Asthma, enuresis, and chronic illness: long term impact on height

Association of Height and Prevalence of Kidney Stones

Introduction and objectives Nephrolithiasis is universally understood to be a multifactorial disease resulting from genetic and environmental factors including gender, diet, calcium, and uric acid excretion. Notably, several of these factors may be related to body habitus. Because men are more likely to develop kidney stones and on average have a larger body size, height may be an important risk factor for stone formation. Several studies have demonstrated that short adult stature is associated with numerous conditions such as hypertension, hypercholesterolemia, and cardiovascular diseases. However, other studies have demonstrated otherwise. Additionally, stones have been shown to be correlated with a high body mass index (BMI). This is likely due to dietary factors. Although height is a component of BMI, there is minimal literature regarding the relationship of height to stone prevalence adjusting for weight.  Methods We aimed to examine whether short adult height is associated with the development of kidney stones using a population-based cohort of the National Center for Health Statistics. Data was gathered from National Health and Nutrition Examination Surveys (NHANES) "Kidney Conditions - Urology" and "Weight History" questionnaire datasets from March 2017 to March 2020 along with demographic data. Logistic regression analysis was used to determine an association between current self-reported height (inches) and if the participant has ever had kidney stones, controlling for weight, gender, age, race, educational level, and marital status.  Results We found that those who were shorter had higher odds of reporting a history of stones (OR: 1.017; 95%CI: 1.005-1.028). This association was found after controlling for covariates such as age, gender, race, education, and weight. In addition, the male gender and Hispanic race had higher odds of reporting a history of stones (OR: 1.43 and 1.073, respectively).  Conclusion Our results suggest that short height is related to the prevalence of kidney stones independent of weight, age, gender, and race. This supports previous literature indicating height to be a component of renal disease.

Association of Height with Elevated Mortality Risk in ESRD: Variation by Race and Gender

The association of adult height with mortality has been extensively investigated in the general population, but little is known about this relationship among dialysis patients. We explored the relationship between height and mortality in a retrospective cohort study of 1,171,842 adults who began dialysis in the United States from 1995 to 2008 and were followed until December 31, 2010. We evaluated height-mortality associations in sex-specific quintiles of increasing height (Q1-Q5) using multivariable Cox regression models adjusted for demographics, comorbid conditions, lifestyle and disability indicators, socioeconomic status, and body weight. For men, compared with the referent quintile (Q1 <167 cm), successive height quintiles had significantly increased hazard ratios (HRs [95% confidence interval]) for mortality: 1.04 (1.02-1.06), 1.08 (1.06-1.10), 1.12 (1.11-1.14), and 1.18 (1.16-1.20) for Q2-Q5, respectively. For women (referent Q1 <155 cm), HRs for mortality were 1.00 (0.99-1.02), 1.05 (1.03-1.06), 1.05 (1.03-1.07), and 1.08 (1.06-1.10) for Q2-Q5, respectively. However, stratification by race showed the pattern of association differed significantly by race (P<0.001 for interaction). For black men, unlike other race groups, height only associated with mortality in Q5, with an HR of 1.06 (1.02-1.09). For black women, HRs for mortality were 0.94 (0.91-0.97), 0.98 (0.95-1.02), 0.96 (0.93-0.99), and 0.99 (0.96-1.02) for Q2-Q5, respectively. These results indicate tallness is associated with higher mortality risks for adults starting dialysis, but this association did not extend to black patients.

Infant mortality and the health of survivors: Britain, 1910–50

The first half of the twentieth century saw rapid improvements in the health and height of British children. Average height and health can be related to infant mortality through a positive selection effect and a negative scarring effect. Examining town-level panel data on the heights of school children, no evidence is found for the selection effect, but there is some support for the scarring effect. The results suggest that the improvement in the disease environment, as reflected by the decline in infant mortality, increased average height by about half a centimetre per decade in the first half of the twentieth century.

[Prevalence of nocturnal enuresis in the Valencian Community. Pediatric section of the National Incontinence Survey. The EPICC Study]

OBJECTIVE

To ascertain the prevalence of enuresis among primary school children in Spain.

MATERIALS AND METHODS

A multicenter, observational, cross-sectional, epidemiologic, regional study. After sample size calculation, a total of 1687 questionnaires were sent to schools. Nocturnal enuresis was defined as <<loss of urine occurring during sleep, at least once a month>>.

RESULTS

The prevalence of enuresis found in primary school children aged 6-11 years was 7.8%, decrease with age, and was significantly greater in boys (70%). Children without enuresis were taller and had a greater weight than those with enuresis, but the differences were not statistically significant. No differences were found in the family or educational setting between children with and without enuresis. Seventy-three percent of children with enuresis had a family history of the condition. The disorder also occurred in some sibling of 21% of children with enuresis who had siblings. Fifty-five percent of the bedwetting population had primary enuresis. Thirty-one percent of children with enuresis reported losses every night, 38% at least once a week, and 31% at least once a month. Eighty-seven percent of this population was under treatment for this condition. As regards subjective symptoms, 96.9% said they felt fine, but there were more bedwetting children who reported feeling a little bit uncomfortable (76.7% vs 23.1%; P=.004).

