1
|
Szczudlik E, Stępniewska A, Bik-Multanowski M, Brandt-Heunemann S, Flehmig B, Małecka-Tendera E, Mazur A, Petriczko E, Ranke MB, Wabitsch M, Zachurzok A, Wójcik M. The age of the obesity onset is a very important factor for the development of metabolic complications and cardiovascular risk in children and adolescents with severe obesity. Eur J Pediatr 2024:10.1007/s00431-024-05636-x. [PMID: 38877324 DOI: 10.1007/s00431-024-05636-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
Severe obesity defined as BMI value corresponding to an adult > 40 kg/m2 affects 1-5% of children and adolescents in Europe. The purpose of this study was to assess the occurrence of cardiovascular risk factors in children and adolescents with severe obesity. The analysis included 140 patients (75 female) at the mean age of 14 ± 2.1 SD (range 10-18) years (all recruited in 4 regional reference centers in Poland). Severe obesity was defined as BMI > 35 kg/m2 (children 6-14 years), and BMI > 40 kg/m2 (> 14 years). Fasting plasma samples have been obtained in all patients, and OGTT was performed in all patients. The metabolic risk factors were defined as high blood pressure (BP > 90 percentile for height, age, and sex), HDL cholesterol < 1.03 mmol/L, TG ≥ 1.7 mmol/L, and hyperglycemic state (fasting blood glucose > 5.6 mmol/L, or blood glucose 120' after oral glucose load > 7.8 mmol/L). Additionally, the MetS z-score was calculated using Metabolic Syndrome Severity Calculator. One hundred twenty-four (89%) participants presented with high BP, 117 (84%) with abnormal lipid profile, and 26 with the hyperglycemic. Only 12 (9%) were free of metabolic complications. More than 60% of patients had more than one cardiovascular risk factor. The high BP was significantly associated with the severity of obesity (F = 9.9, p = 0.002). Patients with at least one metabolic complication presented with significantly younger age of the onset of obesity (the mean age of the patients with no overt obesity complications was 10 years, while the mean age of those who presented at least one was 4.7 ± 3.5 SD years (p = 0.002)). A significant positive association between in the value of the Mets BMI z-score with age was observed (R = 0.2, p < 0.05). There were no differences between girls and boys regarding Mets BMI z-score (1.7 ± 0.8 vs 1.7 ± 0.7, p = 0.8).Conclusions: The most common metabolic risk factor in children and adolescents with severe obesity was high BP. The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity. What is Known? • It is estimated that 1-5% of children and adolescents in Europe suffer from severe obesity corresponding to an adult BMI > 40 kg/m2, and it is the fastest growing subcategory of childhood obesity. • Children with severe obesity face substantial health risk that may persist into adulthood, encompassing chronic conditions, psychological disorders and premature mortality. What is new: • The most common complication is high BP that is significantly associated with the severity of obesity (BMI z-score), contrary to dyslipidemia and hyperglycemic state, which do not depend on BMI z-score value. • The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity.
Collapse
Affiliation(s)
- Ewa Szczudlik
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland
| | - Anna Stępniewska
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland
| | - Mirosław Bik-Multanowski
- Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
- Institute of Human Genetics, University Hospital, LMU, Munich, Germany
| | - Stephanie Brandt-Heunemann
- Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | | | - Ewa Małecka-Tendera
- Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Elżbieta Petriczko
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Michael B Ranke
- Children's Hospital, University of Tübingen, Tübingen, Germany
| | - Martin Wabitsch
- Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - Agnieszka Zachurzok
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland.
| |
Collapse
|
2
|
Ding N, Li S, Zhou H, Tang Z, Gao T, Tian M, Liu C, Luo X, Chen H, Yu L, Chen Y, Yang L, Zhu L. Exploring the complex dynamics of BMI, age, and physiological indicators in early adolescents. BMC Pediatr 2024; 24:222. [PMID: 38561702 PMCID: PMC10983764 DOI: 10.1186/s12887-024-04680-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the relationship between body mass index (BMI) and blood biochemical indicators in early adolescence, and to provide ideas for early prevention of diseases and explore possible disease-related predictors. METHODS 3125 participants aged 10 ∼ 14 years were selected from China from the survey of "China Nutrition and Health Surveillance ( 2016 ∼ 2017 ) ". Employing advanced statistical methods, including generalized linear models, heatmaps, hierarchical clustering, and generalized additive models, the study delved into the associations between BMI and various biochemical indicators. RESULTS In early adolescence, indicators including systolic pressure, diastolic pressure, weight, height, BMI, hemoglobin, blood uric acid, serum creatinine, albumin, vitamin A presented increasing trends with the increase of age ( P < 0.05 ), whereas LDL-C, vitamin D, and ferritin showed decreasing trends with the increase of age ( P < 0.05 ). The increase in hemoglobin and blood uric acid levels with age was more pronounced in males compared to females ( P < 0.05 ). BMI was positively correlated with blood glucose, hemoglobin, triglyceride, LDL-C, blood uric acid, serum creatinine, ferritin, transferrin receptor, hs-CRP, total protein, vitamin A ( P < 0.05 ). There was a significant BMI × age interaction in the correlation analysis with LDL-C, transferrin receptor, serum creatinine, and hs-CRP ( P < 0.05 ). BMI was a risk factor for hypertension, hypertriglyceridemia, low high density lipoprotein cholesterolemia, and metabolic syndrome in all age groups ( OR > 1, P < 0.05 ). CONCLUSIONS High BMI was a risk factor for hypertension, hypertriglyceridemia, low high density lipoprotein cholesterolemia, and MetS in early adolescents. With the focus on energy intake beginning in early adolescence, the maintenance of a healthy weight warrants greater attention.
