RESUMO
OBJECTIVES: To investigate the association of blood pressure elevation with body mass index (BMI) and total cholesterol levels in children who screened positive for proteinuria, glucosuria, and/or hamaturia. STUDY DESIGN: From 1992 to 2000, a mass urine screening program was conducted annually for nearly 3,000,000 students aged 6 to 18 years. Of 99,350 students with positive results on urine tests, further examination found 17,548 students (17.7%) had blood pressure elevation. A case-control analysis was performed with randomly selected subjects with normal blood pressure who were frequency matched by sex and age. RESULTS: The adjusted odds ratio for blood pressure elevation in obese students was 3.45 (95% CI, 3.20-3.72), compared with students of normal weight. The odds ratio for blood pressure elevation increased to 6.15 (95% CI, 4.12-9.18) for students with a total cholesterol level > or =250 mg/dL and obesity, compared with students with a total cholesterol level <200 mg/dL and normal weight. CONCLUSION: This study found a high prevalence of elevated blood pressure in children with abnormal urinalysis results, with a strong association with BMI and total cholesterol level.
Assuntos
Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Adolescente , Albuminúria/epidemiologia , Nitrogênio da Ureia Sanguínea , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Colesterol/sangue , Creatinina/urina , Feminino , Taxa de Filtração Glomerular , Glicosúria/epidemiologia , Hematúria/epidemiologia , Humanos , Masculino , Programas de Rastreamento , Análise Multivariada , Proteinúria/epidemiologia , Taiwan/epidemiologiaRESUMO
OBJECTIVE: Rarely has childhood stroke been compared with adult stroke for incidence or cost. This population study compared the stroke incidence and the associated hospitalization care costs between children and adults in Taiwan. STUDY DESIGN: We used reimbursement claims data from the National Health Insurance program to identify stroke diagnoses in 1997 to 2003. The inpatient costs of both the first admission and recurrent stroke from 1979 childhood cases and 365,169 adult cases were compared by age and stroke subtype, excluding those less than 1 month of age. RESULTS: The mean inpatient costs were higher for patients <10 and 10 to 19 years of age ($3565 per case) compared with adult cases ($1933), including both first and recurrent hospitalizations, and they were higher for the recurrent cases. Patients <10 years old had the highest proportional incidence of hemorrhage events (71.4%), followed by patients in the 10- to 19-year-old group (61.4%), and the lowest for adults (21.3%). Hemorrhagic events incurred 2 to 12 times higher cost than other types of stroke. CONCLUSIONS: The hospitalization care costs for stroke are higher for children than for adults because of a greater proportion of hemorrhagic cases among children.