Browsing by Author "Garcia, Hernan"

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    3-Epi-25 Serum 25-Hydroxyvitamin D3 Concentrations in Chilean Children Between 5 and 8 Years
    (KARGER, 2018) Arancibia, Monica; Seiltgens, Cristian; Poggi, Helena; Allende, Fidel; Solari, Sandra; Peredo, Soledad; Trincado, Claudia; Garcia, Hernan; Moore, Rosario; Dapremont, Ivonne; Andrade, Daniela; Sifaqui, Sofia; Ossa, Jt; Campino, Carmen; Carvajal, Cristian; Fardella, Carlos; Baudrand, Rene; Sanchez, Ximena; Martinez Aguayo, Alejandro
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    Aldosterone, Plasma Renin Activity, and Aldosterone/Renin Ratio in a Normotensive Healthy Pediatric Population
    (LIPPINCOTT WILLIAMS & WILKINS, 2010) Martinez Aguayo, Alejandro; Aglony, Marlene; Campino, Carmen; Garcia, Hernan; Bancalari, Rodrigo; Bolte, Lillian; Avalos, Carolina; Loureiro, Carolina; Carvajal, Cristian A.; Avila, Alejandra; Perez, Viviana; Inostroza, Andrea; Fardella, Carlos E.
    Primary aldosteronism is an important cause of secondary hypertension and is suspected in adults with an aldosterone/renin ratio >= 25. The normal aldosterone/renin ratio is unknown in children. The aim was to establish serum aldosterone, plasma renin activity, and aldosterone/renin ratio values in a healthy pediatric population. A cross-sectional study was performed in 211 healthy normotensive children (4 to 16 years old). Two subgroups of normotensive children were obtained: with hypertensive parents (NH) (n=113) and normotensive parents (n=98). Blood samples for measuring serum aldosterone, plasma renin activity, aldosterone/renin ratio, and DNA were collected. In subjects with aldosterone/renin ratio >= 25, the chimeric CYP11B1/CYP11B2 gene was investigated by long-extension PCR. Results are expressed as median [Q(1)-Q(3)]. NH and normotensive parents groups were similar in serum aldosterone (6.5 [3.6 to 9.0] ng/dL versus 6.5 [2.9 to 9.7] ng/dL; P=0.968) and plasma renin activity (2.3 [1.6 to 3.1] versus 2.4 [1.7 to 3.7] ng/mL per hour; P=0.129). The aldosterone/renin ratio was higher in the NH group, but this difference did not reach statistical significance (2.8 [1.9 to 4.1] versus 2.5 [1.4 to 4.0], P=0.104). In one subject of the NH group, the chimeric CYP11B1/CYP11B2 gene was detected. We demonstrated that normal aldosterone/renin ratio values in a healthy pediatric population without NH were lower than those reported for an adult normotensive population. (Hypertension. 2010;56:391-396.)
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    Association of metabolic syndrome markers with abnormal alanine aminotransferase levels in healthy children
    (SOC MEDICA SANTIAGO, 2012) Arancibia, Gabriel; Garcia, Hernan; Jaime, Francisca; Bancalari, Rodrigo; Harris, Paul R.
    Background: There is a high prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) among pediatric patients. The identification of clinical predictors of these conditions would allow a timely treatment. Aim: To evaluate the relationship between serum alanine aminotransferase levels and parameters of metabolic syndrome in asymptomatic school students without hepatic illness. Subjects and Methods: A randomized sample of 175 children aged between 9 and 14 years (54% females) was selected, from a database of 3010 students living in Santiago, Chile. Weight, height, abdominal circumference, systolic and diastolic blood pressure were measured. A fasting blood sample was obtained to measure glucose, total cholesterol, HDL, LDL-cholesterol, triglycerides, alanine aminotransferase (ALT) and insulin levels. Results: Forty percent of participants were obese, 17% had metabolic syndrome and 13.1% had abnormal ALT levels. Compared with children with normal ALT levels, the latter had significantly higher waist obesity, body mass index, systolic and diastolic blood pressure and triglycerides. However on multivariate analysis, only waist obesity was independently associated with abnormal ALT levels (adjusted odds ratio 3.93, 95% confidence intervals 1.44-10.78, p = 0.008). Conclusions: Only waist obesity was independently associated with abnormal ALT levels in this sample of children. (Rev Med Chile 2012; 140: 896-901).