Collapse
Affiliation(s)
- Ning Ding
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Suyun Li
- Shandong Center for Disease Control and Prevention, Ji'nan, Jinan, Shandong, China
| | - Han Zhou
- Shandong Center for Disease Control and Prevention, Ji'nan, Jinan, Shandong, China
| | - Zhenchuang Tang
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Tianlin Gao
- School of Public Health, Qingdao University, Qingdao, China
| | - Meina Tian
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Changqing Liu
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Xiaoyan Luo
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Hongtong Chen
- Department of cardiothoracic Surgery, Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianlong Yu
- Shandong Center for Disease Control and Prevention, Ji'nan, Jinan, Shandong, China.
| | - Yao Chen
- People's Hospital of Rizhao, Rizhao, Shandong, China.
| | - Li Yang
- Jinan Center for Disease Control and Prevention, Jinan, Shandong, China.
| | - Lichao Zhu
- Department of Pediatric Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
| |
Collapse
|
3
|
Vandoni M, Marin L, Cavallo C, Gatti A, Grazi R, Albanese I, Taranto S, Silvestri D, Di Carlo E, Patanè P, Carnevale Pellino V, Zuccotti G, Calcaterra V. Poor Motor Competence Affects Functional Capacities and Healthcare in Children and Adolescents with Obesity. Sports (Basel) 2024; 12:44. [PMID: 38393264 PMCID: PMC10891969 DOI: 10.3390/sports12020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND From a young age, children learn different motor skills known as fundamental motor skills. The acquisition of these skills is crucial for the future development of context-tailored actions that could improve adherence to physical activity (PA) practice. Motor competence and function deficits have been associated with pediatric obesity. We reviewed the literature data regarding motor competence in pediatrics and impaired motor performance in children and adolescents with obesity. METHODS We assessed the abstracts of the available literature (n = 110) and reviewed the full texts of potentially relevant articles (n = 65) that were analyzed to provide a critical discussion. RESULTS Children and adolescents with obesity show impaired motor performance, executive functions, postural control, and motor coordination. Children's age represents a crucial point in the development of motor skills. Early interventions are crucial to preventing declines in motor proficiency and impacting children's PA and overall fitness levels. CONCLUSIONS To involve children, the PA protocol must be fun and tailored in consideration of several aspects, such as clinical picture, level of physical fitness, and motor skills. A supervised adapted exercise program is useful to personalized PA programs from an early pediatric age.
Collapse
Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Caterina Cavallo
- Department of Sport and Exercise Science, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg;
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Roberta Grazi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Ilaria Albanese
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Eleonora Di Carlo
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Pamela Patanè
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| |
Collapse
|
4
|
Lehman JR, Schuchman M, Mitchell E, Capone CA, Sethna CB. Hypertension after multisystem inflammatory syndrome in children (MIS-C). Pediatr Nephrol 2023; 38:4083-4091. [PMID: 37422605 DOI: 10.1007/s00467-023-06061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/20/2023] [Accepted: 06/08/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Multisystem inflammatory syndrome in children (MIS-C) is associated with SARS-CoV-2. Long-term consequences of MIS-C remain unknown. The objective was to describe the prevalence and clinical predictors of hypertension (HTN) and elevated blood pressure (BP) following MIS-C. METHODS A retrospective study of children ≤ 18 years admitted to a tertiary center with MIS-C was performed. HTN and elevated BP were classified as per the 2017 American Academy of Pediatrics Clinical Practice Guidelines and indexed to the 95th percentile. Data included demographics, inpatient clinical measures, and echocardiograms over 1-year follow-up. Data were analyzed using Kruskal-Wallis, chi-square, and logistic regression. RESULTS Among 63 children hospitalized with MIS-C (mean age 9.7 ± 4.2 years, 58.7% male, body mass index (BMI) z-score 0.59 ± 1.9), 14% had HTN, and 4% had elevated BP > 30 days post-hospitalization. Multivariate linear regression analysis showed that BMI z-score was significantly associated with higher mean systolic (β = 2.664, CI = 1.307-3.980, p < 0.001) and diastolic (β = 2.547, CI = 0.605-4.489, p = 0.012) BP index > 30 days post-hospitalization. Acute kidney injury (AKI) (23.8%) (OR = 2.977, CI = 1.778-4.987, p < 0.001), peak inpatient serum creatinine (OR = 2.524, CI = 1.344-4.740, p = 0.004), and maximum CRP (OR = 1.009, CI = 1.002-1.016, p = 0.014) were all associated with increased odds of post-hospitalization HTN. Left ventricular hypertrophy was present in 46% while hospitalized, compared to 10% at last follow-up. All had return of normal systolic function. CONCLUSIONS Post-hospitalization HTN and elevated BP may be associated with MIS-C. Children with greater BMI or AKI may be at greater risk for developing HTN after MIS-C. MIS-C follow-up requires careful BP monitoring and antihypertensive medication consideration. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Jake R Lehman
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Elizabeth Mitchell
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Division of Pediatric Cardiology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Christine A Capone
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Division of Pediatric Cardiology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Christine B Sethna
- The Feinstein Institutes for Medical Research, Manhasset, NY, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
- Division of Pediatric Nephrology, Cohen Children's Medical Center of New York, 269-01 76th Avenue, NY, 11040, New Hyde Park, USA.
