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肥胖、钠稳态与儿童和青少年的动脉高血压。

Obesity, Sodium Homeostasis, and Arterial Hypertension in Children and Adolescents.

机构信息

Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, 30-663 Kraków, Poland.

Department of Pediatrics, Gastroenterology and Nutrition, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Kraków, Poland.

出版信息

Nutrients. 2021 Nov 11;13(11):4032. doi: 10.3390/nu13114032.

Abstract

BACKGROUND

The relationship between obesity, arterial hypertension, and excessive salt intake has been known for a long time; however, the mechanism of this relationship remains not clear.

METHODS

The paper presents a current literature review on the relationship between salt consumption and the development of arterial hypertension in children and adolescents with obesity.

RESULTS

In addition to the traditional theory of hypertension development due to the increase in intravascular volume and disturbances of sodium excretion, recent studies indicate the existence of a complex mechanism related to excessive, pathological secretory activity of adipocytes, insulin resistance, and impaired function of the renin-angiotensin-aldosterone axis. That makes obese children and adolescents particularly vulnerable to the development of salt-sensitive arterial hypertension. Studies performed in many countries have shown that children and adolescents consume more sodium than recommended. It is worth noting, however, that the basis for these recommendations was the extrapolation of data from studies conducted on adults. Moreover, more important than sodium intake is the Na/K ratio and water consumption.

CONCLUSION

Regardless of the population-wide recommendations on reducing salt intake in children, specific recommendations for overweight and obese patients should be developed.

摘要

背景

肥胖、动脉高血压和盐摄入量过多之间的关系早已为人所知;然而,这种关系的机制仍不清楚。

方法

本文对肥胖儿童和青少年中盐摄入量与动脉高血压发展之间的关系进行了当前文献综述。

结果

除了由于血管内体积增加和钠排泄紊乱导致高血压发展的传统理论外,最近的研究表明存在与脂肪细胞过度、病理性分泌活动、胰岛素抵抗和肾素-血管紧张素-醛固酮轴功能障碍相关的复杂机制。这使得肥胖的儿童和青少年特别容易发生盐敏感型动脉高血压。许多国家的研究表明,儿童和青少年的钠摄入量超过了建议量。然而,值得注意的是,这些建议的依据是从对成年人进行的研究中推断出来的数据。此外,比钠摄入量更重要的是钠/钾比值和水的摄入。

结论

尽管针对儿童普遍建议减少盐摄入量,但应针对超重和肥胖患者制定具体建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c1e/8622119/f3ddd99db989/nutrients-13-04032-g001.jpg

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