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    Birth weight is inversely associated with blood pressure and serum aldosterone and cortisol levels in children
    (WILEY, 2012) Martinez Aguayo, Alejandro; Aglony, Marlene; Bancalari, Rodrigo; Avalos, Carolina; Bolte, Lillian; Garcia, Hernan; Loureiro, Carolina; Carvajal, Cristian; Campino, Carmen; Inostroza, Andrea; Fardella, Carlos
    Context Low birth weight has been independently associated with adult hypertension, and renin-angiotensin system (RAS) plays a role in this connection.
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    Citosine-Adenine-Repeat Microsatellite of 11 beta-hydroxysteroid dehydrogenase 2 Gene in Hypertensive Children
    (OXFORD UNIV PRESS, 2016) Valdivia, Carolina; Carvajal, Cristian A.; Campino, Carmen; Allende, Fidel; Martinez Aguayo, Alejandro; Baudrand, Rene; Vecchiola, Andrea; Lagos, Carlos F.; Tapia Castillo, Alejandra; Fuentes, Cristobal A.; Aglony, Marlene; Solari, Sandra; Kalergis, Alexis M.; Garcia, Hernan; Owen, Gareth I.; Fardella, Carlos E.
    BACKGROUND
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    Frequency of Familial Hyperaldosteronism Type 1 in a Hypertensive Pediatric Population Clinical and Biochemical Presentation
    (LIPPINCOTT WILLIAMS & WILKINS, 2011) Aglony, Marlene; Martinez Aguayo, Alejandro; Carvajal, Cristian A.; Campino, Carmen; Garcia, Hernan; Bancalari, Rodrigo; Bolte, Lillian; Avalos, Carolina; Loureiro, Carolina; Trejo, Pamela; Brinkmann, Karin; Giadrosich, Vinka; Mericq, Veronica; Rocha, Ana; Avila, Alejandra; Perez, Viviana; Inostroza, Andrea; Fardella, Carlos E.
    Familial hyperaldosteronism type 1 is an autosomal dominant disorder attributed to a chimeric CYP11B1/CYP11B2 gene (CG). Its prevalence and manifestation in the pediatric population has not been established. We aimed to investigate the prevalence of familial hyperaldosteronism type 1 in Chilean hypertensive children and to describe their clinical and biochemical characteristics. We studied 130 untreated hypertensive children (4 to 16 years old). Blood samples for measuring plasma potassium, serum aldosterone, plasma renin activity, aldosterone/renin ratio, and DNA were collected. The detection of CG was performed using long-extension PCR. We found 4 (3.08%) of 130 children with CG who belonged to 4 unrelated families. The 4 patients with CG had very high aldosterone/renin ratio (49 to 242). In addition, we found 4 children and 5 adults who were affected among 21 first-degree relatives. Of the 8 affected children, 6 presented severe hypertension, 1 presented prehypertension, and 1 presented normotension. High serum aldosterone levels (> 17.7 ng/dL) were detected in 6 of 8 subjects (range: 18.6 to 48.4 ng/dL) and suppressed plasma renin activity (<= 0.5 ng/mL per hour) and high aldosterone/renin ratio (> 10) in 8 of 8 children (range: 49 to 242). Hypokalemia was observed in only 1 of 8 children. We demonstrated that the prevalence of familial hyperaldosteronism type 1 in a pediatric hypertensive pediatric population was surprisingly high. We found a high variability in the clinical and biochemical characteristics of the affected patients, which suggests that familial hyperaldosteronism type 1 is a heterogeneous disease with a wide spectrum of presentations even within the same family group. (Hypertension. 2011;57:1117-1121.). Online Data Supplement
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    Higher Dehydroepiandrosterone Levels in Prepubertal Children Born Very Preterm
    (KARGER, 2018) Mericq, Veronica; Martinez Aguayo, Alejandro; Iniguez, German; Poggi, Helena; D'Apremont, Ivonne; Moore, Rosario; Arancibia, Monica; Garcia, Hernan; Peredo, Soledad; Trincado, Claudia; Sifaqui, Sofia; Tomas Ossa, Jose; Fardella, Carlos; Carvajal, Cristian; Campino, Carmen; Baudrand, Rene; Solari, Sandra; Allende, Fidel
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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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    Insulin Resistance Parameters in Children Who Were Born Very Preterm and Adequate for Gestational Age
    (KARGER, 2018) Garcia, Hernan; Poggi, Helena; Arancibia, Monica; Peredo, Soledad; Trincado, Claudia; Moore, Rosario; D'Apremont, Ivonne; Andrade, Daniela; Sifaqui, Sofia; Ossa, J. T.; Campino, Carmen; Carvajal, Cristian; Fardella, Carlos; Baudrand, Rene; Solari, Sandra; Allende, Fidel; Martinez Aguayo, Alejandro
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    Polymorphisms in the RAC1 Gene Are Associated With Hypertension Risk Factors in a Chilean Pediatric Population
    (OXFORD UNIV PRESS, 2014) Tapia Castillo, Alejandra; Carvajal, Cristian A.; Campino, Carmen; Vecchiola, Andrea; Allende, Fidel; Solari, Sandra; Garcia, Lorena; Lavanderos, Sergio; Valdivia, Carolina; Fuentes, Cristobal; Lagos, Carlos F.; Martinez Aguayo, Alejandro; Baudrand, Rene; Aglony, Marlene; Garcia, Hernan; Fardella, Carlos E.