| |
Collapse
|
5
|
Al-Daghri NM, Amer OE, Khattak MNK, Hussain SD, Alkhaldi G, Alfawaz HA, Elsaid MA, Sabico S. Attendance-Based Adherence and Outcomes of Obesity Management Program in Arab Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1449. [PMID: 37761410 PMCID: PMC10529466 DOI: 10.3390/children10091449] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to the lifestyle educational program and target outcomes, obesity, and hypertension. A total of 363 (nonadherent, N = 179; adherent, N = 184) Saudi school adolescents aged 12-18 were recruited from 60 schools in Riyadh City, Saudi Arabia. Anthropometrics, lipid profile, and blood glucose were measured at baseline and post-intervention. The level of adherence was based on the number of attended educational sessions, and participants were grouped accordingly into two groups: adherent group (attended ≥ 3 sessions) and nonadherent group (attended 1-2 sessions) out of a total of five sessions. Results demonstrated that significantly more participants in the adherent group achieved the primary program goal of reducing obesity indices [body weight, body mass index (BMI), and BMI z-score] than the nonadherent group. Additionally, among adherent obese participants, BMI z-score significantly decreased after the 12-month intervention (post-intervention: 1.5 ± 0.7 vs. baseline: 1.7 ± 0.6, p < 0.05), while the trend in BMI z-score modestly increased in the nonadherent obese participants post-intervention (post-intervention: 1.8 ± 0.7 vs. baseline: 1.7 ± 0.6, p > 0.05). Moreover, there was a substantial reduction in hypertension prevalence only in the adherent group (p = 0.003) and among adherent obese participants in particular (p = 0.03). Furthermore, adherence to session attendance was higher in girls than boys, which led to better outcomes among girls than boys. For the secondary outcomes, lipid profile indices increased in both groups, while no changes were observed in the glycemic profile. In conclusion, greater adherence to educational sessions achieved modest but favorable weight changes and improved blood pressure among obese adolescents. Future intervention studies should take into consideration the need to improve attendance to enhance adherence to the program among adolescents at risk.
Collapse
Affiliation(s)
- Nasser M. Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Osama E. Amer
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Malak N. K. Khattak
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Syed D. Hussain
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Ghadah Alkhaldi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Hanan A. Alfawaz
- Department of Food Science and Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Mohamed A. Elsaid
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| |
Collapse
|
6
|
Karam S, Cohen DL, Jaoude PA, Dionne J, Ding FL, Garg A, Tannor EK, Chanchlani R. Approach to Diagnosis and Management of Hypertension: A Comprehensive and Combined Pediatric and Adult Perspective. Semin Nephrol 2023; 43:151438. [PMID: 37951795 DOI: 10.1016/j.semnephrol.2023.151438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
The global prevalence of primary hypertension has been increasing both in children and in the adolescent and adult populations and can be attributed to changes in lifestyle factors with an obesity epidemic, increased salt consumption, and sedentary lifestyles. Childhood blood pressure is the strongest predictor of adult hypertension. Although hypertension in adults is associated strongly with an increased risk for cardiovascular disease, chronic kidney disease, and mortality, outcomes in children are defined less clearly. In adults, major guidelines agree on a threshold of less than 120/80 mm Hg as the optimal blood pressure (BP) and recommend a target of less than 130/80 mm Hg for treatment in most cases. In children, international pediatric guidelines recommend using thresholds based on the normative distribution of BP in healthy normal-weight children. Out-of-office BP assessment is extremely useful for confirming the diagnosis of hypertension and monitoring response to treatment. Lifestyle modifications are instrumental whether coupled or not with pharmacologic management. New agents such as nonsteroidal mineralocorticoid-receptor antagonists, aminopeptidase A inhibitors, aldosterone synthase inhibitors, and dual endothelin antagonists hold significant promise for resistant hypertension. The transition from pediatric to adult care can be challenging and requires careful planning and effective coordination within a multidisciplinary team that includes patients and their families, and pediatric and adult providers.
