Assessment of Carotid Intima Media Thickness and Left Ventricular Mass Index in Children with Idiopathic Nephrotic Syndrome

Figures & data

Table 1 Clinical and Investigational Data of Cases and Controls

		Cases (Mean ± SD)	Controls (Mean ± SD)	p
Age (years)		8.80± 3.44	7.65± 3.66	0.103
Weight (kg)		30.71± 10.63	26.28± 11.71	0.04
Height (cm)		121.60± 21.88	129.43± 19.54	0.041
BMI (kg/m^2)		17.55± 3.18	16.26± 1.46	0.013
Systolic BP (mmHg)		109.07 ± 9.12	104.37 ± 10.81	0.01
Diastolic BP (mmHg)		70.88± 6.17	68.00± 6.07	0.01
Urea (mg/dl)		23.42± 7.18	20.35± 3.56	0.012
Creatinine (mg/dl		0.42± 0.12	0.41± 0.13	0.737
Na (mE/L		139.27± 2.54	140.17± 2.51	0.068
K (mE/L)		6.10± 16.75	4.27± 0.30	0.492
PCR(mg/mg creatinine)		0.63± 2.21	0.09 ±.03	0.039
TG (mg/dl)		139.81± 219.99	105.72± 38.53	0.334
HDL-cholesterol(mg/dl)		54.98± 9.39	66.52± 13.48	<0.001
LDL-cholesterol (mg/dl)		119.37± 93.67	81.24± 28.74	0.014
Cholesterol (mg/dl)		205.20± 112.54	148.77± 26.49	0.001
Sex	Female	27 (33.3%)	30 (30.0%)	0.79
	Male	54 (66.7%)	70 (70.0%)
Albumin (gm/dl)		3.6±.69	4.825±1.02	0.02
EF		72.01± 8.37	68.32± 4.19	0.010
CIMT (mm)		0.51± 0.12	0.42± 0.09	<0.001
LVM (gm)		70.38± 24.59	44.85± 11.96	<0.001
LVM Index (g/m^2)		67.86± 20.10	49.20± 15.87	<0.001

Abbreviations: BMI, body mass index; BP, blood pressure; CIMT, carotid intima media thickness; EF, ejection fraction; HDL, high-density lipoprotein; K, potassium; LDL, low-density lipoprotein; LVM, left ventricular mass; Na, sodium; PCR, protein/creatinine in urine; TG, triglycerides.

Table 2 Carotid Intima Media Thickness, LVM and LVM Index According to Age Groups in Cases and Controls

	Age Group	Cases	Controls	p
CIMT	G1	0.531 ± 0.111	0.453 ± 0.083	0.003
	G2	0.506 ± 0.117	0.393 ± 0.07988	<0.001
	G3	0.521± 0.090	0.442± 0.113	0.005
LVM	G1	62.926 ± 12.296	53.466 ± 13.512	0.013
	G2	75.746 ± 15.357	64.636 ± 20.827	0.013
	G3	82.892± 19.335	64.101± 22.643	0.002
LVM index	G1	86.200 ± 19.498	66.947 ± 33.971	0.026
	G2	79.256± 15.062	68.187± 20.881	0.014
	G3	76.344 ± 18.802	57.500± 16.051	<0.001

Abbreviations: CIMT, carotid intima media thickness; LVM, left ventricular mass.

