Schiel R, Beltschikow W, Kramer G, Stein G
Inselklinik Heringsdorf GmbH, Department of Diabetes and Metabolic Diseases, Setheweg 11, D-17424 Seeheilbad Heringsdorf, Germany.
Eur J Med Res. 2006 Mar 27;11(3):97-101.
Since many years in adults associations between dyslipidaemia, increased insulin resistance, arterial hypertension and the risk for cardiovascular diseases have been recognized. It was the aim of the present trial to investigate these associations and interactions between height, weight, body-mass index and blood pressure values in overweight/obese and normal weight children and adolescents.
172 children and adolescents (n = 86 with overweight and obesity, n = 86 controls) were studied. In all the subjects anthropometrical data and blood pressure values were assessed.
Overweight and obese children had significantly higher blood pressure values (systolic 117.9 +/- 9.7, diastolic 75.6 +/- 8.8 mmHg) than control subjects (systolic 111.4 +/- 11.0, diastolic 69.5 +/- 8.8 mmHg, p<0.001/0.001). Additionally in overweight and obese subjects the number of patients with blood pressure values below the 50th percentile was lower, but the numbers of children and adolescents with values >or=50th age-, height- and gender-specific percentiles were significantly higher. In multivariate analysis of overweight/obese children and adolescents only patients' BMI (R-square = 0.26, beta = 0.52, p<0.001), but not sex, age, height or weight revealed any association with systolic blood pressure values. Diastolic blood pressure revealed an association with childrens' and adolescents' weight (R-square = 0.22, beta = 0.48, p<0.001), but there were no associations with body-mass index, sex, age or height. In normal weight control subjects age (beta = 0.32, p = 0.01) and height (beta = 0.28, p = 0.03) showed associations with the systolic blood pressure values (R-square = 0.15), but only childrens' and adolescents' height (beta = 0.39, p<0.001) was associated with diastolic blood pressure (R-square = 0.28).
Overweight and obesity in childhood are highly associated with multiple comorbidities, elevated blood pressure values, dyslipidaemia, reduced insulin sensitivity and alterations of large and minor vessels. Overweight and obesity in children and adolescents should not longer be regarded as variations of normality, but as diseases with an extremely high risk for the development of atherosclerosis and cardiovascular complications in adulthood. Knowledge of these complex associations implicate even in young age the need for intervention.
多年来，成人血脂异常、胰岛素抵抗增加、动脉高血压与心血管疾病风险之间的关联已得到认可。本试验旨在研究超重/肥胖及正常体重儿童和青少年的身高、体重、体重指数与血压值之间的这些关联及相互作用。
对172名儿童和青少年（86名超重和肥胖者，86名对照者）进行了研究。对所有受试者评估了人体测量数据和血压值。
超重和肥胖儿童的血压值（收缩压117.9±9.7，舒张压75.6±8.8 mmHg）显著高于对照受试者（收缩压111.4±11.0，舒张压69.5±8.8 mmHg，p<0.001/0.001）。此外，超重和肥胖受试者中血压值低于第50百分位数的患者数量较少，但血压值≥年龄、身高和性别特异性第50百分位数的儿童和青少年数量显著较多。在超重/肥胖儿童和青少年的多因素分析中，仅患者的体重指数（R平方=0.26，β=0.52，p<0.001）与收缩压值相关，而性别、年龄、身高或体重均无相关性。舒张压与儿童和青少年的体重相关（R平方=0.22，β=0.48，p<0.001），但与体重指数、性别、年龄或身高均无相关性。在正常体重对照受试者中，年龄（β=0.32，p=0.01）和身高（β=0.28，p=0.03）与收缩压值相关（R平方=0.15），但仅儿童和青少年的身高（β=0.39，p<0.001）与舒张压相关（R平方=0.28）。
儿童期超重和肥胖与多种合并症、血压值升高、血脂异常、胰岛素敏感性降低以及大血管和小血管改变高度相关。儿童和青少年的超重和肥胖不应再被视为正常变异，而应被视为成年期发生动脉粥样硬化和心血管并发症风险极高的疾病。了解这些复杂关联意味着即使在年轻时也需要进行干预。
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