Collapse
Affiliation(s)
- Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, MN.
| | - Debbie L Cohen
- Renal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Pauline Abou Jaoude
- Division of Pediatric Nephrology, Hotel-Dieu de France-University Medical Center, Beirut, Lebanon
| | - Janis Dionne
- Division of Nephrology, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - FangChao Linda Ding
- Division of Nephrology, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Anika Garg
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Elliot Koranteng Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana; Renal Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Rahul Chanchlani
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
7
|
Mihuta MS, Paul C, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Stoian D. Unveiling the Silent Danger of Childhood Obesity: Non-Invasive Biomarkers Such as Carotid Intima-Media Thickness, Arterial Stiffness Surrogate Markers, and Blood Pressure Are Useful in Detecting Early Vascular Alterations in Obese Children. Biomedicines 2023; 11:1841. [PMID: 37509481 PMCID: PMC10376407 DOI: 10.3390/biomedicines11071841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Obese children present a higher cardio-metabolic risk. Measuring vascular biomarkers that assess the evolution of arterial stiffness, subclinical atherosclerosis, and hypertension in such patients could be helpful in the long term. We studied 84 children, aged from 6 to 18 years: 50 obese subjects, versus 34 of normal weight. Clinical examination involved: BMI, waist circumference, waist-to-height ratio, and detection of the presence of acanthosis nigricans and irregular menstrual cycles (the latter in adolescent girls). The carotid intima-media thickness (CIMT) was measured with the Aixplorer MACH 30 echography device. The pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures (i.e., SBP, DBP, cSBP, cDBP, and cPP) were acquired through a Mobil-O-Graph device. Obese subjects underwent body composition analysis with a Tanita BC-418. Blood tests were: HOMA-IR, lipid panel, uric acid, and 25-OH vitamin D. All vascular biomarkers presented increased values in obese subjects versus controls. The following cut-off values were significant in detecting obesity: for PWV > 4.6 m/s, cSBP > 106 mmHg for the <12-year-olds, PWV > 4.5 m/s and cSBP > 115 mmHg for the 12-15-year-olds, and PWV > 5 m/s, cSBP > 123 mmHg for the >15-year-olds. AIx is higher in obese children, regardless of their insulin resistance status. Waist circumference and waist-to-height ratio correlate to all vascular parameters. HOMA-IR is an independent predictor for all vascular parameters except CIMT. Cut-off values for PWV of >4.8 m/s, SBP > 125 mmHg, and a cSBP > 117 mmHg predicted the presence of acanthosis nigricans. Obese girls with irregular menses displayed significantly higher PWV, SBP, and DPB. Elevated levels of uric acid, LDL-c, non-LDL-c, triglycerides, and transaminases, and low levels of HDL-c and 25-OH vitamin D correlated with higher arterial stiffness and CIMT values. We conclude that CIMT and the markers of arterial stiffness are useful in the early detection of vascular damage in obese children.
Collapse
Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Andreea Borlea
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Dana Stoian
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| |
Collapse
|
8
|
Ortiz-Marrón H, Cabañas Pujadas G, Ortiz-Pinto MA, Martín García A, Matesanz Martínez C, Antonaya Martín MDC, Cortés Rico O, Galán I. Changes in general and abdominal obesity in children at 4, 6 and 9 years of age and their association with other cardiometabolic risk factors. Eur J Pediatr 2023; 182:1329-1340. [PMID: 36639534 PMCID: PMC10023764 DOI: 10.1007/s00431-022-04802-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023]
Abstract
Temporary changes in childhood obesity and their association with cardiometabolic risk factors have been receiving increased attention. The objective of this study was to evaluate changes in general (GO) and abdominal (AO) obesity in children from 4 to 9 years of age and their associations with cardiometabolic risk factors at 9 years of age. This study includes 1344 children from the Longitudinal Childhood Obesity Study (ELOIN). Physical examinations performed at 4, 6 and 9 years of age and a blood sample was only taken at 9 years of age. Changes in obesity from 4 to 9 years of age were estimated using Body Mass Index and waist circumference. Participants were classified into four groups according to GO and AO: (1) stable without obesity (no obesity at all three measurements); (2) remitting obesity at 9 years (obesity at 4 and/or 6 years but not at 9 years); (3) incident or recurrent obesity at 9 years (obesity only at 9 years, at 4 and 9 years or at 6 and 9 years); and (4) stable or persistent with obesity (obesity at 4, 6 and 9 years). Dyslipidemia and dysglycemia were defined by the presence of at least one altered parameter of the lipid or glycemic profile. Odds ratios (OR) were estimated using logistic regression. Compared with children without GO at all ages, those with persistent GO had an OR of 3.66 (95% CI: 2.06-6.51) for dyslipidemia, 10.61 (95% CI: 5.69-19.79) for dysglycemia and 8.35 (95% CI: 4.55-15.30) for high blood pressure. The associations were fairly similar in the case of AO, with ORs of 3.52 (95% CI: 1.96-6.34), 17.15 (95% CI: 9.09-32.34) and 8.22 (95% CI: 4.46-15.15), respectively, when comparing persistent versus stable without AO. Children with incident obesity at 9 years presented a moderate cardiometabolic risk that was nevertheless higher compared to those stable without obesity, whereas those with remitting obesity did not show any significant associations. CONCLUSION Incident, and especially, persistent obesity, is associated with an increased cardiometabolic risk. The very early prevention of obesity, with a focus on nutrition, physical activity and sedentary behaviour, as well as tracking growth from birth to age 5, should be a priority to prevent the burden of cardiometabolic disease with consequences for adulthood. WHAT IS KNOWN • General and abdominal obesity has been shown to be associated with other cardiometabolic risk factors such as dyslipidemia, insulin resistance and hypertension. • Temporary changes in obesity and their associations with cardiometabolic risk factors have not been sufficiently explored in childhood. WHAT IS NEW • Children with incident, and especially persistent, general and/or abdominal obesity, had an increased risk of dyslipidemia, dysglycemia and high blood pressure. •Remitting obesity was not associated with an increased cardiometabolic risk.
