Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Paediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Acta Paediatr. 2014 Feb;103(2):225-30. doi: 10.1111/apa.12479. Epub 2013 Dec 3.
To investigate the prevalence of nocturnal blood pressure dipping among obese prepubertal and early pubertal children and to analyse the relationship between dipping and measures of insulin-glucose metabolism or sleep-disordered breathing.
We studied 76 obese children (41% girls) under clinical care, with an average age of 10.4 ± 1.7 and a body mass index Z-score (BMI Z-score) of 6.2 ± 1.6. We performed a 24-h ambulatory blood pressure measurement. Non-dipping was defined as a nocturnal blood pressure reduction of <10%. We calculated measures of insulin-glucose metabolism from the performed frequently sampled intravenous glucose-tolerance test and from fasting blood samples. Overnight sleep polygraph recordings were performed to assess sleep-disordered breathing.
Forty-two percent of the children were systolic non-dippers, and 17% were diastolic non-dippers. There were no associations between systolic or diastolic dipping and measures of insulin-glucose metabolism after adjustments for BMI Z-score, gender and pubertal status. There were no associations between dipping and measures of sleep-disordered breathing.
Nocturnal non-dipping was two times higher among severely obese, prepubertal and early pubertal children, compared to previous reports among children in general. There were no associations between nocturnal dipping and insulin-glucose metabolism or measures of sleep-disordered breathing in this group.
调查肥胖青春期前和早期青春期儿童夜间血压下降的患病率，并分析下降与胰岛素-葡萄糖代谢或睡眠呼吸障碍测量值之间的关系。
我们研究了 76 名在临床护理下的肥胖儿童（41%为女孩），平均年龄为 10.4 ± 1.7 岁，体重指数 Z 评分（BMI Z 评分）为 6.2 ± 1.6。我们进行了 24 小时动态血压测量。夜间血压下降<10%定义为非杓型。我们从进行的频繁采样静脉葡萄糖耐量试验和空腹血样中计算了胰岛素-葡萄糖代谢的测量值。进行整夜睡眠多导睡眠图记录以评估睡眠呼吸障碍。
42%的儿童为收缩压非杓型，17%为舒张压非杓型。调整 BMI Z 评分、性别和青春期状态后，收缩压或舒张压下降与胰岛素-葡萄糖代谢测量值之间没有关联。下降与睡眠呼吸障碍测量值之间也没有关联。
与一般儿童的先前报告相比，严重肥胖、青春期前和早期青春期儿童夜间非杓型的发生率高两倍。在该组中，夜间杓型与胰岛素-葡萄糖代谢或睡眠呼吸障碍测量值之间没有关联。
