Obez çocuklarda ambulatuar arteriyel kan basıncı izlem sonuçları

Amaç: Obezite ile esansiyel hipertansiyon arasındaki ilişki iyi bilinmektedir. Bu çalışmada benzer demografik özelikler taşıyan obez ve normal çocuklarda, ambulatuar arteriyel kan basınç izlemi yapmayı amaçladık. Gereç ve yöntem: Toplam 71 çocuk ve adolesan (n=39 obez, n=32 kontrol) çalışmaya dahil edildi. Çalışmada kan basınç ölçümü, ambulatuar kan basınç izlem aleti ile yapıldı. Bulgular: Obez çocuklarda ortalama sistolik ve diyastolik kan basınçları (sistolik 121.9±11.7 mmHg, diyastolik 70.2±5.3 mmHg), kontrol grubuna (sistolik 109.3±6.7 mmHg, diyastolik 65.1±4.6 mmHg) göre daha yüksek bulundu (p

Results of ambulatory arterial blood pressure monitoring in children with obesity

Objectives: The relationship between obesity and essential hypertension is well known. In this study, we aimed to evaluate ambulatory arterial blood pressure monitoring of obese and non-obese children who had similar demographic characteristics. Materials and methods: Seventy one children and adolescents (n=39 obesity, n=32 controls) were studied. Blood pressure of the children were measured by 24 hour ambulatory blood pressure monitoring device. Results: Obese children had significantly higher mean blood pressure values (systolic 121.9±11.7 mmHg, diastolic 70.2±5.3 mmHg) than control subjects (systolic 109.3±6.7 mmHg, diastolic 65.1±4.6 mmHg, p<0.05). Also, daytime and nighttime systolic and diastolic blood pressures were higher in patients with obesity than controls (p<0.05). Distribution of dipping status was not different between groups (p>0.05). Blood pressure load was found to be increased in obese children compared to the controls (%13.6±12.9 and %2.6±3.4, respectively; p<0.05). Serum total cholesterol and LDL-cholesterol levels of obese children (181.1±33.4 and 131.1±23.1mg/dl) were significantly higher than those of the controls (134.3±11.1 and 103.3±14.2 mg/dl, p<0.05). Conclusions: Obesity in children and adolescents should not be regarded as variations of normality, but as abnormality with an extremely high risk for the development of hypertension and hyperlipidemia in adulthood.

PDF

___

1. King DS, Wofford MR. Obesity and hypertension. Drug Topics 2000;3: 59-67.
2. Donohoue PA. Obesity. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics, 17th edn. Saunders: Philedelphia, 2004:173-77.
3. Soylu ÖB, Soylu A. Çocukluk çağı obezitesinde hipertansiyon ve böbrek hastalığı. Türkiye Klinikleri J Pediatr 2008;17:37-43.
4. Cindik N, Baskın E, Agras PI, Kınık ST, Turan M, Saatci U. Effect of obesity on inflammatory markers and renal functions. Acta Pediatrica 2005;94:1732-7.
5. Şimşek F, Ulukol B, Berberoğlu M, Gülnar SB, Adıyaman P, Öcal G. Ankara’da bir ilköğretim okulu ve lisede obezite sıklığı. Ankara Üniversitesi Tıp Fakültesi Mecmuası 2005;58:163-6.
6. Acosta AA, McNiece KL. Ambulatory blood pressure monitoring: a versatile tool for evaluating and managing hypertension in children. Pediatr Nephrol 2008;23:1399–408.
7. Hassan MO, Jaju D, Albarwani S, et al. Non-dipping blood pressure in the metabolic syndrome among Arabs of the Oman: Family study. Obesity 2007;15:2445-53.
8. Arslan S, Arslan N, Soylu A, et al. High altitude and blood pressure in children. Yale J Biol Med 2003;76:145-8.
9. Soylu A, Kavukçu, Türkmen M, Çabuk N, Duman M. Effect of socioeconomic status on the blood pressure in children living in a devoloping country. Pediatr Int 2000;42:37-42.
10. Dişligil G, Aydoğdu A, Başak O, Gemalmaz A, Gürel FS. Aydın ilindeki ilkokul çocuklarında hipertansiyon prevalansı ve ilişkili faktörler. Türk Aile Hek Derg 2008;12:70-4.
11. Speiser PW, Rudolf MC, Anhalt H, et al. Childhood obesity. J Clin Endocrinol Metab 2005;90:1871-8.
12. Masuo K, Rakugi H, Ogihara T, Esler MD, Lambert GW. Cardiovascular and renal complications of type 2 diabetes in obesity: role of sympathetic nerve activity and insulin resistance. Curr Diabetes Rev. 2010;6:58-67.
13. Kaneko K, Shiraishi K, Yamauchi K, Murakami M, Kitagawa T. Obesity and the kidney. J Pediatr. 2010;156:342-3.
14. Bosma RJ, van der Heide JJ, Oosterop EJ, de Jong PE, Navis G. Body mass index is associated with altered renal hemodynamics in non-obese healthy subjects. Kidney Int 2004;65:259-65.
15. Bingham MO, Harrell JS, Takada H, et al. Obesity and cholesterol in Japanese, French, and U.S. children. J Pediatr Nurs 2009;24:314-22.