Tepe Derya, Yılmaz Songül
Department of Pediatric Endocrology, Ankara Yıldırım Beyazıt Üniversity, Yenimahalle Education and Research Hospital, Ankara, Turkey.
Department of Pediatric Nephrology, Ankara Yıldırım Beyazıt Üniversity, Yenimahalle Education and Research Hospital, Ankara, Turkey.
Diabetes Metab Syndr Obes. 2021 Sep 1;14:3809-3817. doi: 10.2147/DMSO.S329273. eCollection 2021.
Although it is not reflected in the OBP measurement in obese children, ambulatory BP changes are known to occur. MH, non-dipper pattern and nocturnal hypertension have been reported to increase in obese children. On the other hand, the factors that indicate a high risk of hypertension are still unclear. The aim of our study is to especially detect masked hypertension by 24-hour BP measurement in obese adolescents and to evaluate the relationship of masked hypertension with metabolic syndrome parameters, anthropometric measurements and hepatosteatosis in these patients.
A total of 63 adolescents diagnosed with obesity were evaluated between January 2019 and December 2019. Office blood pressure was measured for all children, and all of them underwent ABPM. Patients with and without hypertension in ABPM were compared in terms of clinical and laboratory findings.
The mean age was 14.0 ± 1.7 years, females composed 49.2% of the study population. Office blood pressure measurement revealed hypertension in 4 (6.3%) patients and prehypertension in 15 (23.8%) patients. Thirteen patients (20.9%) were diagnosed with masked hypertension, white coat hypertension was diagnosed in 3 (4.7%) patients. Abnormal ABPM patterns were found to be significantly more frequent in patients with severely obesity (with obesity: 26.4% vs severe obesity: 55.6%, p = 0.03) and patients with a higher waist circumference and waist circumference/height ratio.
The prevalence of masked hypertension in obese adolescents has been found to be quite high. Therefore, we recommend ABPM in adolescents with high waist circumference/height ratio and severe obesity, even if their office blood pressure measurements are normal.
尽管肥胖儿童的诊室血压测量未反映出动态血压变化，但已知这种变化会发生。据报道，肥胖儿童的隐匿性高血压、非勺型血压模式和夜间高血压有所增加。另一方面，提示高血压高风险的因素仍不清楚。我们研究的目的是通过24小时血压测量特别检测肥胖青少年中的隐匿性高血压，并评估这些患者中隐匿性高血压与代谢综合征参数、人体测量指标和肝脂肪变性之间的关系。
2019年1月至2019年12月期间，对总共63名诊断为肥胖的青少年进行了评估。对所有儿童测量诊室血压，并且他们全部接受了动态血压监测。比较动态血压监测中有高血压和无高血压的患者的临床和实验室检查结果。
平均年龄为14.0±1.7岁，女性占研究人群的49.2%。诊室血压测量显示4名（6.3%）患者患有高血压，15名（23.8%）患者患有高血压前期。13名患者（20.9%）被诊断为隐匿性高血压，3名（4.7%）患者被诊断为白大衣高血压。发现严重肥胖患者（肥胖：26.4% 对比严重肥胖：55.6%，p = 0.03）以及腰围和腰围/身高比更高的患者中异常动态血压模式明显更常见。
已发现肥胖青少年中隐匿性高血压的患病率相当高。因此，我们建议对腰围/身高比高和严重肥胖的青少年进行动态血压监测，即使他们的诊室血压测量正常。