Collapse
Affiliation(s)
- Honorato Ortiz-Marrón
- Department of Epidemiology, General Directorate of Public Health, Ministry of Health, C/López de Hoyos, n° 35, 1st Floor, Community of Madrid, 28006, Madrid, Spain.
| | - Gloria Cabañas Pujadas
- Department of Epidemiology, General Directorate of Public Health, Ministry of Health, C/López de Hoyos, n° 35, 1st Floor, Community of Madrid, 28006, Madrid, Spain
| | | | - Aránzazu Martín García
- Clinical Analysis and Biochemistry Service, Puerta de Hierro University Hospital, Majadahonda, Community of Madrid, Spain
| | | | | | - Olga Cortés Rico
- Canillejas Health Center, Northern Area of Primary Care of Madrid, Community of Madrid, Madrid, Spain
| | - Iñaki Galán
- National Center for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| |
Collapse
|
9
|
Ge WX, Han D, Ding ZY, Yi LP, Yang ZQ, Wang XN, Xiao Y, Liang F, Hai B, Lv HL, Shen H, Yang HB, Yin JY, Hu J. Pediatric body mass index trajectories and the risk of hypertension among adolescents in China: a retrospective cohort study. World J Pediatr 2023; 19:76-86. [PMID: 36245067 DOI: 10.1007/s12519-022-00626-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/15/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The impact of pediatric body mass index (BMI) trajectories on the risk of adolescent hypertension (HTN) determined by three separate visits remains unclear. This longitudinal study aims to identify potential pediatric sex-specific BMI trajectories and to assess their associations with HTN and HTN subtypes. METHODS Based on the Health Promotion Program for Children and Adolescents (HPPCA) in Suzhou, China, a total of 24,426 participants who had initial normal blood pressure (BP) and had at least four BMI measurements during 2012-2020 were included. HTN was defined as simultaneously having three separate visits of elevated BP in 2020. Latent class growth models were used to explore sex-specific BMI trajectories, whose associations with HTN and HTN subtypes were further examined by logistic regression. RESULTS The incidence of HTN determined through three separate visits was 3.34%. Four trajectories were identified for both sexes: low BMI increasing, medium BMI increasing, high BMI increasing, and highest BMI increasing. Compared to the medium BMI increasing group, the odds ratio (95% confidential interval) for developing adolescent HTN of the low, high, and highest BMI increasing groups among boys were 0.54 (0.39, 0.75), 1.90 (1.44, 2.51), and 2.89 (1.90, 4.39), respectively; and the corresponding values for girls were 0.66 (0.48, 0.90), 2.30 (1.72, 3.09), and 4.71 (3.06, 7.26). Similar gradually elevated associations between different trajectories with isolated systolic hypertension, systolic and diastolic hypertension were observed. CONCLUSION Current results emphasized the adverse effects of stable high BMI on HTN and the benefits of maintaining normal weight throughout childhood.
Collapse
Affiliation(s)
- Wen-Xin Ge
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Di Han
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, China
| | - Zi-Yao Ding
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, China.,Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Li-Ping Yi
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
| | - Zhuo-Qiao Yang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Xin-Nan Wang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Yue Xiao
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Fei Liang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Bo Hai
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, China
| | - Hui-Ling Lv
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hui Shen
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, China.,State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.,Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China
| | - Hai-Bing Yang
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, China.,State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.,Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China
| | - Jie-Yun Yin
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
| | - Jia Hu
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, China. .,State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China. .,Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China.
