Maggio Albane B R, Aggoun Yacine, Marchand Laetitia M, Martin Xavier E, Herrmann François, Beghetti Maurice, Farpour-Lambert Nathalie J
Pediatric Cardiology Unit, Department of Child and Adolescent, University Hospitals of Geneva, Switzerland.
J Pediatr. 2008 Apr;152(4):489-93. doi: 10.1016/j.jpeds.2007.10.042. Epub 2007 Dec 21.
To measure resting and ambulatory systemic blood pressure (BP) and left ventricular mass (LVM) in prepubertal obese and lean children and to determine their relationships.
Cross-sectional study including 44 obese and 22 lean prepubertal children (mean age 8.8 +/- 1.5 years). We measured casual and 24-hour ambulatory BP, LVM and LVM index (LVMI) by echocardiography, and whole body lean tissue and fat mass by dual-energy X-ray absorptiometry.
Mean 24-hour systolic BP (124.8 +/- 14.2 vs 105.5 +/- 8.8 mm Hg), diastolic BP (72.8 +/- 7.3 vs 62.7 +/- 3.8 mm Hg), and LVMI (36.1 +/- 5.8 vs 30.9 +/- 5.7, g x m(-2.7)) were significantly higher in obese than in lean subjects. Systolic ambulatory hypertension was present in 47.6% of obese children, and casual BP was normal in 55% of those cases. Body fatness, lean tissue mass, and 24-hour BP correlated positively with LVMI. When adjusted for body fatness, LVMI was only associated with 24-hour systolic BP (adjusted R(2) = 15.9%; P = .001).
Ambulatory systemic hypertension and increased LVM are found in obese children. Left ventricular mass is partially determined by systemic BP. We conclude that prevention and treatment of childhood obesity should be initiated as early as possible to prevent the premature development of hypertension and end-stage organ damage.
测量青春期前肥胖和消瘦儿童的静息和动态全身血压（BP）以及左心室质量（LVM），并确定它们之间的关系。
横断面研究，纳入44名肥胖和22名消瘦的青春期前儿童（平均年龄8.8±1.5岁）。我们通过超声心动图测量了随机和24小时动态血压、LVM和左心室质量指数（LVMI），并通过双能X线吸收法测量了全身瘦组织和脂肪量。
肥胖儿童的平均24小时收缩压（124.8±14.2 vs 105.5±8.8 mmHg）、舒张压（72.8±7.3 vs 62.7±3.8 mmHg）和LVMI（36.1±5.8 vs 30.9±5.7，g x m（-2.7））显著高于消瘦儿童。47.6%的肥胖儿童存在动态收缩期高血压，其中55%的病例随机血压正常。体脂、瘦组织量和24小时血压与LVMI呈正相关。调整体脂后，LVMI仅与24小时收缩压相关（调整后R（2）=15.9%；P = 0.001）。
肥胖儿童存在动态全身高血压和LVM增加。左心室质量部分由全身血压决定。我们得出结论，应尽早开始预防和治疗儿童肥胖，以防止高血压和终末期器官损害的过早发生。
