OBJECTIVE: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects children worldwide, with potential associations to metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD). Limited research exists on the interplay between AD, MetS, and NAFLD in the pediatric population. This study aimed to investigate the prevalence and potential relationships among AD, MetS, and NAFLD in children.
METHODS: A case-control study design was employed, recruiting 50 children with AD (median age: 9.5 years) and 50 age- and sex-matched healthy controls (median age: 11.5 years, p = .051). Data on demographic characteristics, clinical features, disease severity, treatment history, anthropometric measurements, and laboratory evaluations were collected. MetS and NAFLD were diagnosed based on established criteria.
RESULTS: The prevalence of MetS was significantly higher in children with AD compared with controls (24% vs. 2%, p = .002). Significant differences for systolic blood pressure (p < .001), diastolic blood pressure (p = .012), and waist circumference (p = .040) were observed between AD patients and controls. Children with AD had higher triglyceride levels (p = .005). NAFLD was exclusively seen in moderate to severe AD cases (6% vs. 0%, p = .242). AD severity showed associations with increased body mass index (p = .020).
CONCLUSIONS: This study highlights the increased prevalence of MetS and the potential association with NAFLD in children with AD. The findings suggest that AD may contribute to the development of metabolic abnormalities at an early age. Further research is needed to elucidate the underlying mechanisms and explore preventive strategies for these interconnected conditions.

OBJECTIVE: The association between Helicobacter pylori and hypertension is unclear. Herein, we aimed to investigate the association between H. pylori and hypertension among adults in Sudan.
METHODS: We conducted a community-based case-control study (175 participants in each arm) in the Wad Hamid district in northern Sudan. Cases comprised adults with hypertension and controls were non-hypertensive adults. We assessed participants\' data using a questionnaire. We also conducted rapid H. pylori antibody tests and binary and linear regression analyses.
RESULTS: Multivariable logistic regression revealed age (adjusted odds ratio [AOR] 1.05, 95% confidence interval [CI] 1.03-1.07), female sex (AOR 5.50, 95% CI 2.36-12.80), and body mass index (AOR 1.12, 95% CI 1.07-1.17) were significantly associated with hypertension. Moreover, compared with controls, a significantly higher number of patients with hypertension were positive for H. pylori (82/175, 46.9% vs. 46/175, 26.3%). H. pylori seropositivity was associated with systolic blood pressure (coefficient 3.811), diastolic blood pressure (coefficient 3.492), mean blood pressure (coefficient 3.599), and hypertension (AOR 3.15, 95% CI 1.82-5.46).
CONCLUSIONS: Our study revealed a significant positive association between H. pylori seropositivity and hypertension. This finding supports literature recommending the eradication of H. pylori to prevent hypertension and its complications.

Background Exposure to lead and its accumulation in the body can lead to progressive adverse effects, including increased blood pressure which is associated with the onset of cardiovascular diseases. In this study, we aimed to determine the relationship between blood lead levels and blood pressure. In addition, we compared blood lead levels between hypertensives and normotensives to determine relationships, if any, between lead exposure and high blood pressure. Methodology This was a hospital-based, case-control study. In total, 102 individuals (hypertensives = 51, normotensives = 51) were included in this study. Hypertensive patients (defined as systolic blood pressure (SBP) of ≥140 mmHg, diastolic blood pressure (DBP) of ≥90 mmHg, or taking antihypertensive medication for regulating blood pressure) were considered to be study cases and normotensive individuals were considered to be study controls. Blood lead levels were compared between the two groups, and the effects of blood lead levels on SBP and DBP were estimated. The blood lead levels were measured using optical emission spectrometry. Results The mean blood lead level among hypertensive individuals (5.5743 ± 1.77 µg/dL) was significantly higher compared to normotensive individuals (4.5029 ± 1.3213 µg/dL, P = 0.001). A positive correlation was detected between blood lead levels and SBP (r = 0.304, P = 0.002). However, no significant correlation was found between blood lead levels and DBP. Conclusions Blood lead levels were significantly higher in hypertensive patients compared to normotensive individuals. A significant positive correlation was observed between blood lead levels and SBP.

BACKGROUND: Approximately 75% of Chinese hypertensive patients have elevated homocysteine (Hcy). Its implication in risk assessment and prevention of the first stroke remains an important clinical and public health question.
METHODS: This study was based on a community cohort recruited from 2016 to 2018 in the rural China. To maximize cost efficiency, we used a nested case-control design, including 3,533 first stroke cases and 3,533 controls matched for age ±1 years, sex, and village. Individual associations of tHcy and traditional risk factors with the first stroke were examined, and their population-attributable risks (PARs) were estimated.
RESULTS: There was a significant dose-response association between first stroke and total Hcy (tHcy) levels, with adjusted odds ratios of 1.11 (95% CI: 0.97, 1.26) for tHcy 10-15 μmol/L and 1.44 (1.22, 1.69) for tHcy ≥ 15 μmol/L, all compared to tHcy < 10 μmol/L. A similar trend was found for ischemic and hemorrhagic stroke. tHcy and systolic blood pressure (SBP) were independently and additively associated with the risk of first stroke (tHcy: 1.06 [1.02, 1.1]; SBP: 1.13 [1.1, 1.16]; P-interaction, 0.889). Among the ten main risk factors examined, the top two contributors to the first stroke were SBP and tHcy, with PARs of 25.73 and 11.24%, respectively.
CONCLUSIONS: Elevated tHcy is the second most important contributor and acts additively with SBP to increase the risk of the first stroke. This finding underscores the importance of screening and treating elevated tHcy along with traditional risk factors to further reduce the burden of the first stroke in the high-risk populations.

