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当前肥胖与极低出生体重儿的儿童高血压有关。

Current obesity was associated with hypertension in children born very low birth weight.

机构信息

Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Division of Nephrology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

BMC Res Notes. 2021 May 21;14(1):196. doi: 10.1186/s13104-021-05611-x.

Abstract

OBJECTIVES

Previous studies from the developed countries showed that children born very low birth weight have a higher risk of hypertension compared with that of the normal birth weight controls. However, studies regarding the prevalence of hypertension in such children from the developing countries are scarce. This study aimed to identify the perinatal and postnatal factors associated with hypertension in children born very low birth weight.

RESULTS

Forty-six children aged ≥ 6 years from the VLBW cohort of Ramathibodi Hospital, Bangkok, Thailand underwent the ambulatory blood pressure monitoring. The prevalence of hypertension was 15.2% (7/46). The hypertension group had a significant higher BMI z-score at 3 years of age (0.90 ± 1.44 vs - 0.45 ± 1.47, p = 0.045) and a greater proportion of current obesity (42% vs 2.5%, p < 0.01) compared to those in the normotensive group. Multivariate analysis revealed that current obesity was associated with hypertension (OR 34.77, 95%CI 1.814-666.5). Among 36 children with normal office blood pressure, four children (11.1%) had high blood pressure uncovered by ABPM, called "masked hypertension". Office systolic blood pressure at the 85th percentile was the greatest predictor for masked hypertension with a sensitivity of 75% and a specificity of 81.2%.

摘要

目的

来自发达国家的先前研究表明,与正常出生体重对照组相比,极低出生体重儿患高血压的风险更高。然而,来自发展中国家的此类儿童高血压患病率的研究却很少。本研究旨在确定与极低出生体重儿高血压相关的围产期和产后因素。

结果

泰国曼谷 Ramathibodi 医院 VLBW 队列中 46 名年龄≥6 岁的儿童接受了动态血压监测。高血压的患病率为 15.2%(7/46)。与血压正常组相比,高血压组在 3 岁时 BMI z 评分显著更高(0.90±1.44 与-0.45±1.47,p=0.045),且当前肥胖的比例更高(42%与 2.5%,p<0.01)。多变量分析显示,当前肥胖与高血压有关(OR 34.77,95%CI 1.814-666.5)。在 36 名办公室血压正常的儿童中,有 4 名儿童(11.1%)存在 ABPM 未发现的高血压,称为“隐匿性高血压”。办公室收缩压第 85 百分位数是隐匿性高血压的最大预测因素,其敏感性为 75%,特异性为 81.2%。

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