Department of Internal Medicine, Pozzuoli Hospital (Naples), Italy.
Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
Nutr Metab Cardiovasc Dis. 2024 Feb;34(2):299-306. doi: 10.1016/j.numecd.2023.09.005. Epub 2023 Sep 9.
To evaluate the relationship between HDL-Cholesterol (HDL-C), hypertension, and left ventricular hypertrophy (LVH) in a large sample of Caucasian youths with overweight/obesity (OW/OB).
A cross-sectional multicenter study was performed in 1469 youths (age 6-16 years) with OW/OB observed in the period 2016-2020. An additional independent sample of 244 youths with an echocardiographic evaluation, observed in a single center was analyzed. The sample was divided in six quantiles (Q) of HDL-C: Q1: >56, Q2: ≤56 > 51, Q3: ≤51 > 45, Q4: ≤45 > 41, Q5: ≤41 > 39, Q6: <39 mg/dL. The nadir of the relationship was identified in youths in the first quantile. Among HDL-Cholesterol quantiles the distribution of hypertension was non-linear with a percentage of 25.0%, 40.1%, 33.6%, 31.3%, 35.2% and 39.7% in the six quantiles, respectively. The percentage of LVH was 21.8%, 43.6%, 48.8%, 35.5%, 38.5% and 52.0% in the six quantiles, respectively. The highest odds [95%Cl] of hypertension were 2.05 (1.33-3.16) (P < 0.01) in Q2, 1.67 (1.10-2.55) (P < 0.05) in Q3 and 1.59 (1.05-2.41) (P < 0.05) in Q6 vs Q1. The odds of LVH were 3.86 (1.15-10.24) (P < 0.05) in Q2, 4.16 (1.58-10.91) (P < 0.05) in Q3 and 3.60 (1.44-9.02) (P < 0.05) in Q6 vs Q1, independently by centers, age, sex, prepubertal stage, and body mass index.
Contrary to the common belief, the present study shows that high levels of HDL-C may be not considered a negative predictor of hypertension and LVH, two risk factors for future CV disease.
评估在患有超重/肥胖（OW/OB）的大量白种青少年中，高密度脂蛋白胆固醇（HDL-C）、高血压和左心室肥厚（LVH）之间的关系。
在 2016 年至 2020 年期间观察到的 1469 名患有 OW/OB 的青少年中进行了一项横断面多中心研究。还分析了在单一中心接受超声心动图评估的 244 名青少年的独立样本。该样本分为六个 HDL-C 定量（Q）：Q1：>56；Q2：≤56>51；Q3：≤51>45；Q4：≤45>41；Q5：≤41>39；Q6：<39mg/dL。在第一定量的青少年中发现了关系的最低点。在 HDL-C 定量中，高血压的分布是非线性的，分别在六个定量中占 25.0%、40.1%、33.6%、31.3%、35.2%和 39.7%。LVH 的百分比分别为 21.8%、43.6%、48.8%、35.5%、38.5%和 52.0%。在六个定量中，高血压的最高优势比（95%CI）分别为 Q2 中为 2.05（1.33-3.16）（P<0.01），Q3 中为 1.67（1.10-2.55）（P<0.05），Q6 中为 1.59（1.05-2.41）（P<0.05）。LVH 的优势比分别为 Q2 中为 3.86（1.15-10.24）（P<0.05），Q3 中为 4.16（1.58-10.91）（P<0.05），Q6 中为 3.60（1.44-9.02）（P<0.05），这三个因素均与中心、年龄、性别、青春期前阶段和体重指数独立相关。
与普遍看法相反，本研究表明，高水平的 HDL-C 可能不能被视为高血压和 LVH 的负面预测因素，而高血压和 LVH 是未来心血管疾病的两个危险因素。