CONCLUSIONS

Enuresis is a common disorder which is significantly more frequent in boys as compared to girls and whose prevalence decreases with age. It has a significant hereditary component. Most enuresis sufferers take measures against urine losses.

Adult height and the risk of mortality in South Korean women

To evaluate the association between adult height as a surrogate marker of childhood circumstances and the risk of mortality, 344,519 South Korean women aged 40-64 years categorized into six height groups were prospectively followed for mortality between 1994 and 2004. In Cox proportional hazards regression with adjustment for behavioral and biologic risk factors, there was an inverse association between height and total mortality; mortality risk decreased 7% for each 5-cm increment in height. The association did not materially change after adjustment for behavioral factors and adulthood socioeconomic factors or after full adjustment for all available covariates. When height-associated risks of death from specific causes were evaluated in a fully adjusted analysis, a 5-cm increment in height was associated with lower risks of death from respiratory diseases, stroke, diabetes mellitus, and external causes (hazard ratios were 0.84 (95% confidence interval (CI): 0.74, 0.96), 0.84 (95% CI: 0.80, 0.88), 0.87 (95% CI: 0.80, 0.96), and 0.88 (95% CI: 0.83, 0.94), respectively) and with a higher risk of death from cancer (hazard ratio = 1.05, 95% CI: 1.02, 1.09). Given that adult height reflects early-life conditions, the independent associations between height and mortality from all causes and specific causes support the view that early-life circumstances significantly influence health outcomes in adulthood.

Childhood nocturnal enuresis: Developing a conceptual framework

Nocturnal enuresis has been described as the most prevalent and chronic of all childhood problems. The experience, particularly for the older child, can be extremely distressing and limiting. It is now thought that psychological distress (emotional, behavioural, and self-esteem) arises as a consequence of bedwetting, and reaches clinical importance in only a minority who are vulnerable. Many aetiological theories have been proposed with the cause of nocturnal enuresis now regarded as heterogeneous. Based on empirical findings, a new model, termed 'the three systems,' has facilitated a greater clinical understanding of the problem and identification of the appropriate intervention. The model proposes bedwetting results from excessive nocturnal urine production and/or nocturnal bladder overactivity coupled with an inability to arouse to bladder sensations. Effective treatment arises from identification of the child's particular need and application of the appropriate psychological and pharmacological approach. Treatment methods are reviewed in terms of the new model, the mode of action, effectiveness, and application in combination.

The adolescent with a chronic condition. Part I: developmental issues

The prevalence of chronic conditions among adolescents is difficult to assess due to the lack of quality data focusing specifically on this age group, as well as the diversity in methodology and definitions used. However, surveys carried out by self administered questionnaires among in-school adolescent populations indicate that around 10% of adolescents suffer from such a condition. The aim of this paper is to analyse the reciprocal effects of chronic conditions and adolescent development by reviewing the effect of chronic disease on growth and puberty and on psychosocial development, and the effect of developmental issues on the course and management of chronic disease.

Enuresis alarm treatment as a second line to pharmacotherapy in children with monosymptomatic nocturnal enuresis

PURPOSE

We evaluate the effectiveness of enuresis alarm as second line therapy for partial or nonresponders to pharmacotherapy.

MATERIALS AND METHODS

We recommended enuresis alarm treatment for 67 partial or nonresponders to pharmacotherapy for monosymptomatic nocturnal enuresis. Of these patients 28 were evaluable by inclusion and exclusion criteria. We analyzed the effectiveness of enuresis alarm therapy using the response criteria defined by the reduction rate of wet nights, defined as complete response (greater than 90%), partial response (50% to 90%) and no response (less than 50%). We defined initial and lasting cure when patients showed persistent full response for 4 weeks and 6 months after cessation of all treatments, respectively.

RESULTS

After pharmacotherapy partial responders showed a mean response of 81.2%. On the other hand, nonresponders exhibited a mean response of 26.4% with more than 20 wet nights in 4 weeks. After using second line enuresis alarm treatment 90.5% (19 of 21) of partial responders became full responders and 71.4% (15 of 21), 61.9% (13 of 21) of partial responders showed initial and lasting cure, respectively. In addition, 71.4% (5 of 7) of nonresponders became full responders and 57.1% (4 of 7) exhibited initial and lasting cure.

CONCLUSIONS

Enuresis alarm as second line therapy for monosymptomatic nocturnal enuresis is effective for lasting cure as well as high initial full response rate in partial and nonresponders to pharmacotherapy. Therefore, enuresis alarm is a reasonable second line therapeutic option for partial or nonresponders to pharmacotherapy.

