No association between fluctuating asymmetry in highly stabilized traits and second to fourth digit ratio (2D:4D) in human fetuses

Recent studies have suggested that the ratio of the length of the second and fourth digit (2D:4D) may be associated with developmental instability (DI) as measured by the left-right asymmetry of the same digits. Because the 2D:4D ratio is amongst others, determined prenatally as a result of exposure to sex hormones, such an association could indicate that the same prenatal developmental processes determine levels of DI. In this study we criticize these earlier findings and show by simulations that they are confounded by the fact that (non-) linear combinations of the digit lengths are used as both dependent (average asymmetry in digits 2 and 4) and independent (ratio of the lengths of digits 2 and 4) variable. We therefore studied associations between 2D:4D ratios and asymmetry not only in digits but also in several other skeletal elements in deceased human fetuses. In contrast to the earlier studies, we did not find an association between 2D:4D ratios and asymmetry in digits 2 and 4. We argue that this may be due to the low levels of DI in this study, which limits the confounding effects of DI. Also, no associations were detected with the asymmetry of all other trait either. Thus, there appears to be very little evidence of any link between DI and 2D:4D in this population for limb measurements. We conclude that highly stabilized and functionally important traits such as human limbs may in general show limited increases in asymmetry with prenatal stress.     

Second to fourth digit ratio,handedness and testicular germ cell tumors

Background

Research on early life exposures and testicular germ cell tumors (TGCT) risk has focused on a possible perinatal etiology with a well-known hypothesis suggesting that hormonal involvement during fetal life is associated with risk. Second-to-fourth digit ratio (2D:4D) and left-hand dominance have been proposed as markers of prenatal hormone exposure.

Aim

To evaluate associations between 2D:4D digit ratio, right minus left 2D:4D (Δ_R − L), and left-hand dominance and TGCT in the U.S. Servicemen's Testicular Tumor Environmental and Endocrine Determinants Study.

Methods

A total of 246 TGCT cases and 236 non-testicular cancer controls participated in the current study, and completed a self-administered questionnaire. Associations between digit ratio, hand dominance and TGCT were estimated using unconditional logistic regression adjusting for identified covariates.

Results

Right 2D:4D was not associated with TGCT [odds ratio (OR) for a one-standard deviation (SD) increase in right-hand 2D:4D: 1.12, 95% confidence interval (CI): 0.93–1.34]. The results were consistent when evaluating the association based on the left hand. The difference between right and left-hand 2D:4D was also not associated with TGCT risk [OR for a one-SD increase in Δ_R − L: 1.03, 95% CI: 0.87–1.23]. Compared to men who reported right-hand dominance, ambidexterity [OR (95% CI) = 0.65 (0.30–1.41)] and left-hand dominance [OR (95% CI) = 0.79 (0.44–1.44)] were not associated with risk.

Conclusions

These results do not support the hypothesis that prenatal hormonal imbalance is associated with TGCT risk. Given the limited sample size, further evaluation of the relationship between TGCT and prenatal hormonal factors using digit ratio, Δ_R − L, or left-hand dominance and larger sample size are warranted.     

Fetal development of the hand, digits and digit ratio (2D:4D)

OBJECTIVE: The purpose of this study was to investigate growth patterns in human hands, digits and digit ratio (2D:4D) during the fetal period. METHODS: The study is carried out on 161 human fetuses (83 males, 78 females) free from external pathology or malformation with ages ranging between 9 and 40 weeks of gestation. Following general external measurements, length and width of the hand, digit lengths separate for each hand was measured, hand index and the ratio of the lengths of the 2nd finger to the 4th finger (2D:4D index) was computed. RESULTS: Means and standard deviations of the parameters with respect to gestational weeks, months and trimesters were calculated. There was a significant correlation between all parameters and gestational age (p<0.001). No significant differences were observed between sexes or sides for any of the parameters (p>0.05). 2D:4D ratio was significantly higher in females compared to males (p<0.05) and mean 2D:4D did not change with gestational age. CONCLUSION: Detailed information of hand and digit parameters related to the fetal period will reveal the extent of biological variations of hand and digit parameters to be used in future studies. We hope that data acquired in this study will facilitate other studies on hand and digit anomalies, pathologies and variations as well as diagnoses and treatments of such conditions conducted in obstetrics, perinatology, forensic medicine and fetal pathology departments.     

