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Blood pressure assessment in children has acquired special relevance to prevent cardiovascular diseases later in life, therefore, there is a need to implement appropriate measurement techniques and suitable and accurate support instruments. Traditionally, blood pressure has been measured with mercury sphygmomanometers using the auscultatory technique and, at present, it is even considered to be the gold standard. Nevertheless, this device has a number of measurement pitfalls that, combined with its potential ecological risk owing to accidental mercury pollution, has stimulated the development and design of automated devices, which mainly use the oscillometric method for blood pressure measurement. Automated devices are mercury free and they have abolished some measurement procedures errors, mainly those related to the observer. However, these instruments are not better than mercury sphygmomanometers when accuracy parameters regarding blood pressure measurement are taken into consideration; on the other hand, at present, there are scarce validated automated devices for children. It is expected that mercury sphygmomanometers will be superseded in the near future, but only if automated devices are validated by international protocols and, of course, also considering the fact that they will be affordable., Author(s): Samuel Flores Huerta [sup.[[dagger]]] [sup.1] , Miguel Klünder Klünder [sup.2] , Patricia Medina Bravo [sup.3] Keywords: Keywords accuracy; auscultation; automated devices; blood pressure; children; mercury sphygmomanometer; oscillometric; validation The [...]

Objective: Visceral adiposity index (VAI) is a mathematical model associated with cardiometabolic risk in adults, but studies on children failed to support this association. Our group has proposed a pediatric VAI model using pediatric ranges, but it has not yet been evaluated and needs further adjustments. The objective of this study was to further adjust the proposed pediatric VAI by age, creating a new pediatric metabolic index (PMI), and assess the correlation of the PMI with insulin resistance indexes and hepatic enzymes., Methods: A cross-sectional design with data from 396 children (age 5 to 17 years) was analyzed with a generalized linear model to find the coefficients for triglycerides, high-density-lipoprotein cholesterol, and waist circumference-body mass index quotient. The model was constructed according to sex and age and designated PMI. A cross-validation analysis was performed and a receiver operating characteristic curve was used to determine cut-off points., Results: Significant moderate correlation was found between PMI and homeostatic model assessment of insulin resistance (HOMA-IR) ( r = 0.452; P = .003), Matsuda ( r = -0.366; P = .019), alanine aminotransferase ( r = 0.315, P = .045), and γ-glutamyltransferase ( r = 0.397; P = .010). A PMI score >1.7 was considered as risk., Conclusion: PMI correlates with HOMA-IR, Matsuda, and hepatic enzymes. It could be helpful for identifying children at risk for cardiometabolic diseases., Abbreviations: ALT = alanine transaminase BMI = body mass index GGT = γ-glutamyltransferase HDL-C = high-density-lipoprotein cholesterol HOMA-IR = homeostatic model assessment of insulin resistance hs-CRP = high sensitivity C-reactive protein ISI = insulin sensitivity index NAFLD = nonalcoholic fatty liver disease PMI = pediatric metabolic index QUICKI = quantitative insulin sensitivity check index ROC = receiver operating characteristic TG = triglyceride TNF-α = tumor necrosis factor-alpha VAI = visceral adiposity index VAT = visceral adipose tissue WC = waist circumference.