Drozdz Dorota, Kwinta Przemko, Korohoda Przemysław, Pietrzyk Jacek A, Drozdz Maciej, Sancewicz-Pach Krystyna
Dialysis Unit, Polish-American Children's Hospital, Collegium Medicum of Jagiellonian University, 265 Wielicka Street, Cracow, Poland.
Pediatr Nephrol. 2009 Sep;24(9):1735-40. doi: 10.1007/s00467-009-1207-9. Epub 2009 May 28.
Obesity is a well-known risk factor for arterial hypertension. The aim of this study was to analyze which surrogate marker of adiposity, i.e., body mass index (BMI) or fat mass (FM), as measured by bioimpedance analysis (BIA), best correlated with blood pressure in healthy children. Body weight, height, and casual blood pressure (BP) were measured in 193 healthy children (103 boys), aged 8-16 years. Body composition was determined by BIA. The correlation between BMI and age was linear, whereas the correlation between percentage of FM and age was nonlinear and it was different in boys and girls. Blood pressure standard deviation scores (SDS) correlated with FM SDS (BIA) over the entire normal range (systolic: r = 0.26, p = 0.002; diastolic: r = 0.33, p < 0.01). An evaluation of the children based on BP (three groups: BP < 50th percentile, 50th < BP > 95th percentile; BP > 95th percentile) revealed that hypertensive children had a higher BMI (17.6 vs. 19.4 vs. 26.2 kg/m(2), respectively) and a greater FM (14.0 vs. 16.8 vs. 30.2%, respectively). In conclusion, the divergence in FM in healthy boys and girls can be determined by BIA but not by BMI. In healthy children, BP within the entire normal range correlated with FM, children with established hypertension presented with a significantly higher FM. The study points to FM as an important determinant of BP pressure in obese and non-obese children.
肥胖是动脉高血压的一个众所周知的危险因素。本研究的目的是分析哪种肥胖替代标志物,即通过生物电阻抗分析(BIA)测量的体重指数(BMI)或体脂(FM),与健康儿童的血压相关性最好。对193名8至16岁的健康儿童(103名男孩)测量了体重、身高和偶测血压(BP)。通过BIA测定身体成分。BMI与年龄之间的相关性呈线性,而FM百分比与年龄之间的相关性呈非线性,且在男孩和女孩中有所不同。在整个正常范围内,血压标准差评分(SDS)与FM SDS(BIA)相关(收缩压:r = 0.26,p = 0.002;舒张压:r = 0.33,p < 0.01)。根据血压对儿童进行评估(三组:血压<第50百分位数、第50百分位数<血压>第95百分位数;血压>第95百分位数)显示,高血压儿童的BMI较高(分别为17.6 vs. 19.4 vs. 26.2 kg/m²),FM也更高(分别为14.0 vs. 16.8 vs. 30.2%)。总之,健康男孩和女孩的FM差异可以通过BIA确定,但不能通过BMI确定。在健康儿童中,整个正常范围内的血压与FM相关,已确诊高血压的儿童FM显著更高。该研究指出FM是肥胖和非肥胖儿童血压的一个重要决定因素。