Associations between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and prognosis in patients with neuroblastoma

Objectives

Recent studies have shown that the neutrophil-to-lymphocyte ratio (NLR) is a new inflammatory marker that is effective in determining the prognosis of many solid tumors, chemotherapy responses, survival, and their recurrence rate. Therefore, we performed a retrospective study to investigate the effect of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio (PLR) on risk factors and prognosis in these patients.

Materials and methods

In this study, 246 pediatric patients with neuroblastoma who were diagnosed, treated, and followed up during 2000–2021 in Division of Pediatric Oncology, Çukurova University Faculty of Medicine, were included. Required information of patients was obtained from archive files, Mergentech hospital program, and E-pulse system.

Results

Median value for NLR was found to be 1.06, for PLR it was found as 92. The relationship of NLR values with age, stage, risk group, and Shimada was found to be statistically signifıcant with p < .001, vanillylmandelic acid (VMA) (p = .006) also depicted the signifıcant value. Likewise, the relationship of PLR values with age (p < .001), stage (p = .022), Shimada (p = .004), and N-Myc amplification (p = .039) was found to be statistically significant as well. Survival analysis showed that no statistically significant difference was observed among the higher and lower values of NLR. Survival rates were noticed to be higher in the lower values of NLR (10-year overall survival [OS] 55% vs. 49%, 10-year event-free survival (EFS) 54% vs. 43%), albeit nonsignificant.

Conclusion

Pretreatment evaluation of NLR and PLR values in patients with neuroblastoma may be instructive in respect of prognosis and risk group.     

Digit ratio (2D:4D) is associated with gastric cancer

Background

Sex steroid exposure during early human development may influence disease susceptibility. Digit ratio (2D:4D) is a putative marker for prenatal hormone exposure and sensitivity, as well as the action of genes closely related to carcinogenesis. Digit ratio could act as a possible marker for cancer predisposition.

Aims

The aim of this study is to investigate the possible correlations between right hand, left hand and right minus left (R − L) 2D:4D and gastric cancer (GCA) in men and women and assess the correlations with tumor staging and histological diagnosis.

Methods

Digital images of the right and left hand palms of patients diagnosed with GCA (n = 57, 42 males, 15 females) and age and sex-matched controls (n = 59, 41 males, 18 females) were obtained. Means for 2D:4D were compared. Data were analyzed by repeated-measures one-way ANOVA and Student's t-test for finger measurements and group comparisons and Pearson's and Spearman's tests for correlations with tumor staging (α = 0.05).

Results

GCA group presented significantly higher left 2D:4D, but significantly lower R − L in comparison to healthy controls, particularly so for males. Digit ratio did not correlate to clinical staging or TNM staging. However, low R − L was significantly related to adenocarcinomas.

Conclusions

Early developmental conditions, including prenatal testosterone seem to play a role on the malignant transformation of gastric lesions. The 2D:4D pattern found for gastric cancer parallels that earlier described for breast cancer. The findings suggest that 2D:4D could add to the list of etiological factors and be a putative marker for the screening of patients’ susceptibility to develop gastric cancer.     

Infertility, infertility treatment, and mixed-handedness in children

Background

Mixed-handedness, which may reflect atypical brain laterality, has been linked to a number of medical conditions as well as prenatal stress.

Aims

The aim of the study was to examine whether infertility or infertility treatment was associated with an increased risk of mixed-handedness in children.

Study design, subjects and outcome measures

We used data from three population-based birth cohorts in Denmark: the Aalborg-Odense Birth Cohort (1984-1987), the Aarhus Birth Cohort (1990-1992) and the Danish National Birth Cohort (1996-2002) (N = 7728, 5720 and 29486, respectively). Data on time to pregnancy and infertility treatment were collected during pregnancy. Handedness was reported in a follow-up questionnaire when the children were at least 7 years old. Children were categorized as mixed-handed if their mothers reported that they used both hands equally.

Results

Children born after infertility treatment, particularly intrauterine insemination, had a higher risk of being mixed-handed compared to children of fertile couples with a time to pregnancy ≤ 12 months (odds ratio 1.41, 95% confidence interval 1.09-1.82). Children of couples with unplanned pregnancies, particularly after an oral contraceptives failure, were also more likely to be mixed-handed. There was no association between a long waiting time to pregnancy and mixed-handedness in children.

Conclusions

Children born after infertility treatment, particularly intrauterine insemination, and children exposed to oral contraceptives during early gestation may have a higher risk of being mixed-handed.     

