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Clin J Am Soc Nephrol. 2016 Nov 7;11(11):1962-1968. Epub 2016 Sep 14.

Cardiovascular Disease Risk Factors and Left Ventricular Hypertrophy in Girls and Boys With CKD.

Author information

1
Division of Nephrology, Department of Pediatrics, and.
2
Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
3
Division of Nephrology, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio.
4
Department of Pediatrics, Montreal Children's Hospital, Montreal, Quebec, Canada.
5
Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, and.
6
Division of Nephrology, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.
7
Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, and furths@Email.chop.edu.
8
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania; and.

Abstract

BACKGROUND AND OBJECTIVES:

Prior studies suggested that women with CKD have higher risk for cardiovascular disease (CVD) and mortality than men, although putative mechanisms for this higher risk have not been identified. We assessed sex differences in (1) CVD risk factors and left ventricular hypertrophy (LVH), and (2) the relationship of left ventricular mass (LVM) with different measures of body size in children with CKD.

DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS:

The study population comprised 681 children with CKD from the Chronic Kidney Disease in Children cohort, contributing 1330 visits. CVD risk factors were compared cross-sectionally by sex. LVH was defined as LVM/height2.7 >95th percentile and LVM relative to estimated lean body mass (eLBM) >95th percentile for age and sex. Differences in LVM by sex were assessed by adjusting for age, weight, height, and eLBM using bivariate and multivariate regression models.

RESULTS:

Girls were less likely to have uncontrolled hypertension (26% versus 38%, P=0.001), had lower diastolic BP z-scores (+0.3 versus +0.6, P=0.001), and had lower prevalence of high triglycerides (38% versus 47%, P=0.03) compared with boys. When LVH was defined by LVM indexed to height, girls had higher prevalence of LVH (16% versus 9%, P=0.01); when LVH was defined by LVM relative to eLBM, prevalence of LVH was similar between girls and boys (18% versus 17%, P=0.92). In regression models adjusting for eLBM, no sex differences in LVM were observed.

CONCLUSIONS:

Despite lack of increased prevalence of CVD risk factors, indexing LVM to height showed a higher proportion of LVH among girls, while estimates of LVH based on eLBM showed no sex differences. Indexing LVM to eLBM may be an alternative to height indexing in children with CKD.

KEYWORDS:

Body Size; Body Weight; Humans; Hypertrophy, Left Ventricular; Male; Prevalence; Renal Insufficiency, Chronic; Sex Characteristics; Triglycerides; cardiovascular disease; child; chronic kidney disease; female; hypertension; left ventricular hypertrophy; pediatric nephrology; risk factors

PMID:
27630183
PMCID:
PMC5108185
DOI:
10.2215/CJN.01270216
[Indexed for MEDLINE]
Free PMC Article

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