TY - JOUR
T1 - Elevated blood pressure, cardiometabolic risk and target organ damage in youth with overweight and obesity
AU - Di Bonito, Procolo
AU - Pacifico, Lucia
AU - Licenziati, Maria Rosaria
AU - Maffeis, Claudio
AU - Morandi, Anita
AU - Manco, Melania
AU - del Giudice, Emanuele Miraglia
AU - Di Sessa, Anna
AU - Campana, Giuseppina
AU - Moio, Nicola
AU - Baroni, Marco Giorgio
AU - Chiesa, Claudio
AU - De Simone, Giovanni
AU - Valerio, Giuliana
AU - Forziato, Claudia
AU - Gilardini, L.
AU - Loche, Sandro
AU - Tornese, Gianluca
N1 - Funding Information:
The following investigators belong to the CARdiometabolic risk factors in overweight and obese children in ITALY (CARITALY) study group:, Claudia Forziato, Pediatric Unit, ?S. Maria delle Grazie?, Pozzuoli Hospital, Naples, Italy. Francesca Franco, Pediatric Unit, AOU Udine, Udine, Italy. Luisa Gilardini, IRCCS Istituto Auxologico Italiano, Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Milan, Italy. Sandro Loche, Pediatric Endocrine Unit, Pediatric hospital for microcitemia, AO Brotzu, Cagliari, Italy. Gianluca Tornese, Institute for maternal and child health IRCCS ?Burlo Garofolo?, Trieste.
Publisher Copyright:
© 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9/24
Y1 - 2020/9/24
N2 - Background and aim: To compare cardiometabolic risk profile and preclinical signs of target organ damage in youth with normal and elevated blood pressure (BP), according to the American Academy of Pediatrics (AAP) guidelines. Methods and results: This cross-sectional multicenter study included 2739 youth (5-17 year-old; 170 normal-weight, 610 overweight and 1959 with obesity) defined non hypertensive by the AAP guidelines. Anthropometric, biochemical and liver ultrasound data were available in the whole population; carotid artery ultrasound and echocardiographic assessments were available respectively in 427 and 264 youth. Elevated BP was defined as BP ≥ 90th to <95th percentile for age, gender and height in children or BP ≥ 120/80 to <130/80 in adolescents. The overall prevalence of elevated BP was 18.3%, and significantly increased from normal-weight to obese youth. Young people with elevated BP showed higher levels of body mass index (BMI), insulin resistance and a higher prevalence of liver steatosis (45% vs 36%, p < 0.0001) than normotensive youth, whilst they did not differ for the other cardiometabolic risk factors, neither for carotid intima media thickness or left ventricular mass. Compared with normotensive youth, individuals with elevated BP had an odds ratio (95%Cl) of 3.60 (2.00–6.46) for overweight/obesity, 1.46 (1.19–1.78) for insulin-resistance and 1.45 (1.19–1.77) for liver steatosis, controlling for centers, age and prepubertal stage. The odds for insulin resistance and liver steatosis persisted elevated after correction for BMI-SDS. Conclusion: Compared to normotensive youth, elevated BP is associated with increased BMI, insulin resistance and liver steatosis, without significant target organ damage.
AB - Background and aim: To compare cardiometabolic risk profile and preclinical signs of target organ damage in youth with normal and elevated blood pressure (BP), according to the American Academy of Pediatrics (AAP) guidelines. Methods and results: This cross-sectional multicenter study included 2739 youth (5-17 year-old; 170 normal-weight, 610 overweight and 1959 with obesity) defined non hypertensive by the AAP guidelines. Anthropometric, biochemical and liver ultrasound data were available in the whole population; carotid artery ultrasound and echocardiographic assessments were available respectively in 427 and 264 youth. Elevated BP was defined as BP ≥ 90th to <95th percentile for age, gender and height in children or BP ≥ 120/80 to <130/80 in adolescents. The overall prevalence of elevated BP was 18.3%, and significantly increased from normal-weight to obese youth. Young people with elevated BP showed higher levels of body mass index (BMI), insulin resistance and a higher prevalence of liver steatosis (45% vs 36%, p < 0.0001) than normotensive youth, whilst they did not differ for the other cardiometabolic risk factors, neither for carotid intima media thickness or left ventricular mass. Compared with normotensive youth, individuals with elevated BP had an odds ratio (95%Cl) of 3.60 (2.00–6.46) for overweight/obesity, 1.46 (1.19–1.78) for insulin-resistance and 1.45 (1.19–1.77) for liver steatosis, controlling for centers, age and prepubertal stage. The odds for insulin resistance and liver steatosis persisted elevated after correction for BMI-SDS. Conclusion: Compared to normotensive youth, elevated BP is associated with increased BMI, insulin resistance and liver steatosis, without significant target organ damage.
KW - Adolescents
KW - Carotid intima media thickness
KW - Children
KW - Elevated blood pressure
KW - Left ventricular mass
KW - Liver steatosis
KW - Obesity
KW - Overweight
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U2 - 10.1016/j.numecd.2020.05.024
DO - 10.1016/j.numecd.2020.05.024
M3 - Article
C2 - 32736956
AN - SCOPUS:85088798041
VL - 30
SP - 1840
EP - 1847
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
SN - 0939-4753
IS - 10
ER -