Digit ratio (2D:4D) in newborns: Influences of prenatal testosterone and maternal environment

Introduction

The 2D:4D digit ratio is sexually-dimorphic, probably due to testosterone action through the perinatal period. We characterize the 2D:4D ratio in newborn (NB) infants, in between the pre- and postnatal surges of testosterone, and relate it to the mother's 2D:4D and to testosterone levels in the amniotic fluid (AF).

Subjects and methods

Testosterone was assayed in samples of maternal plasma and AF collected at amniocentesis. Shortly after birth, 106 NBs and their mothers were measured for 2D:4D ratio.

Results

NB males had lower mean 2D:4D ratios than females but this dimorphism was significant only for the left hand (males: 0.927; females: 0.950; p = 0.004). Mothers who had sons had lower 2D:4D ratios than those who had daughters and the mother's 2D:4D were higher than those of NBs regardless of sex. Both hands of NB females were negatively correlated with AF testosterone and positively correlated with the mother's 2D:4D, but males showed no significant associations. Maternal plasma testosterone also showed a negative weak correlation with NB's digit ratio in both sexes.

Conclusions

Sexual dimorphism at birth was only significant for the left hand, in contrast with reports of greater right hand dimorphism, suggesting that postnatal testosterone is determinant for 2D:4D stabilization. The lower 2D:4D ratios in mothers who had sons support claims that hormone levels in parents are influential for determining their children's sex. NB female's digit ratio, but not males', was associated to the level of AF testosterone. The mother's 2D:4D ratios were positively correlated with their daughters' 2D:4D, but the same was not observed for male NBs, suggesting that prenatal testosterone levels in male fetus lead their 2D:4D ratios to stray from their mothers' with high individual variability.     

P2X7基因多态性与中国汉族儿童结核病易感性的研究

目的探讨中国汉族儿童P2X7基因多态性与结核病易感性相关关系，以探讨P2X7基因在儿童结核病发病中的作用。方法病例组为2005年1月至2008年9月首都医科大学附属北京儿童医院收治的汉族结核病患儿；对照组为同期在儿外科行手术前体检的患儿。按照年龄等与病例组3：1进行匹配。扩增基因组DNA P2X7基因，应用限制性酶切片段长度多态性（PCR-PFLP）分析方法和碱基特异性PCR方法，分别对P2X7基因1513和-762位点多态性与儿童结核病易感性进行相关分析。结果 病例组纳入96例，平均年龄（5.5±4.5）岁；对照组纳入384例，平均年龄（5.9±4.0）岁。P2X7基因1513位点A/C和C/C基因型分布，病例组（38.5%和8.3%）较对照组（31.0%和11.5%）比率增高，但差异无统计学意义(χ2=2.306，P=0.316)；1513C在病例组和对照组分布频率分别为27.6%和27.0%，差异无统计学意义（χ2=0.033，P=0.856）。-762位点C/C基因型在整体人群中的分布频率为56.5%，-762C 在病例组和对照组中的分布频率分别为77.4%和71.7%，对照组和病例组各基因频率或基因型频率差异无统计学意义(χ2=4.742，P=0.093)。上述基因型和等位基因频率在肺结核亚组和肺外结核病亚组差异均无统计学意义。结论宿主P2X7基因1513位点A/C和-762位点T/C的转换可能与中国汉族儿童结核病易感性无相关性。因此，P2X7基因多态性与结核病发病以及是否为结核病易感性的影响因素有待进一步验证。     

上海地区汉族人谷胱甘肽S转移酶基因多态性分析(英文)

目的：测定GST基因在上海地区健康汉族人中的遗传多态性,筛选出汉族人的GST候选单核苷酸多态性(SNP)位点,为开展GST基因多态性与汉族人群肿瘤易感性及治疗相关性研究作一初步探索。方法：采用荧光标记自动测序法,筛选GSTT1,GSTM1基因在20名上海地区的汉族健康志愿者中的候选SNP位点。结果：4例受检者在GSTT1外显子4和3之间的第86 057位点发生点突变,由腺嘌呤A取代鸟嘌呤G,经与Genebank中SNP数据库比对,可能为一新的GSTT1基因候选SNP位点;在外显子5的第793位点和921位点,所有受检者均为G&A的杂合子。GSTM1在8个外显子中均发现有候选SNP位点,但多为单核苷酸的杂合子。约40%受检者的外显子2出现腺嘌呤A缺失,所有受检者在第1 383位点和1 385位点分别是A&G受C&G杂合子;在第101位点60%个体为A&T杂合,40%个体为腺嘌呤A的纯合子。我们还初步发现在外显子2的190 bp以后可能存在多个碱基或小片段缺失。结论：上海地区健康汉族人的GST基因具有丰富的遗传多态性。这些多态性是否为汉族人所特有、与肿瘤易感性的关系,以及这些可能的候选SNP位点是否会造成其编码氨基酸的改变并引起产物蛋白一级结构的变化、进而导致GST酶活性发生改变而表现为具有不同的表型及基因型,尚需深入探讨。     