    The GTPase Rac1 has been implicated in hypertension as a modulator of mineralocorticoid receptor activity. Our aim is to investigate the frequency of polymorphisms rs10951982 (intron 1, G > A) and rs836478 (intron 3, T > C) in the RAC1 gene and perform association studies with clinical and biochemical parameters in a Chilean pediatric cohort.
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    Prevalence of components of the metabolic syndrome according to birthweight among overweight and obese children and adolescents
    (WALTER DE GRUYTER GMBH, 2012) Eyzaguirre, Francisca; Bancalari, Rodrigo; Roman, Rossana; Silva, Ricardo; Youlton, Ronald; Urquidi, Cinthyia; Garcia, Hernan; Mericq, Veronica
    Background/objectives: Extremes of birthweight (BW) have been associated with increased rates of metabolic risks. The objective was to study the prevalence of metabolic risks markers among obese and overweight (OW) subjects according to BW.
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    Prevalence of hypertension in school age children and its association with obesity
    (SOC MEDICA SANTIAGO, 2011) Bancalari, Rodrigo; Diaz, Carlos; Martinez Aguayo, Alejandro; Aglony, Marlene; Zamorano, Juanita; Cerda, Veronica; Fernandez, Manuel; Garbin, Flabia; Cavada, Gabriel; Valenzuela, Maria; Garcia, Hernan
    Background: Hypertension in children is a frequently overlooked problem that is an important cardiovascular risk factor. Aim: To determine the prevalence of hypertension among school age children. Material and Methods: Cross-sectional study of 2980 children aged 10 +/- 2 years (48% females) from 10 schools of middle and lower class in Metropolitan Santiago. Blood pressure (BP) was measured in the sitting position on three occasions after a rest period, using a mercury sphygmomanometer with appropriate cuff arm diameter, averaging the results of the measurements. Systolic and diastolic hypertension were defined as blood pressure values over 95 percentile for age, sex and height. Results: The overall prevalence of hypertension was 12.2% in women and 15% in men (p < 0.05). According to nutritional status, the prevalence was 6.7, 8.9, 13.6 and 26% in underweight, eutrophic, overweight and obese children, respectively (p < 0.01). Compared with normal weight children, the risk of being hypertensive for overweight children was 1.6 (95% confidence intervals (CI) 1.2-2.3) and for obese children was 3.6 (95% CI 2.8-4.7). Conclusions: The studied children had a high prevalence of hypertension, that was directly related to a higher body mass index. (Rev Med Chile 2011; 139: 872-879).
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    Seasonal 25-hydroxy Vitamin D3 variations in school-aged children from Santiago de Chile
    (KARGER, 2019) Poggi, Helena; Dominguez, Gonzalo; Monica, Arancibia; Moore, Rosario; D'Apremont, Ivonne; Solari, Sandra; Allende, Fidel; Sifaqui, Sofia; Garcia, Hernan; Martinez Aguayo, Alejandro
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    Second Consensus of the Chilean Society of Endocrinology and Diabetes about insulin resistance
    (SOC MEDICA SANTIAGO, 2015) Pollak, Felipe; Araya, Veronica; Lanas, Alejandra; Sapunar, Jorge; Arrese, Marco; Gloria Aylwin, Carmen; Gloria Bezanilla, Carmen; Carrasco, Elena; Carrasco, Fernando; Codner, Ethel; Diaz, Erik; Durruty, Pilar; Galgani, Jose; Garcia, Hernan; Lahsen, Rodolfo; Liberman, Claudio; Lopez, Gloria; Maiz, Alberto; Mujica, Veronica; Poniachik, Jaime; Sir, Teresa; Soto, Nestor; Valderas, Juan; Villaseca, Paulina; Zavala, Carlos
    Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.
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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.