Tepe Derya, Demirel Fatma, Seker Esra Dag, Arhan Ebru Petek, Tayfun Meltem, Esen Ihsan, Kara Ozlem, Kizilgun Murat
J Pediatr Endocrinol Metab. 2016 Aug 1;29(8):907-14. doi: 10.1515/jpem-2015-0470.
Idiopathic intracranial hypertension (IIH) is one of the most important and rare complications of obesity. Prevalence of IIH in childhood obesity is not known. The purpose of this study was to determine the prevalence of IIH in obese children and adolescents and to investigate the relevant factors.
In this study, 1058 obese children and adolescents between 2 and 18 years of age were included. Funduscopic examination was conducted for all subjects. In cases with papilledema, increase in intracranial pressure was clarified by measuring CSF pressure with a lumbar puncture. Other causes of IIH were ruled out with clinical, laboratory tests and imaging techniques.
Idiopathic intracranial hypertension was diagnosed in 14 subjects (1.32%). Rates of headache and systemic hypertension in subjects with IIH was determined to be 78.6% and 28.6%, respectively. Morning cortisol, fasting insulin and HOMA-IR values were found to be significantly higher in this cases (p<0.05).
In childhood obesity, IIH should be kept in mind as a serious complication. Funduscopic examination is an easy method that suggests IIH. In particular, obese children with systemic hypertension and refractory headache should be considered for IIH.
特发性颅内高压(IIH)是肥胖最重要且罕见的并发症之一。儿童肥胖中IIH的患病率尚不清楚。本研究的目的是确定肥胖儿童和青少年中IIH的患病率,并调查相关因素。
本研究纳入了1058名2至18岁的肥胖儿童和青少年。对所有受试者进行眼底检查。对于出现视乳头水肿的病例,通过腰椎穿刺测量脑脊液压力来明确颅内压升高情况。通过临床、实验室检查和影像学技术排除IIH的其他病因。
14名受试者(1.32%)被诊断为特发性颅内高压。IIH受试者的头痛和系统性高血压发生率分别确定为78.6%和28.6%。发现这些病例的早晨皮质醇、空腹胰岛素和HOMA-IR值显著更高(p<0.05)。
在儿童肥胖中,应将IIH视为一种严重并发症。眼底检查是提示IIH的一种简便方法。特别是患有系统性高血压和难治性头痛的肥胖儿童应考虑患有IIH。