| |
Collapse
|
10
|
Comparison of Glycosylated Haemoglobin, Blood Pressure, and Anthropometric Measurements Depending on Gender and Bodyweight State in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121922. [PMID: 36553365 PMCID: PMC9777222 DOI: 10.3390/children9121922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
Background/Objective: The greatest anthropometric and physiological changes occur during adolescence. Assessment of growth patterns is necessary to prevent future health risks. Aims: To describe the values of glycosylated haemoglobin (HbA1c), systolic (SBP) and diastolic (DBP) blood pressure, triceps skinfold, and abdominal circumference according to gender and age (between 12 and 17 years), as well as explore the differences between body weight conditions. Methods: A descriptive cross-sectional study was carried out, including 4130 adolescents between 12 and 17 years old. SBP and DBP, HbA1c, triceps skinfold, and abdominal circumference were evaluated. Results: Significant differences were observed between males and females for HbA1c (p < 0.001), SBP (p < 0.001), triceps curl (p < 0.001), and abdominal circumference (p < 0.001), independently of the age group. Regardless of gender and age groups, significant differences were observed between overweight/obese and normal-weight adolescents in SBP (p < 0.001), DBP (p < 0.001 to 0.009), triceps skinfold (p < 0.001), and abdominal perimeter (p < 0.001). Conclusions: Our findings revealed higher SBP, DBP, triceps skinfold, and abdominal circumference in overweight/obese adolescents compared to normal-weight adolescents in both genders.
Collapse
|
11
|
Gong QH, Li SX, Qian LJ, Wang SJ, Zhang Y, Zou ZQ. Effect of changes in body mass index and waist-to-height ratio on blood pressure in 11- to 13-year-old children: a prospective population study. Ann Hum Biol 2022; 49:280-290. [PMID: 36382866 DOI: 10.1080/03014460.2022.2148739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Existing evidence about associations between change in body mass index (BMI) and waist-to-height ratio (WHtR) change and high blood pressure are relatively limited. AIMS We aimed to investigate the associations of general overweight (based on BMI) and abdominal obesity (based on WHtR) change with high blood pressure in Chinese children. SUBJECTS AND METHODS A school-based cohort study in Ningbo region (China) was conducted among children with baseline evaluations in October 2016 with follow-up two years later. A total of 1432 children aged 11-13 years participated in this study. RESULTS Our results showed that a change from normal BMI or WHtR to overweight or abdominal obesity in children was associated with high blood pressure (adjusted odds ratio (AOR), 2.62; p<0.05 or AOR, 2.79; p<0.05, respectively). In addition, an increased risk of high blood pressure was observed in children who maintained overweight or abdominal obesity (AOR, 1.67; p<0.05 or AOR, 1.69; p<0.05, respectively), but not in children who experienced remission to non-excess weight. Interestingly, children who increased BMI or WHtR had greater impact on SBP than on DBP. CONCLUSION The 2-year longitudinal study indicated that general overweight or abdominal obesity can predict the risk factor of high blood pressure in children. However, children who remitted to non-excess weight did not exhibit an increased risk of high blood pressure.
Collapse
Affiliation(s)
- Qing-Hai Gong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Si-Xuan Li
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Li-Jia Qian
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Si-Jia Wang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Yan Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Zu-Quan Zou
- Beilun District Center for Disease Control and Prevention, Ningbo, China
| |
Collapse
|
12
|
Xu H, Wu L, Lu H, Sun Y, Wu D, He Y, Yu L, Peng H, Li H. Relationship between Gestational Weight Gain Rate Trajectory and Overweight in Offspring at Three Years of Age. Child Obes 2022; 18:540-547. [PMID: 35352949 DOI: 10.1089/chi.2021.0288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: The incidence of childhood obesity has increased rapidly, and its relationship with adult diseases is constantly being revealed. Maternal factors have been shown to play an important role in the growth and development of newborns. In this article, we explored the relationship between the gestational weight gain (GWG) rate and overweight/obesity in offspring at 3 years of age. Methods: A total of 5146 pregnant women and their children registered between January 2010 and December 2018 were studied by a retrospective cohort study. The Group-based Trajectory Model was used to distinguish the GWG rate patterns. Overweight/obesity was diagnosed by the weight-for-height Z-score at 3 years of age. Logistic regression was used to analyze the association between GWG rate patterns and outcomes. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated to analyze the association between GWG rate patterns and overweight/obesity in offspring at 3 years of age. Results: Three GWG rate growth patterns were identified in this study. The incidence of offspring overweight/obesity in the low-stable, high-stable, and low-sharp patterns was 8.33%, 3.68%, and 6.03% respectively. After adjusting covariates, compared with the low-stable pattern, the high-stable pattern increased the risk for offspring to be overweight/obesity at 3 years of age, with OR of 2.26 (95% CI, 1.31-3.90). However, the low-sharp pattern was not associated with overweight/obesity in offspring at 3 years of age. Conclusions: The high-stable increasing pattern of the GWG rate is a risk factor for overweight/obesity in offspring at 3 years of age.
