Genovesi Simonetta, Salvi Paolo, Nava Elisa, Tassistro Elena, Giussani Marco, Desimone Ilaria, Orlando Antonina, Battaglino Mariagrazia, Lieti Giulia, Montemerlo Massimo, Antolini Laura, Parati Gianfranco
School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
Istituto Auxologico Italiano, IRCCS, Cardiologic Unit, 20100 Milan, Italy.
J Clin Med. 2020 Sep 12;9(9):2954. doi: 10.3390/jcm9092954.
High blood pressure (BP) and excess weight can lead to early cardiovascular organ damage already in children. Carotid-femoral pulse wave velocity (cf-PWV) is the non-invasive gold standard method for assessing aortic stiffness, while carotid-radial PWV (cr-PWV) provides information on the distensibility of the upper limb arteries. The aim of this study was to evaluate the relationship of BP and BMI z-scores with arterial stiffness and left ventricular mass index (LVMI) in a pediatric population.
In 343 children (57.7% males; age ± SD 11.7 ± 2.9 years), systolic (SBP) and diastolic (DBP) BP, BMI, cf-PWV, cr-PWV and LVMI were measured. A multiple linear regression model was used to assess the impact of BMI and SBP (or DBP) z-scores on cf-PWV, cr-PWV and LVMI.
About 21% of children were normal weight, 34% were overweight and 45% obese. Adjusted for possible confounders, SBP and DBP z-scores were significantly associated with cf-PWV ( < 0.001), while only DBP z-scores were related to cr-PWV ( < 0.01). BMI was neither associated with cf-PWV nor with cr-PWV values but was a strong predictor of LVMI (<0.001), whereas cardiac mass and BP z-scores were not related.
Our study suggests that, in children, elevated BP values and excess weight may have different effects on the heart and the vessels in causing early cardiovascular alterations.
高血压和超重可能在儿童期就导致早期心血管器官损害。颈股脉搏波速度（cf-PWV）是评估主动脉僵硬度的无创金标准方法，而颈桡脉搏波速度（cr-PWV）则提供有关上肢动脉扩张性的信息。本研究的目的是评估儿科人群中血压和BMI z评分与动脉僵硬度及左心室质量指数（LVMI）之间的关系。
对343名儿童（57.7%为男性；年龄±标准差11.7±2.9岁）测量收缩压（SBP）、舒张压（DBP）、BMI、cf-PWV、cr-PWV和LVMI。采用多元线性回归模型评估BMI和SBP（或DBP）z评分对cf-PWV、cr-PWV和LVMI的影响。
约21%的儿童体重正常，34%超重，45%肥胖。校正可能的混杂因素后，SBP和DBP z评分与cf-PWV显著相关（<0.001），而只有DBP z评分与cr-PWV相关（<0.01）。BMI与cf-PWV和cr-PWV值均无关联，但却是LVMI的强预测因子（<0.001），而心脏质量与血压z评分无关。
我们的研究表明，在儿童中，血压升高和体重超标在引起早期心血管改变方面可能对心脏和血管有不同影响。
