Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, 71013 Foggia, Italy; Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.
Assistance Publique- Hôpitaux de Paris, Hôpital Robert-Debré, Service d'Endocrinologie Pédiatrique, 48, Boulevard Sérurier, 75019 Paris; French Clinical Research Group in Adolescent Medicine and Health, 75014 Paris, France.
Nutr Metab Cardiovasc Dis. 2024 Nov;34(11):2589-2595. doi: 10.1016/j.numecd.2024.07.006. Epub 2024 Jul 15.
systolic and diastolic blood pressure values identify different subtypes of Primary Hypertension. In pediatric age, hypertension is often related to obesity. Characterization of an individual's Blood Pressure (BP) status needs multiple measurements in the course of time, but this is rarely the case, principally in everyday pediatrics. Thus, the finding of abnormal BP values even in a single routine check visit should need a special attention. The aim of this study was to evaluate if even a single abnormal measurement could be a marker of metabolic risk, according to clinical and/or metabolic phenotype and subtypes of hypertension in a population of overweight/obese children and adolescents.
We reviewed data from 489 overweight-obese children and adolescents. BP values were classified according to American Academy of Pediatrics Guidelines (2017). Considering study design, we used the term "Abnormal" instead of "High" BP. Data on lipid profile, glucose metabolism and ultrasonographic pattern of the liver were recorded. Mean age was 9.4 ± 2.5 years: 76.9% had normal BP values. Children with Abnormal BP harbored more frequently an unfavorable metabolic profile. Children with Abnormal Systolic-Diastolic BP values had higher BMI z-score and Waist to Height ratio (p = 0.022 and p = 0.032). Hepatic Steatosis was detected in 4.5%, 14.8 % and 17.6 % of children with normal, abnormal systolic and abnormal systo-diastolic blood pressure, respectively. (p < 0.001).
Identification of abnormal BP subtypes even in a single measurement could be useful for identification of specific clinical-metabolic phenotypes allowing an individual targeted management of obesity-related comorbidities.
收缩压和舒张压值可识别原发性高血压的不同亚型。在儿科年龄，高血压通常与肥胖有关。个体血压（BP）状态的特征需要在一段时间内进行多次测量，但在日常生活儿科中很少这样做。因此，即使在单次常规检查中发现异常 BP 值也需要特别注意。本研究旨在评估即使单次异常测量是否可以成为代谢风险的标志物，根据超重/肥胖儿童和青少年人群的临床和/或代谢表型以及高血压亚型进行评估。
我们回顾了 489 名超重肥胖儿童和青少年的数据。根据美国儿科学会指南（2017 年）对 BP 值进行分类。考虑到研究设计，我们使用“异常”而不是“高”BP 来表示。记录了血脂谱、葡萄糖代谢和肝脏超声模式的数据。平均年龄为 9.4 ± 2.5 岁：76.9%的人血压值正常。异常 BP 的儿童更频繁地存在不利的代谢特征。异常收缩-舒张 BP 值的儿童 BMI z 评分和腰围身高比更高（p = 0.022 和 p = 0.032）。正常、异常收缩和异常收缩-舒张血压的儿童中分别有 4.5%、14.8%和 17.6%检测到肝脂肪变性（p < 0.001）。
即使在单次测量中识别异常 BP 亚型也有助于识别特定的临床代谢表型，从而可以对肥胖相关合并症进行个体化靶向管理。
