Department of Mother & Child, Biology-Genetics, University of Verona, Verona, Italy.
Nutr Metab Cardiovasc Dis. 2010 May;20(4):266-73. doi: 10.1016/j.numecd.2009.04.005. Epub 2009 Sep 11.
The prevalence of children with hypertension is increasing, especially in obese children. This study was to assess the relationship between blood pressure, indexes of adiposity, body fat distribution and insulin resistance.
1044 children (M/F: 484/560; aged 6-11 years). Anthropometry and blood pressure were measured and fasting blood samples were tested for triacylglycerol, total cholesterol, HDL cholesterol, glucose, insulin and ALT. The prevalence of high blood pressure in overweight males and females was 14.3 and 6.4%, respectively (chi(2)=16.73, p<0.001) and in obese it was 40.4 and 32.8%, respectively (chi(2)=5.56, p<0.001). High blood pressure increased progressively with BMI z-score categories (chi(2)=67.99, p<0.001) as well as with waist/height ratio (W/Hr) categories (chi(2)=23.51, p<0.001). Hypertensive subject had significantly higher insulin (15.6+/-9.8 vs 11.9+/-7.2, p<0.001 and 20.63+/-14.7 vs 15.26+/-9.8, p<0.001 in males and females respectively) and HOMA(IR) (3.23+/-2.1 vs 2.42+/-1.49, p<0.001 and 4.12+/-2.87 vs 3.07+/-1.98, p<0.001 in males and in females, respectively) than non-hypertensive ones. Among metabolic and cardiovascular risk factors, HOMA(IR) was the only variable able to predict high blood pressure in obese boys and girls, in addition to BMI or body fat distribution (waist, W/Hr). The highest HOMA(IR) category was the most important predicting factor of high blood pressure in overweight and obese children in addition to body size or body fat distribution.
Blood pressure is associated with the degree of overweight and the indices of body fat distribution. Insulin resistance is an independent additional risk factor for hypertension.
儿童高血压的患病率正在上升，尤其是肥胖儿童。本研究旨在评估血压、肥胖指标、体脂分布与胰岛素抵抗之间的关系。
1044 名儿童（男/女：484/560；年龄 6-11 岁）。测量了体格和血压，并检测了空腹血样中的三酰甘油、总胆固醇、高密度脂蛋白胆固醇、葡萄糖、胰岛素和丙氨酸氨基转移酶。超重男童和女童高血压的患病率分别为 14.3%和 6.4%（卡方=16.73，p<0.001），肥胖儿童分别为 40.4%和 32.8%（卡方=5.56，p<0.001）。高血压随着 BMI z 评分（卡方=67.99，p<0.001）和腰围/身高比（W/Hr）（卡方=23.51，p<0.001）的增加而逐渐增加。与非高血压者相比，高血压患者的胰岛素（15.6+/-9.8 比 11.9+/-7.2，p<0.001 和 20.63+/-14.7 比 15.26+/-9.8，p<0.001，男性和女性分别）和 HOMA（IR）（3.23+/-2.1 比 2.42+/-1.49，p<0.001 和 4.12+/-2.87 比 3.07+/-1.98，p<0.001，男性和女性分别）显著更高。在代谢和心血管危险因素中，除了 BMI 或体脂分布（腰围、W/Hr）外，HOMA（IR）是唯一能预测肥胖男孩和女孩高血压的变量。在超重和肥胖儿童中，HOMA（IR）的最高类别是高血压的最重要预测因素，除了身体大小或体脂分布外。
血压与超重程度和体脂分布指数相关。胰岛素抵抗是高血压的一个独立的附加危险因素。
