Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa.
Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria.
BMJ Open. 2021 Mar 17;11(3):e042955. doi: 10.1136/bmjopen-2020-042955.
Prevalence of child and adolescents' overweight and obesity in low- and middle-income countries has increased dramatically. Simultaneously, the incidence of pre-hypertension/hypertension is also increasing in children, which, in turn, predisposes these children to the risk of cardiovascular disease (CVD) in later life. The present study assessed cardiometabolic risk factors and early indicators of vascular dysfunction in adolescents from a low socio-economic rural area in South Africa.
Cross-sectional cohort study.
The study was conducted in public schools in Mthatha, OR Tambo district municipality, Eastern Cape Province, South Africa.
A total of 244 adolescents (188 females) of African ancestry aged 13-16 years were enrolled.
Anthropometric and haemodynamic measures and pulse wave velocity (PWV) were related to overweight/obesity and hypertension. Blood markers of cardiometabolic syndrome were assessed as well as vascular function (via PWV).
One-third (33.0%) of the adolescents exceeded the age and sex-specific body mass index percentiles for overweight (≥85th) or obesity (>95th) with a prevalence of 61.1% pre-hypertensives in this group. Overweight/obesity and hypertension were associated with higher triglycerides (lean:overweight: 0.79<1.01 mmol/L; normotensive:hypertensive: 0.82<0.89 mmol/L). Fasting glucose was higher in hypertensive as compared to normotensive adolescents (4.85>4.69 mmol/L, p<0.05). PWV was elevated in 25.9% of the children and significantly correlated with asymmetric dimethylarginine and systolic blood pressure (p<0.001).
Overweight/obesity and hypertension show a high prevalence in rural South African youth. Almost half of the studied adolescents are at risk for developing CVD. The high association between cardiometabolic risk factors and PWV further suggests that hypertension in adolescents may promote the progression of CVD in adulthood. Early detection of those at risk and the implementation of preventive strategies in underprivileged young people is urgently needed to stop the progression of vascular damage and manifestation of CVD in rural African children.
中低收入国家儿童和青少年超重和肥胖的患病率显著增加。与此同时，儿童期高血压前期/高血压的发病率也在增加，这反过来又使这些儿童在以后的生活中易患心血管疾病 (CVD)。本研究评估了南非一个低社会经济农村地区青少年的心脏代谢危险因素和血管功能障碍的早期指标。
横断面队列研究。
该研究在南非东开普省 Mthatha 市的公立学校进行。
共纳入 244 名 13-16 岁的非洲裔青少年（188 名女性）。
与超重/肥胖和高血压相关的人体测量和血液动力学指标以及脉搏波速度（PWV）；评估心脏代谢综合征的血液标志物以及血管功能（通过 PWV）。
三分之一（33.0%）的青少年超重（≥第 85 百分位）或肥胖（>第 95 百分位），其中该组高血压前期患病率为 61.1%。超重/肥胖和高血压与较高的甘油三酯有关（瘦：超重：0.79<1.01mmol/L；正常血压：高血压：0.82<0.89mmol/L）。与正常血压青少年相比，高血压青少年的空腹血糖更高（4.85>4.69mmol/L，p<0.05）。25.9%的儿童的 PWV 升高，与不对称二甲基精氨酸和收缩压显著相关（p<0.001）。
超重/肥胖和高血压在南非农村青少年中患病率较高。近一半的研究青少年有患 CVD 的风险。心脏代谢危险因素与 PWV 之间的高度相关性进一步表明，青少年高血压可能会促进成年期 CVD 的进展。迫切需要在贫困青年中早期发现高危人群并实施预防策略，以阻止血管损伤的进展和非洲农村儿童 CVD 的发生。