Background: Increase of collagen in the extracellular matrix occurs with ageing. We investigated whether a collagen marker, tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), was associated with risk of stroke. Methods and Results: In a nested case-control study of 953 subjects from the general population, we evaluated determinants of TIMP-1 level and stroke risk. Mean subject age was 65.7±8.6 years (53.0% men); TIMP-1 was 72.4±28.2 pg/mL in the control group and 75.3±30.9 pg/mL in the stroke group. The relationship between TIMP-1 quartile and stroke was J-curved. Subjects in the highest TIMP-1 quartile (≥89 ng/mL) had a significantly higher OR of stroke (59-72 ng/mL; OR, 1.90; 95% CI: 1.09-3.31, P=0.023) than those in the second TIMP-1 quartile, and this tended toward significance even after adjusting for confounding factors (P=0.059). Elevation of serum TIMP-1 became more marked after age 65 years. On multiple linear regression analysis, significant determinants of TIMP-1 were older age (B=0.21 per 1 year; 95% CI: 0.52-1.07, P<0.001) and higher systolic blood pressure (SBP; B=0.19 per 1 mmHg, 95% CI: 0.08-0.42, P=0.004). Conclusions: TIMP-1 increased with ageing and with SBP, and can be associated with stroke.

To determine the minimum blood pressure increases that would confirm or exclude, with the greatest predictive values, hypertensive disorders of pregnancy (HDP) in pregnant adolescents after 24 weeks gestation.
We conducted a case-control study of pregnant women aged ≤19 years with and without HDP. Using systolic and diastolic blood pressure increases, a predictive analysis was performed, and the area under the curve was calculated.
The cases and controls had systolic blood pressure increases of 45.3 ± 17.5 mm Hg and 6.4 ± 7.9 mm Hg, respectively (P = 0.001) and diastolic blood pressure increases of 30.8 ± 11.7 mm Hg and 3.5 ± 5.7 mm Hg, respectively (P = 0.001). Systolic and diastolic increases of ≥20 mm Hg showed the greatest sensitivity and specificity. A combined analysis showed that an increase of ≥20 mm Hg had a greater positive likelihood ratio of 35.4 (95% CI 22.4-55.9) and negative likelihood ratio of 0.10 (95% CI 0.07-0.13), with an area under the curve of 0.98 (95% CI 0.96-0.99).
Systolic and diastolic blood pressure increases of ≥20 mm Hg must be considered in the diagnostic criteria for preeclampsia and gestational hypertension among pregnant adolescents past 24 weeks gestation.

To evaluate the association between plasma retinol levels with all-cause mortality and investigate the possible effect modifiers in general hypertensive patients with no previous cardiovascular disease (CVD). This case-control study was nested in the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The current study included 617 cases of all-cause mortality and 617 controls matched on age (≤1 year), sex, treatment group, and study site. All-cause mortality was the main outcome in this analysis, which included death due to any reason. The median follow-up duration was 4.5 years. Overall, there was a U-shaped relation of plasma retinol with all-cause mortality. In the threshold effect analysis, the risk of all-cause mortality significantly decreased with the increase in plasma retinol (per 10 μg/dL increments: OR, 0.73; 95% CI: 0.61-0.87) in participants with plasma retinol <58.3 μg/dL and increased with the increase in plasma retinol (per 10 μg/dL increments: OR, 1.08; 95% CI: 1.01-1.16) in those with plasma retinol ≥58.3 μg/L. In participants with plasma retinol <58.3 μg/dL, a stronger inverse association was observed in those with higher time-averaged SBP (≥140 vs <140 mm Hg; P-interaction = .034), or higher vitamin E levels (≥11.5 [quartile 4]; vs <11.5 μg/mL; P-interaction = .013). The present study demonstrated that there was a U-shaped relationship of plasma retinol levels with the risk of all-cause mortality in general hypertensive patients, with a turning point around 58.3 μg/dL.

OBJECTIVE: Longitudinal data are often collected to study the evolution of biomedical markers. The study of the joint evolution of response variables concerning hypertension over time was the aim of this paper. A hospital based retrospective data were collected from September 2014 to August 2015 to identify factors that affect hypertensive. The joint mixed effect model with unstructured covariance was fitted. A total of 172 patients screened for antihypertensive drugs treated were longitudinally considered from Felege Hiwot referral.
RESULTS: The joint mixed effect model with unstructured covariance (AIC: 12,236.9 with [Formula: see text] = 1007.8, P < 10-4) was significantly best fit to the data. The correlation between the evolutions of DBP and SBP was 0.429 and the evolution of the association between responses over-time was found 0.257. Among all covariates included in joint-mixed-effect-models, sex, residence, related disease and time were statistically significant on evolution of systolic and diastolic blood pressure. The joint modeling of longitudinal bivariate responses is necessary to explore the association between paired response variables like systolic and diastolic blood pressure. Fitting joint model with modern computing method is recommended to address questions for association of the evolutions with better accuracy.