Child Health Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.
Medical Doctoral Program Student, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.
Pan Afr Med J. 2019 Nov 7;34:134. doi: 10.11604/pamj.2019.34.134.18309. eCollection 2019.
Obesity is a global health problem with growing prevalence in developing countries. Obesity causes chronic inflammation due to imbalances between pro- and anti-inflammatory cytokines. This causes metabolic complications such as dyslipidemia, hypertension, and cardiovascular disorder. Carotid intima-media thickness (CIMT) is a predictor of atherosclerosis which could be measured easily and non-invasively. Early detection of cardiovascular diseases in obese adolescents at risk is hoped to improve outcomes.
This is a cross-sectional study on obese adolescents aged 13-16 year old at Pediatric Clinic of Dr. Soetomo General Hospital. Obesity is defined as Body mass index higher than 95 percentiles according to CDC (2000). Dyslipidemia is diagnosed when either an increase in cholesterol, LDL, triglyceride or a decrease in HDL level is found, as recommended by NCPE and American Academy of Pediatrics. Hypertension is defined as an increase of blood pressure > P95 according to age and gender. The differences of CIMT based on dyslipidemia, hypertension, and gender were analyzed with Wilcoxon Mann Whitney with significant p value (p < 0,005).
This study included 59 obese adolescents, consisting of 32 (54.2%) male adolescents and 35 (59.3%) female adolescents. Dyslipidemia was found on 38 (64.4%) adolescents and hypertension was found on 35 (59.3%) adolescents. No difference of CIMT was found between obese adolescents with and without dyslipidemia and with and without hypertension based on gender (p > 0.05).
No difference of CIMT based on gender between adolescents aged below 18. The high number of dyslipidemia and hypertension in obese adolescents need an early detection of cardiovascular complication.
肥胖是一个全球性的健康问题，在发展中国家的发病率不断上升。肥胖会导致促炎和抗炎细胞因子之间失衡，引起慢性炎症。这会导致代谢并发症，如血脂异常、高血压和心血管疾病。颈动脉内膜中层厚度（CIMT）是动脉粥样硬化的预测指标，可以通过简便、无创的方式进行测量。早期发现肥胖青少年的心血管疾病，有望改善预后。
这是一项横断面研究，对象为在苏加诺综合医院儿科诊所就诊的 13-16 岁肥胖青少年。肥胖的定义为根据疾病预防控制中心（CDC）（2000 年）的标准，体重指数高于第 95 百分位数。根据国家胆固醇教育计划（NCPE）和美国儿科学会的建议，当胆固醇、LDL、甘油三酯升高或 HDL 水平降低时，诊断为血脂异常。高血压的定义为根据年龄和性别，血压升高超过第 95 百分位数。采用 Wilcoxon 秩和检验分析 CIMT 与血脂异常、高血压和性别之间的差异，显著水平为 p < 0.005。
本研究共纳入 59 例肥胖青少年，其中男性 32 例（54.2%），女性 35 例（59.3%）。38 例（64.4%）青少年存在血脂异常，35 例（59.3%）青少年存在高血压。根据性别，血脂异常和无血脂异常、高血压和无高血压的肥胖青少年的 CIMT 无差异（p > 0.05）。
18 岁以下青少年的 CIMT 不受性别影响。肥胖青少年血脂异常和高血压的发生率较高，需要早期发现心血管并发症。