Collapse
Affiliation(s)
- He Xu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Lei Wu
- Department of Maternal and Child Health, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Heng Lu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yexiu Sun
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Di Wu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yan He
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Lugang Yu
- Department of Maternal and Child Health, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, Jiangsu, China
| | - Hongmei Li
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, Jiangsu, China
| |
Collapse
|
13
|
Kim ST, Song YH. Nutrition, Body Composition, and Blood Pressure in Children and Adolescents from the Korea National Health and Nutrition Examination Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13272. [PMID: 36293851 PMCID: PMC9603145 DOI: 10.3390/ijerph192013272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
We aimed to investigate the association between nutrition and blood pressure and the role that body composition plays in this relationship. Korea National Health and Nutrition Examination Survey data from the years 2008-2020 were reviewed. A total of 11,234 subjects (5974 boys and 5260 girls) aged 10-18 years of age were selected. We analyzed the correlation between nutrition (intakes of energy, protein, fat, carbohydrate, sodium, saturated fatty acid (SFA), unsaturated fatty acid (USFA), and dietary fiber (DF)) and body composition (height, weight, waist circumference (WC), body mass index (BMI), and waist to height ratio (WHtR)), and performed multiple regression analysis to find the independent correlation between body composition and blood pressure (BP). We then compared the correlation between nutrition and BP, with or without adjustment for body composition. The intakes of energy, protein, fat, carbohydrate, sodium, and USFA had positive associations with height, weight, WC, and BMI. Systolic BP (SBP) and diastolic BP (DBP) were independently positively correlated with height and BMI. The intakes of energy, protein, fat, carbohydrate, sodium, and SFA had positive correlations with SBP and DBP, which disappeared when additionally adjusted for BMI and height. In conclusion, nutrition seems to affect BP via height and BMI in Korean children and adolescents.
Collapse
|
14
|
Santos LESD, Claro MDL, Carvalho DDS, Oliveira EAR, Silva ARVD, Machado ALG, Conde WL, Lima LHDO. Relationship between sexual maturation and anthropometric and blood pressure indicators in teenagers. CIENCIA & SAUDE COLETIVA 2022; 27:3615-3626. [PMID: 36000648 DOI: 10.1590/1413-81232022279.04622022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/12/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the relationship between sexual maturation and anthropometric and blood pressure indicators in teenagers. This was a population-based cross-sectional study, conducted with 345 teenagers, aged 10 to 19 years, between 2018 and 2020. In this study, data referent to sociodemographic and anthropometric variables, blood pressure, and sexual maturation were collected. The data analysis was performed by applying the Principle Component Analysis (PCA), which generated three components and then tested the correlation between sexual maturation and the generated components. Most of the teenagers were female (53%), normotensive (66.1%), and with a normal weight (73%). A positive correlation was found between breast development and component 1 and component 2, as well as a negative correlation between the breasts and component 3. In the boys, the development of genitals and pubic hair was positively correlated with component 2 and inversely correlated with component 3. It could therefore be concluded that there is a relationship between sexual maturation and the anthropometric and blood pressure indicators, which proved to be representative variables for cardiovascular risk in teenagers, even if not in their entirety.
Collapse
Affiliation(s)
- Luís Eduardo Soares Dos Santos
- Programa de Pós-Graduação em Ciências e Saúde, Universidade Federal do Piauí (UFPI). Campus Universitário Ministro Petrônio Portella s/n, Bairro Ininga. 64049-550 Teresina PI Brasil.
| | - Maísa de Lima Claro
- Programa de Pós-Graduação em Ciências e Saúde, Universidade Federal do Piauí (UFPI). Campus Universitário Ministro Petrônio Portella s/n, Bairro Ininga. 64049-550 Teresina PI Brasil.
| | | | | | - Ana Roberta Vilarouca da Silva
- Programa de Pós-Graduação em Ciências e Saúde, Universidade Federal do Piauí (UFPI). Campus Universitário Ministro Petrônio Portella s/n, Bairro Ininga. 64049-550 Teresina PI Brasil.
| | | | | | - Luisa Helena de Oliveira Lima
- Programa de Pós-Graduação em Ciências e Saúde, Universidade Federal do Piauí (UFPI). Campus Universitário Ministro Petrônio Portella s/n, Bairro Ininga. 64049-550 Teresina PI Brasil.
| |
Collapse
|
15
|
Santos LESD, Claro MDL, Carvalho DDS, Oliveira EAR, Silva ARVD, Machado ALG, Conde WL, Lima LHDO. Relationship between sexual maturation and anthropometric and blood pressure indicators in teenagers. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022279.04622022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to investigate the relationship between sexual maturation and anthropometric and blood pressure indicators in teenagers. This was a population-based cross-sectional study, conducted with 345 teenagers, aged 10 to 19 years, between 2018 and 2020. In this study, data referent to sociodemographic and anthropometric variables, blood pressure, and sexual maturation were collected. The data analysis was performed by applying the Principle Component Analysis (PCA), which generated three components and then tested the correlation between sexual maturation and the generated components. Most of the teenagers were female (53%), normotensive (66.1%), and with a normal weight (73%). A positive correlation was found between breast development and component 1 and component 2, as well as a negative correlation between the breasts and component 3. In the boys, the development of genitals and pubic hair was positively correlated with component 2 and inversely correlated with component 3. It could therefore be concluded that there is a relationship between sexual maturation and the anthropometric and blood pressure indicators, which proved to be representative variables for cardiovascular risk in teenagers, even if not in their entirety.