Sex and ethnic differences in 2nd to 4th digit ratio of children

BACKGROUND: The ratio between the length of the 2nd or index finger and the 4th or ring finger (2D:4D) differs between the sexes, such that males have lower 2D:4D than females, and shows considerable ethnic differences, with low values found in Black populations. It has been suggested that the sex difference in 2D:4D arises early in development and that finger ratio is a correlate of prenatal testosterone and oestrogen. In children, 2D:4D has been reported to be associated with measures of fetal growth, congenital adrenal hyperplasia, developmental psychopathology, autism and Asperger's syndrome. However, little is known of the patterns of sex and ethnic differences in the 2D:4D ratio of children. AIM: To investigate sex and ethnic differences in 2D:4D in Caucasian, Oriental and Black children. STUDY DESIGN: Population survey. METHOD: The 2D:4D ratio was measured from photocopies of the right hand of Berber children from Morocco, Uygur and Han children from the North-West province of China, and children from Jamaica. RESULTS: There were 798 children in the total sample (90 Berbers, 438 Uygurs, 118 Han, and 152 Jamaicans). The 2D:4D ratio was lower in males than in females and this was significant for the overall sample and for the Uygur, Han and Jamaican samples. There were significant ethnic differences in 2D:4D. The Oriental Han had the highest mean 2D:4D, followed by the Caucasian Berbers and Uygurs, with the lowest mean ratios found in the Afro-Caribbean Jamaicans. The sex and ethnic differences were independent of one another with no significant interaction effect. In the overall sample there were no associations between 2D:4D and age and height. CONCLUSIONS: In common with adults, the 2D:4D ratio of children shows sex and ethnic differences with low values found in a Black group. There was no overall association between 2D:4D and age and height suggesting that the sex and ethnic differences in 2D:4D appear early and do not show appreciable change with growth.     

中国儿童慢性咳嗽病因构成比多中心研究

目的 了解中国儿童慢性咳嗽的病因分布及构成比,推动其诊治的标准化和规范化.方法 根据2008年中华医学会儿科学分会呼吸学组制定的《儿童慢性咳嗽诊断和治疗指南》,设计儿童慢性咳嗽病因调查表,组织全国19个省、直辖市、自治区共29所医院前瞻性入组慢性咳嗽病例并完成3个月随访;对汇总的各项数据统计分析、得出全国儿童慢性咳嗽病因构成比等.结果 实际入组病例数共4582例,合格病例4529例,合格率98.80％.列病因构成比前3位的分别是咳嗽变异性哮喘1900例(41.95％)、上气道咳嗽综合征1119例(24.71％)、呼吸道感染和感染后咳嗽984例(21.73％).胃食管反流28例(占0.62％);其他病因者498例(11.00％),其中多病因者占387例(8.54％),首位是上气道咳嗽综合征合并有咳嗽变异性哮喘(占50.13％),其次是呼吸道感染和感染后咳嗽合并上气道咳嗽综合征占(26.10％).总诊断修正率18.83％.不同病因在不同性别间和不同年龄间的分布是有显著差异的,不同病因致慢性咳嗽的好发时相各有特点.结论 中国儿童慢性咳嗽的主要病因构成比依次为咳嗽变异性哮喘、上气道咳嗽综合征、呼吸道感染和感染后咳嗽和其他各种病因,要注意多病因和病因未明的病例.不同年龄和不同性别组儿童慢性咳嗽病因构成比是不同的.要重视观察、等待和随访的原则.     

