinical characteristics. Tumor necrosis factor (TNF) is a proinflammatory cytokine that greatly contributes to tumor pathogenesis.</p><p><strong>Purpose: </strong>To describe the presenting characteristics of COVID-19 infection among pediatric patients, and investigate the possible role of the TNF-α signaling pathway.</p><p><strong>Methods: </strong>This prospective case-control study included 50 Egyptian pediatric patients with COVID-19 and 50 healthy controls. Clinical, laboratory, and radiological assessments were performed. Serum TNF-alpha (TNF-α), TNF-α-converting enzyme (TACE), and angiotensin-converting enzyme 2 (ACE2) were measured using enzyme-linked immunosorbent assay. ACE (I/D) (rs4646994), ACE2 rs2285666, and TNF-α-308G/A single nucleotide polymorphisms (SNPs) were performed using conventional polymerase chain reaction techniques with or without restriction fragment length polymorphism.</p><p><strong>Results: </strong>The median age was 1 year (interquartile range [IQR], 0.31-2.50 years) in the case group and 1.45 years (IQR, 1.00-3.00) in the control group. The main presenting symptoms were fever (92%), dry cough (74%), and dyspnea (72%). The lymphocytic count was normal in 14 patients (28%), decreased in 16 patients (32%), and increased in 20 patients (40%) of the case group. Positive chest computed tomography finding of COVID-19 infection were demonstrated among 40% of patients using COVID-19 Reporting and Data System categories (ground-glass opacity with or without consolidations in the lungs). There were significant increased serum TACE and TNF-α with decreased ACE2 levels among cases versus controls (P< 0.001). The GG genotype and G allele of the TNF-α-308G/A SNP were significantly higher in patients than in controls (P<0.05 for both), with insignificant differences in genotype and allelic frequencies in the ACE (I/D) (rs4646994) and ACE2 rs2285666 SNPs.</p><p><strong>Conclusion: </strong>The TNF signaling pathway was significantly activated in pediatric COVID-19 infection. Only the TNF-α-308G/A SNP was significantly associated with pediatric COVID-19 infection.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"704-717"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of adolescent hypertension definitions for predicting early adulthood carotid artery intima-media thickness: Tehran lipid and glucose study.","authors":"Maryam Barzin, Shirin Yaghoobpoor, Maryam Mahdavi, Behnaz Abiri, Majid Valizadeh, Fereidoun Azizi, Pooneh Dehghan, Farhad Hosseinpanah","doi":"10.3345/cep.2024.00248","DOIUrl":"10.3345/cep.2024.00248","url":null,"abstract":"<p><strong>Background: </strong>Definitions of childhood and adolescent hypertension (HTN) do not precisely elucidate the relationship between HTN and cardiovascular outcomes. Carotid intima-media thickness (CIMT), as a substitute for cardiovascular outcomes, enables the early identification of cardiovascular events throughout early adulthood.</p><p><strong>Purpose: </strong>This study aimed to compare the ability of childhood HTN definitions to predict a high CIMT in early adulthood.</p><p><strong>Methods: </strong>This prospective cohort study included 921 individuals aged 10-17 years from the Tehran Lipid and Glucose Study. The CIMT was measured after 18 years of follow-up. Participants were categorized into normal blood pressure (BP), high-normal BP, HTN stage 1, and HTN stage 2 groups based on the childhood HTN definitions of the 4th report, European Society of Hypertension (ESH), and American Academy of Pediatrics Clinical Practice Guidelines (AAP-CPG). Akaike information criterion (AIC) and relative efficiencies (RE) were calculated to compare the ability of each to predict a high CIMT (≥95th percentile) during early adulthood.</p><p><strong>Results: </strong>The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. According to the RE values, the highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively. In all models, the 4th report's pediatric HTN definition had the lowest AIC value and offered the best predictive ability.</p><p><strong>Conclusion: </strong>Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG. Because the reference population of the 4th report includes overweight, obese, and normal- weight individuals, our findings suggest that excessive adiposity is among the main predictors of early adulthood atherosclerosis risk.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"694-703"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}