Table 3 Clinical and Investigational Data of the Three Nephrotic Groups

	SSNS (n=30) (Mean ± SD)	SDNS (n=36) (Mean ± SD)	SRNS (n=15) (Mean ± SD)	p
Age (years)	7.60± 2.99	9.50±3.34	9.53±4.03	0.05
Age at onset (years)	4.68±1.96	4.84±2.98	5.60±2.68	0.52
Disease duration(years)	2.98±2.43	4.14±2.55	3.56 ±2.73	0.186
Weight (kg)	25.76±10.14	31.32±9.44	32.16±12.82	0.05
Height (cm)	121.06±17.18	133.80±18.29	130.26±23.27	0.02
BMI (kg/m^2)	16.60±4.62	16.97±1.55	18.14±2.39	0.31
Systolic BP (mmHg)	99.83± 8.14	105.83±8.66	108.33±9.19	0.003
Diastolic BP (mmHg)	65.66±5.04	70.27±6.20	72.00±5.60	0.001
Urea (mg/dl)	21.85± 6.32	22.73± 5.87	28.20± 9.75	0.013
Creatinine (mg/dl)	0.38± 0.09	0.42± 0.10	0.20± 0.05	0.066
Na (mE/L	138.56± 2.67	139.47± 2.24	140.20± 2.80	0.104
K (mE/L)	9.20±27.53	4.26± 0.27	4.30±.40	0.446
PCR (mg/mg creatinine)	0.151± 0.059	0.18 ± 0.09	1.93 ± 4.98	0.018
TG (mg/dl)	106.80± 46.39	109.38± 98.09	278.80± 471.83	0.023
HDL-cholesterol(mg/dl)	54.14± 4.99	56.30± 9.57	53.53± 14.67	0.526
LDL-cholesterol (mg/dl)	110.83± 85.96	107.11± 76.25	165.12± 131.84	0.127
Cholesterol (mg/dl)	185.06± 88.44	174.38± 86.50	250.80± 156.63	0.055
Albumin (gm/dl)	3.90± 0.92	3.65± 0.1.02	3.2± 1.11	0.03
EF	69.36± 6.17	72.91± 8.75	75.20± 10.15	0.060
CIMT (mm)	0.51± 0.10	0.51± 0.13	0.51± 0.12	0.964
LVM (gm)	61.90± 20.10	66.16± 25.43	82.06± 25.42	0.043
LVM Index (g/m^2)	64.50± 17.12	63.25± 15.67	79.86± 41.18	0.046

Abbreviations: BMI, body mass index; BP, blood pressure; CIMT, carotid intima media thickness; EF, ejection fraction; HDL, high-density lipoprotein; K, potassium; LDL, low-density lipoprotein; LVM, left ventricular mass; Na, sodium; PCR, protein/creatinine in urine; SDNS, steroid dependent NS; SRNS, steroid resistant NS; SSNS, steroid sensitive nephrotic syndrome; TG, triglycerides.

Table 4 Comparison Between Patients with MCD (n=28) and FSGS (n=6) as Regard CIMD and Echo Findings

	FSGS	MCD	p
EF	73.00±6.03	75.11±1.61	0.644
CIMT (mm)	0.51±.13	0.50±.14	0 0.843
LVM (gm)	75.25±30.62	71.00±18.54	0.747
LVMI(gm/m^2)	64.74±22.74	91.83±43.27	0.037

Abbreviations: CIMT, carotid intima media thickness; EF, ejection fraction; FSGS, focal segmental glomerulosclerosis; LVM, left ventricular mass; MCD, minimal change disease.

Table 5 Correlations Between the Echocardiography Findings and Other Clinical and Laboratory Data. Values are Expressed as p (r)

	CIMT	LVM	LVM Index
Disease duration	<0.001 (0.613)	<0.001 (0.454)	0.011 (0.231)
BMI	0.870 (−0.015)	<0.001 (0.363)	0.01 (0.31)
Systolic BP	0.084 (0.158)	0.003 (0.266)	0.038 (0.273)
Diastolic BP	0.073 (0.147)	0.006 (0.250)	0.016 (0.244)
PCR	0.725 (0.040)	0.98 (0.002)	0.65 (0.050)
TG	0.059 (0.172)	0.002 (0.283)	0.035 (0.284)
HDL-cholesterol	0.530 (−0.058)	0.014 (−0.222-)	0.033 (−0.194-)
LDL-cholesterol	0.528 (0.059)	0.13 (0.143)	0.53 (0.059)
Cholesterol	0.636 (0.043)	0.39 (0.079)	0.88 (0.014)

Abbreviations: BMI, body mass index; BP, blood pressure; CIMT, carotid intima media thickness; HDL; high-density lipoprotein; LDL, low-density lipoprotein; LVM, left ventricular mass; PCR, protein/creatinine in urine; TG, triglycerides.

Table 6 General Linear Multivariate Model for Analyzing the Effect of Risk Factors on CIMT and LVM Index

Dependent Variable	Source	Sum of Squares	df	Mean Square	F	Sig.
CIMT	Nephrotic	0.150	5	0.150	11.009	0.001
	Disease duration	213.627	5	42.725	10.239	<0.001
LVM index	Disease duration	350.259	43	8.146	1.709	0.046
	BMI	148.120	43	37.030	5.631	<0.001
	SYSTOLIC BP	4131.389	43	96.079	1.408	0.045
	DIASTOLIC BP	2090.833	43	48.624	1.876	0.027
	TG	3,626,515.923	43	84,337.580	12.719	<0.001
	HDL	6443.353	43	103.925	3.000	0.006

Abbreviations: BMI, body mass index; BP, blood pressure; CIMT, carotid intima media thickness; HDL; high-density lipoprotein; LVM, left ventricular mass; TG, triglycerides.