Donmez Yasemin Nuran, Sel Kutay
Department of Pediatric Cardiology, Ankara Training and Research Hospital, Ankara, Türkiye.
Department of Pediatric Cardiology, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Türkiye.
Turk Arch Pediatr. 2025 May 2;60(3):268-273. doi: 10.5152/TurkArchPediatr.2025.24243.
Objective: The aim of this study was to assess active standing test responses in ovewrweight or obese children and to determine the factors that contribute to orthostatic abnormalities. Materials and Methods: Orthostatic responses were investigated in bothobese and overweight children. To provide an overview of the autonomic nervous system (ANS), blood pressure and heart rate measurements, laboratory parameters, and anthropometric measures were analyzed. Results: A total of 123 overweight or obese children, with a median age of 15.03 (range from 6.9 to 17.9), were included in this study. Seventy-seven patients (63%) were obese, whereas 46 (37%) were overweight. Orthostatic disturbances were observed in 78 patients (63%). In the standing test, 73 patients (59%) exhibited an abnormal response. Orthostatic hypotension (33%), ortho- static hypertension (30%), and postural orthostatic tachycardia syndrome (18%), were detected in the patients. The group that had orthostatic hypotension had a lower systolic pressure in the standing test after 10 min. The group with orthostatic hypertension had higher body mass index. Furthermore, the orthostatic group displayed significantly higher levels of Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), insulin, and HbA1c. Conclusion: The results of this study signifies a connection between obesity or being overweight and ANS, . highlighting the need for evaluation of the ANS in obese or overweight children to predict the adverse consequences and to prevent occuring during childhood.
本研究旨在评估超重或肥胖儿童的主动站立测试反应,并确定导致体位性异常的因素。材料与方法:对肥胖和超重儿童的体位反应进行了研究。为了全面了解自主神经系统(ANS),分析了血压和心率测量值、实验室参数和人体测量指标。结果:本研究共纳入123名超重或肥胖儿童,中位年龄为15.03岁(范围为6.9至17.9岁)。77例患者(63%)为肥胖,46例(37%)为超重。78例患者(63%)观察到体位性障碍。在站立测试中,73例患者(59%)表现出异常反应。患者中检测到体位性低血压(33%)、体位性高血压(30%)和姿势性直立性心动过速综合征(18%)。体位性低血压组在站立测试10分钟后的收缩压较低。体位性高血压组的体重指数较高。此外,体位性障碍组的胰岛素抵抗稳态模型评估(HOMA-IR)、胰岛素和糖化血红蛋白(HbA1c)水平显著更高。结论:本研究结果表明肥胖或超重与自主神经系统之间存在联系,强调需要对肥胖或超重儿童的自主神经系统进行评估,以预测不良后果并预防在儿童期发生。