TLR2基因多态性与中国汉族儿童结核病易感性的关联研究

目的 探讨TLR2基因5个SNP位点多态性与中国汉族儿童结核病（TB）易感性的关联。方法 以2005年2月至2010年10月在北京儿童医院临床诊断和确诊的TB且排除其他肺部感染的病例作为TB组,并根据感染部位和严重程度分别分为肺TB亚组、肺外TB亚组和重症TB亚组、非重症TB亚组;以健康查体且除外TB的儿童作为对照组。应用高通量MassARRAY技术对于TLR2基因的5个SNP位点：rs3804099(等位基因C/T)、rs1898830(等位基因A/G)、 rs7656411(等位基因G/T)、 rs11935252(等位基因A/G)、rs7696323(等位基因C/T)行基因分型,比较5个SNP位点各基因型和等位基因频率在TB组和对照组的差异,同时采用显性遗传和隐性遗传模式分析各TB亚组与对照组基因型的差异。结果 TB组345例,平均年龄(5.6±4.7)岁,男219例;肺TB亚组151例（43.8%）,肺外TB亚组194例;重症TB亚组155例（44.9%）,非重症TB亚组190例。对照组385例,年龄（6.1±3.8）岁,男226例。Hardy-Weinberg检验提示TLR2基因的5个SNP位点在TB组和对照组的基因型分布均符合遗传平衡（P=0.154~0.992）。调整了年龄和性别因素后,rs3804099位点TC、CC型和C等位基因频率TB组和对照组比较,OR=0.929~1.071;rs1898830位点GA、GG型和G等位基因频率TB组和对照组比较,OR=1.100~1.411;rs7656411位点GT、TT型和T等位基因频率TB组和对照组比较,OR=0.812~1.110;rs11935252位点GA、GG型和A等位基因频率TB组和对照组比较,OR=0.497~1.189; rs7656323位点CT、CC型和C等位基因频率TB组和对照组比较,OR=0.888~1.034;,差异均无统计学意义（P均>0.05）。5个SNP按照显性和隐性遗传模式分析,各基因型TB组和对照组间差异均无统计学意义（P均>0.05）。②TLR2基因的5个SNP位点在显性或隐性遗传模式下,基因型频率在肺TB亚组、肺外TB亚组和对照组比较,OR=0.737~1.326;重症TB亚组、非重症TB亚组和对照组比较,OR=0.675~1.248;差异均无统计学意义（P均>0.05）。③TLR2基因5个SNP位点在各染色体之间均无强连锁。结论 TLR2基因的5个SNP多态性与中国汉族儿童TB易感性不存在关联。     

GDF5基因rs224331多态性与汉族青少年体格发育指标关联分析

目的 探讨中国汉族青少年GDF5基因rs224331位点多态性与身高、体重和BMI的相关性。方法 采集江苏省某技校1 790名17~22岁青少年的身高、体重指标并计算BMI。采用Taqman探针real-time PCR方法检测GDF5基因rs224331位点的单核苷酸多态性,并分析该基因位点与男女生身高、体重和BMI的相关性。结果 97.9%（1 754/1 790名）基因分型成功,男生859名,女生895名。rs224331位点频率最高的基因型为AA（51.7%）,其次为AC（39.6%）,CC最少（8.7%）。rs224331的基因型分布与男生、女生的身高无显著关联（P分别为0.728和0.723）;rs224331不同基因型间的男生体重和BMI差异均有统计学意义（P均<0.01）,男生AC基因型体重和BMI均显著高于AA基因型（P=0.002）,女生中未发现类似的相关性（P分别为0.713和0.921）。结论 GDF5基因rs224331位点多态性在本研究的汉族人群中与身高无明显关联,提示该多态性位点可能存在种族特异性。rs224331位点多态性与男生体重和BMI存在相关性。     

宁夏苯丙酮尿症患儿苯丙氨酸羟化酶基因外显子7突变分析

目的 探讨宁夏地区苯丙酮尿症（PKU）患儿苯丙氨酸羟化酶（PAH）基因外显子7 突变类型及频率,为该地区PKU 的基因诊断和产前诊断提供依据。方法 应用PCR 产物直接测序方法,对宁夏73 例经典型PKU 患儿（回族39 例,汉族34 例）的146 个PAH 等位基因外显子7 及其旁侧内含子区域进行序列分析。结果 共检测出6 种突变基因型,分别是R243Q（14.4%）、R241C（6.8%）、IVS7+2T → A（2.7%）、L255S（0.7%）、G247V（0.7%）和G247R（0.7%）。外显子7 突变基因总频率为26.0%（38/146）,包括错义突变和剪接位点突变两种。回族患儿R241C 等位基因突变检出率高于汉族（10% vs 3%,P<0.05）。结论 宁夏地区PKU 患儿PAH 基因外显子7 突变频率最高的是R243Q,其次为R241C;回族和汉族PKU 患儿R241C 等位基因突变率不同。     

Correlation between lung to thorax transverse area ratio and observed/expected lung area to head circumference ratio in fetuses with left‐sided diaphragmatic hernia