Bone mineral density in children with nocturnal enuresis

In enuretic children there is a significantly higher incidence of fine and gross motor clumsiness, delayed developmental milestones, slower and poor linear growth, and these patients are shorter than normal children. Skeletal maturation of enuretic children has been determined with bone age in only two studies before, but to our knowledge bone mineral content of enuretic children has not previously been determined by bone mineral density measurement. Bone mineral density was measured by the dual-energy x-ray absorptiometry method in children with nocturnal enuresis and compared with that of a control group to detect whether there were any delay in bone development and any decrease in bone mass. Thirty enuretic children were compared with a control group of 40 healthy children with respect to body height and weight measurements, daily calcium intake, serum calcium, phosphorus and ALP levels, chronological and bone ages, and bone mineral density measurements. Of the parameters compared, bone age was significantly retarded, and bone mineral density was significantly reduced in children with enuresis (8.3 +/- 1.9 vs 9.7 +/- 2.3 years; p = 0.01, and 0.5476 +/- 0.07 vs 0.6077 +/- 0.05 g/cm2; p = 0.001, respectively). Chronological ages demonstrated a significant correlation with the bone ages in both the study and control groups (r = 0.852, p < 0.001, and r = 0.844, p < 0.001, respectively). However, the mean chronological age was significantly greater than the mean bone age in the study group (p < 0.001), whereas the mean chronological age was not significantly different from the mean bone age in the control group (p = 0.514). To clarify the exact mechanism responsible for these manifestations of skeletal maturation retardation, the relationship between the maturational delay of the central nervous system connections or the effect of any perinatal insult and the retardation in skeletal maturation remains to be determined.

Factors associated to lifestyle and risk of adult onset asthma

BACKGROUND

Asthma prevalence has been increasing especially in developed countries. The change seems to be associated with changes in lifestyle. We have made a prospective study to assess the effect of lifestyle factors, including smoking, educational level, physical activity and obesity on adult onset asthma.

METHODS

A population of 10,597 adult twins, initially free of asthma was followed for 9 years. The main outcome measure was questionnaire-based report of physician diagnosed asthma. Logistic regression was used to estimate the risk of asthma predicted by lifestyle factors, with adjustment for atopy and respiratory symptoms.

RESULTS

Obesity at baseline increased asthma risk (multivariable adjusted OR = 3.00, 95% CI: 1.64-5.50 for those with BMI > or = 30 compared to those with normal weight BMI: 20-24.99). Taller height was associated to lower asthma incidence. Leisure time physical activity had a slightly protective effect on asthma risk among men (P for trend = 0.037) while smoking and education did not have significant effects on the risk of adult onset asthma.

CONCLUSIONS

Obesity was associated to the risk of adult onset asthma, while short height and low leisure time physical activity can be considered as other potential risk factors.

Effect of asthma and its treatment on growth: four year follow up of cohort of children from general practices in Tayside, Scotland

OBJECTIVE

To investigate whether asthma or its treatment impairs children's growth, after allowing for socioeconomic group.

DESIGN

4 year follow up of a cohort of children aged 1-15.

SETTING

12 general practices in the Tayside region of Scotland.

SUBJECTS

3347 children with asthma or features suggestive of asthma registered with the general practices.

MAIN OUTCOME MEASURES

Height and weight standard deviation scores.

RESULTS

Children who lived in areas of social deprivation (assessed by postcode) had lower height and weight than their contemporaries (mean standard deviation score -0.26 (SD 1.02) and -0.18 (1.15) respectively, P < 0.001 for both). Children who were receiving > or = 400 micrograms daily of inhaled steroids and who were attending both hospital and general practice for asthma care had lower height and weight than average, independent of the effect of deprivation (mean standard deviation score -0.62 (1.01), P = 0.002, for height and -0.58 (0.94), P = 0.005, for weight). Children receiving high doses of inhaled corticosteroids also showed lower growth rates (mean change in standard deviation score -0.19 (0.51), P = 0.003). However, no other children with asthma showed growth impairment.

CONCLUSION

Most children with asthma were of normal height and weight and had normal growth rates. However, children receiving high doses of inhaled steroids and requiring both general practice and hospital services had a significant reduction in their stature. This effect was independent from but smaller than the effect of socioeconomic group on stature.

Family conflict and slow growth

AIMS

Having previously observed that slow growth in childhood is associated with subsequent labour market disadvantage, an attempt was made to determine whether family conflict is associated with slow growth to age 7 years, independently of material disadvantage.

METHODS

A total of 6574 children born between 3 and 9 March 1958 who were members of the British National Child Development Study were used in these analyses. Slow growth at age 7 years was indicated by short stature defined as the lowest fifth of the height distribution. In multivariate analysis, adjustment was made for fully attained adult height as a measure of genetically predetermined height.

RESULTS

A total of 31.1% of children who had experienced family conflict were of short stature compared with 20.2% of those who had not, representing relative odds of 1.79 (95% confidence interval (CI) 1.39 to 2.30). After adjustment for social class, crowding, sex, and predetermined height, the relative odds were slightly reduced to 1.62 (95% CI 1.18 to 2.23). A total of 44.0% of children from the most crowded households were of short stature compared with 16.4% of those from the least crowded. The unadjusted relative odds were 3.99 (95% CI 2.94 to 5.41) and after adjustment for the potential confounding variables they were 3.07 (95% CI 2.08 to 4.51). Low social class was also a risk for short stature at age 7 years, but this was not statistically significant after adjustment for the other confounding factors.

CONCLUSIONS

Family conflict during childhood was independently associated with slow growth to age 7 years.