Browsing by Author "Bruera, Maria Jose"

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    Insulin resistance parameters in children born very preterm and adequate for gestational age
    (WILEY, 2022) Garcia, Hernan; Loureiro, Carolina; Poggi, Helena; D'Apremont, Ivonne; Moore, Rosario; Ossa, Jose Tomas; Bruera, Maria Jose; Peredo, Soledad; Carvajal, Jacqueline; Trincado, Claudia; Martinez Aguayo, Alejandro
    Background Preterm neonates are at risk for metabolic syndrome later in life. Whether prematurity constitutes an independent risk factor for the development of cardiovascular disease and metabolic syndrome remains controversial. Objective To compare anthropometric measures, cardiometabolic risk factors and insulin resistance variables between children who were born very preterm (VPT, <32 gestational weeks) and at term (Term, >37 gestational weeks) and adequate for gestational age (AGA). Methods We designed a cross-sectional cohort study, recruiting 120 children (5.0-8.5 years old) from the preterm clinic at Red de Salud UC-Christus and Complejo Asistencial Dr. Sotero del Rio, and term children from the community. We excluded children born small for gestational age, based on INTERGROWTH21. Anthropometrics data were classified using WHO reference standards. The homeostasis model assessment insulin resistance (HOMA-IR) index, quantitative insulin sensitivity check index (QUICKI), triglyceride-to-HDL-C ratio (TG/HDL-C) and Pediatric Score Index for Metabolic Syndrome (PsiMS) were calculated. Results VPT children born AGA had lower HDL cholesterol levels (p = .019) and a higher PsiMS score than those born at term (p = .043). We observed a higher percentage of children with HDL cholesterol <= 40 mg/dl (13.0% vs. 2.3%, p = .026) and BP >= 90th percentile among the VPT children than among the Term children (26.0% vs. 11.6%, p = .031). Conclusions At school age, blood pressure was higher, and HDL-C was lower among VPT children born AGA, suggesting a potential metabolic risk; therefore, it is essential to follow this group throughout their lives.
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    What is the best method for estimating final height in patients with precocious puberty?
    (2022) Quiroga, Daniela; Bruera, Maria Jose; Vidaurre, Josefa; Cerda, Jaime; Cattani, Andreina; Garcia, Hernan
    Central precocious puberty is the premature activation of the hypothalamic-pituitary-gonadal axis, leading to an early epiphyseal fusion and, in many cases, heights below the genetic target. Therefore, a proper adult stature prediction is essential for the treatment decision. Objective: To compare the concordance of final height using height prediction made by two validated methods versus the genetic target height in girls who consulted due to central precocious puberty. Patients and Method: Retrospective, non-concurrent cohort study including 93 girls with central precocious puberty, who were not treated with LHRH analogs and had reached their final adult height. The data was obtained from the clinical records. To predict height, the Bayley-Pinneau method and the Roche-WainerThissen method were applied, and the results were compared with the genetic target height. The concordance between the estimated final height and the final height obtained was evaluated using the Bland-Altman method. Results: When comparing the final height obtained with that predicted by the Bayley-Pinneau method, there was a mean difference of 1.01 cm, and using the Rocke-Wainer-Thissen method, there was a difference of +0.96 cm. The calculation of the genetic target height showed a difference of +0.05 cm with respect to the final height. Conclusion: The prediction of height made by the Bayley-Pinneau and Roche-Wainer-Thissen methods was adequate and, contrary to expectations, it was similar to the calculation of the genetic target height that does not use the age of bone maturation. This also presented better concordance and less dispersion of the results with respect to the final height obtained.