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Objective: We aimed to investigate the clinical, and laboratory factors that may effect the left ventricular mass index in children with stage predialysis chronic renal disease. Method: Children with predialysis chronic renal disease consisted the study group. The weight, height, renal diagnosis and follow-up duration were retrieved from medical records. Instantaneous and ambulatory blood pressure measurements were performed. Laboratory tests were performed. The left ventricular mass index was calculated based on the echocardiographic measurements. Frequency of hypertension was calculated, and the correlation between the clinical and laboratory parameters and the left ventricular mass index was investigated. Results: Mean left ventricular mass index was 48.8±12.74 g/m2.7, and left ventricular hypertrophy was detected in 16 (76.1%) patients. Hypertension was detected in 5 (23.8%) patients by instantaneous measurements. However, ambulatory measurements showed systolic and diastolic hypertension in 6 (28.6%) and only diastolic hypertension in 2 (9.5%) patients. A positive and significant correlation was detected between left ventricular mass index and relative body mass index, mean night diastolic blood pressure, night diastolic load and cholesterol level (p<0.05). Also a negative significant correlation between albumin and hemoglobin was detected (p<0.05). Conclusion: The results of our study indicate that in predialysis children; ambulatory blood pressure measurement is superior to instantaneous measurements in prediction of left ventricular hypertrophy, and the left ventricular mass index significantly correlates with hemoglobin, cholesterol and albumin levels in addition to blood pressure parameters. [ABSTRACT FROM AUTHOR]

Objective: Respiratory disorders related to sleeping problems are examined in a wide spectrum ranging from simple snoring to obstructive sleep apnea syndrome. Hypertension and the risk for cardiovascular morbidity because of obstructive sleep apnea syndrome have been demonstrated in many previous studies. But, there are limited number of studies demonstrating the influential blood pressure changes during the rime interval from primary snoring to obstructive sleep apnea syndrome. Methods: Twenty children who had no obstructive sleep apnea symptoms with tonsillar hypert- rophy (grade 3-4) and twenty children as control subjects (range: 6-13 years) were included in this study. Healthy children consisting of equal number of boys and girls who were in the same age group with the patient group with no complaints were chosen as a control group. All partici- pants were evaluated by twenty 24-ambulatory blood pressure monitorization, and the data obtained were compared. Results: There was no significant difference between the groups as for average blood pressure measurements obtained during the whole day, daytime and at night Still blood pressure load, blood pressure index and blood pressure variability of both groups did not differ statistically significantly. The number of non-dippers in the patient group was greater than the those in the control group. Although intergroup difference did not reach a statistical significance. Conclusion: This study showed that cardiovascular complications like systemic hypertension did not become manifest in children with tonsillar hypertrophy but without any sign of clinical obs- tructive sleep apnea. Higher number of non-dippers in the patient group, reveal the requirement for larger population-based studies. [ABSTRACT FROM AUTHOR]

Objective: Previous studies showed relation between elevated serum leptin levels (SLL) and hypertension. The aim of this study was to evaluate relationship between SLL and left ventricular hypertrophy (LVH) and body mass index (BMI) in obese hypertensive patients. Methods: Eighty patients with newly diagnosed essential hypertension were included in this cross-sectional, case-controlled study. Hypertensive patients were classified as; level-I or level-II according to JNC-VII classification and as normal weighted (18-24.99 kg/m²), over weighted (25-26.99 kg/m²) and obese (27 kg/m² and above) according to BMI's. All the patients were evaluated by echocardiography and blood samples were withdrawn for determination SLL. Statistical analysis was performed using Wilcoxon sign rank, Mann Whitney U and Kruskal Wallis tests. Logistic regression analysis was applied for the evaluation of relationship between SLL and clinical variables. Results: Mean levels of arterial blood pressure (ABP) of total 80 patients (36 males and 44 females) was 155±1.1/95.1±0.7 mmHg and the mean age was 48.9±1.3 years. Patients with level I hypertension (n=32) had mean ABP of 149.7±0.5/90.9±0.6 mmHg and with level-II hypertension (n=48) - mean ABP 168.5±1.6/102.9±0.9 mmHg. The mean BMI in normal weighted group (n=26) was 22.7±0.3 kg/m², over weighted group (n=19)-26.1±0.2 kg/m² and obese group (n=35)-30.9±0.5 kg/m². There were no differences in LVH incidence between hypertension level groups and BMI groups (p>0.05). Serum leptin levels were similar in patients with level I and level II hypertension (33.5±2.9 ng/ml and 37.3±3.6ng/ml, respectively, p>0.05). However, leptin levels were higher in obese patients as compared with normal and over weighted patients (40.9±3.2 ng/ml versus 28.5±3.6 ng/ml and 32.8 ± 4.9 ng/ml, p<0.01). Patients with LVH had significantly higher levels of leptin as compared with patients without LVH (51.40±5.1 ng/ml versus 28.30±4.20 ng/ml, p<0.05). Logistic regression analysis demonstrated that SLL independently of blood pressure and BMI is related with LVH (OR - 1.7, %95 CI - 1.2-1.9, p<0.05). Conclusion: Our study showed that elevated serum leptin levels are significantly related with LVH independently of body mass index and level of blood pressure. Thus, elevated SLLs, independently of hypertension level and BMI classification, coexist with LVH. Sympathetic activation or direct cardiac receptor activation or proliferative effects of leptin may be responsible for this coexistence. [ABSTRACT FROM AUTHOR]

• Aims: Leptin, which is a hormone secreted by adipose tissue, has many effects on the sympathetic nervous system and other systems. It is well-known that hypertension is associated with high leptin levels. The aim of this study was to determine whether there is any effect of leptin on the development of left ventricular hypertrophy(LVH) in hypertensive patients. • Material and methods: Forty hypertensive patients were enrolled to the study. The study population was divided into two groups according to LVH determined by echocardiography. Group 1 was consisted of 27 hypertensive patients with LVH(m/f: 9/18, the mean age:59.1±7.2yrs) while group 2 was composed of 13 hypertensive patients without LVH (m/f: 5/8,the mean age:62.4±4.9yrs). The blood samples was taken at fasting state and serums were kept at -80°C until examined. Plasma leptin levels were determined by ELISA. The clinical and echocardiographic parameters and the mean plasma leptin levels were compared to each other. • Results: We did not find any statistical significance between groups in terms of the treatment, the duration of hypertension and body mass index. The mean plasma leptin levels was 33.3±15.3 ng/ml in the group 1 whereas this was 28.3±17.6 ngr/ml in the group 2. There was not any statistical difference between them (p>0.05). • Conclusion: The plasma leptin levels in hypertensive patients with LVH was not different from that in hypertensive patients without LVH. It may be concluded that there is not any effect of leptin on the development of LVH in hypertension. [ABSTRACT FROM AUTHOR]