Observed/expected lung area to head circumference ratio (o/e LHR) and lung to thorax transverse area ratio (LTR) are the sonographic indicators of postnatal outcome in fetuses with congenital diaphragmatic hernia (CDH), and they are not influenced by gestational age. We aimed to evaluate the relationship between these two parameters in the same subjects with fetal left‐sided CDH. Fetuses with left‐sided CDH managed between 2005 and 2012 were included. Data of LTR and o/e LHR values measured on the same day prior to 33 weeks' gestation in target fetuses were retrospectively collected. The correlation between the two parameters was estimated using the Spearman's rank‐correlation coefficient, and linear regression analysis was used to assess the relationship between them. Data on 61 measurements from 36 CDH fetuses were analyzed to obtain a Spearman's rank‐correlation coefficient of 0.74 with the following linear equation: LTR = 0.002 × (o/e LHR) + 0.005. The determination coefficient of this linear equation was sufficiently high at 0.712, and the prediction accuracy obtained with this regression formula was considered satisfactory. A good linear correlation between the LTR and the o/e LHR was obtained, suggesting that we can translate the predictive parameters for each other. This information is expected to be useful to improve our understanding of different investigations focusing on LTR or o/e LHR as a predictor of postnatal outcome in CDH.     

儿童青少年腰围身高比与非酒精性脂肪肝病关系的回顾性分析

背景：肥胖是导致儿童青少年人群非酒精性脂肪肝病（NAFLD）发生的重要原因之一,腰围身高比（WHtR）是反映内脏脂肪和评价儿童青少年心血管代谢风险的简单而准确的体格测量指标,但WHtR 与NAFLD的关系研究十分有限。 目的：分析儿童青少年WHtR与NAFLD的关系。 设计：常规体检数据的回顾性分析。 方法：以所有参加上海市闵行区2014至2020年住校学生健康体检的学生为研究对象,将血清ALT水平高于一般人群性别和年龄别第97.5百分位数水平定义为疑似NAFLD（简称NAFLD）。基于全国数据提示心血管代谢风险聚集的WHtR作为切点值,以男孩和女孩WHtR分别≥0.481和≥0.456定义为WHtR升高;以非条件二分类Logistic回归模型,校正年龄、性别等协变量后,分析WHtR升高与NAFLD的关系。通过计算AUC、敏感度、特异度、阳性预测值和阴性预测值,评价WHtR升高对NAFLD的区分效果。 主要结局指标：WHtR与NAFLD的关联性。 结果：与WHtR正常组相比,NAFLD患病率在 WHtR升高人群中显著升高（16.2% vs 2.3%, P<0.001）,且随着年龄的增长呈现上升趋势。在WHtR升高人群中,男孩NAFLD患病率高于女孩（21.6% vs 11.0%,P<0.001）,而在WHtR正常人群中男孩和女孩的NAFLD患病率接近（2.3% vs 2.2%, P=0.71）。WHtR升高人群NAFLD的发生风险增加 71%,校正的OR =1.71,95% CI：1.26~2.31,P=0.001。分层分析结果显示WHtR升高分别能增加男孩77%（OR=1.77,95% CI：1.19~2.63,P=0.005）和女孩69% （OR=1.69,95% CI：1.05~2.71,P=0.005）的NAFLD发生风险 。WHtR升高区分NAFLD的AUC为0.73（95% CI：0.71~0.76）,敏感度63.2%、特异度83.4%、阳性预测值16.8%和阴性预测值97.7%。 结论：儿童青少年WHtR升高与NAFLD的发生独立相关;学校和社区等基层医疗保健机构要重点关注WHtR升高的人群,除了血压、糖脂代谢异常以外,还需特别关注NAFLD的患病情况。     

Urinary calcium to creatinin ratio in children

Due to difficulty of 24hr urine collection in children for detection of hypercalciura, random urine calcium to creatinin ratio (U Ca/Cr) has been used for screening hypercalciuria. The purpose of this study was to determine normal U Ca/Cr ratio in primary school age children in North of Iran. This study was performed on 590 healthy school-age children, aged between 7–11 years. Early morning random urine samples from all children were analyzed for calcium and creatinine. Mean value and 95^th percentile for U Ca/Cr ratio were 0.155 ±0.095 and 0.36, respectively. A negative correlation observed between age and U Ca/Cr ratio was R=-0.101, P=0.014. With regard to variations in U Ca/Cr ratio among different studies, it is recommended to determine this ratio in every geographic area.