Collapse
|
16
|
Wang X, Dong Y, Huang S, Dong B, Ma J, Liang W. Change of weight status during school age and its association with late adolescent blood pressure: Results from a 15-year longitudinal study in China. Front Public Health 2022; 10:980973. [PMID: 36062130 PMCID: PMC9437432 DOI: 10.3389/fpubh.2022.980973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
Background Change in obesity risk could be related to shift in high blood pressure (HBP) risk, while individualized influence of weight change on high blood pressure is in need of exploration. Methods A total of 16,446 children (53.47% boys) and 13,9021 effective annual measurements from 2006 to 2020 were recruited. Children's weight status, both at baseline and endpoint, was categorized as underweight, normal, overweight, and obese according to the age and sex-specific Body Mass Index z scores. HBP at late adolescence was defined with the last two measurements for each child. Populational attributable risk (PAR) of weight trait on HBP risk was calculated. Results Compared to children who maintained normal weight during follow-up, staying obese was associated with the highest HBP risk with OR of 6.39 (95% CI: 4.46, 9.15; p < 0.001) and PAR of 28.71% (95% CI: 21.58, 35.54) in boys, and OR of 6.12 (95% CI: 2.80, 13.37; p < 0.001) and PAR of 12.75% (95% CI: 4.29, 21.02) in girls. Returning from obese to normal weight was associated with lowered HBP risk, with ORs of 1.07 (95% CI: 0.69, 1.66; p = 0.771) in boys and 0.73 (95% CI: 0.25, 2.12; p = 0.566) in girls. Conclusion Weight loss program could be effective to reduce HBP risk during school age, while the underlying mechanism needs further exploration.
Collapse
Affiliation(s)
- Xijie Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Sizhe Huang
- Zhongshan Health Care Center for Primary and Secondary Schools, Zhongshan, China
| | - Bin Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China,*Correspondence: Bin Dong
| | - Jun Ma
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Wannian Liang
| |
Collapse
|
17
|
Pausova Z. Distinct Trajectories of Overweight During Childhood and Elevated Blood Pressure at Late Adolescence. Hypertension 2022; 79:1614-1616. [PMID: 35861752 DOI: 10.1161/hypertensionaha.122.18990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Zdenka Pausova
- Departments of Physiology and Nutritional Sciences, The Hospital for Sick Children, University of Toronto, Canada
| |
Collapse
|
18
|
The Cardiovascular Disease (CVD) Risk Continuum from Prenatal Life to Adulthood: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148282. [PMID: 35886134 PMCID: PMC9317926 DOI: 10.3390/ijerph19148282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 02/06/2023]
Abstract
The risk of developing cardiovascular diseases (CVDs) arises from the interaction of prenatal factors; epigenetic regulation; neonatal factors; and factors that affect childhood and adolescence, such as early adiposity rebound (AR) and social and environmental influences. Thus, CVD risk varies between the group of low-risk metabolically healthy normal-weight subjects (MHNW); the intermediate-risk group, which includes metabolically healthy obese (MHO) and metabolically unhealthy normal-weight subjects (MUHNW); and the high-risk group of metabolically unhealthy obese (MUHO) subjects. In this continuum, several risk factors come into play and contribute to endothelial damage, vascular and myocardial remodeling, and atherosclerotic processes. These pathologies can occur both in prenatal life and in early childhood and contribute to significantly increasing CVD risk in young adults over time. Early intervention in the pediatric MUHO population to reduce the CVD risk during adulthood remains a challenge. In this review, we focus on CVD risk factors arising at different stages of life by performing a search of the recent literature. It is urgent to focus on preventive or early therapeutic strategies to stop this disturbing negative metabolic trend, which manifests as a continuum from prenatal life to adulthood.
Collapse
|
19
|
Hayashi T, Sato R, Ito Y, Ninomiya M, Tanaka S, Tamura K. High Blood Pressure and Changes in the Body Mass Index Category Among Japanese Children: A Follow-Up Study Using the Updated American Academy of Pediatrics Guidelines. Cureus 2022; 14:e26377. [PMID: 35911320 PMCID: PMC9329601 DOI: 10.7759/cureus.26377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background High blood pressure (HBP) has become a public health issue worldwide. The relationship between high BP and changes in the body mass index (BMI) category in Japanese pubertal children has not yet been examined. To resolve this issue, we examined existing data with a focus on the primordial prevention of high BP signs, including elevated BP, among pubertal children aged 12 and 15 years. Methods Height, body weight, and BP data were examined from health checkups of 18,247 children conducted between 1993 and 2000 in the Karatsu Study, which was a cohort of pediatric lifestyle-related disease prevention medical health checkups in Japan. BP and BMI were assessed using the updated American Academy of Pediatrics (AAP) guidelines and Endocrine Society’s clinical practice guidelines definitions, respectively. Results Follow-up data were obtained from 7,090 subjects (50.5% boys). Stage 2 hypertension (HTN) was detected in 3% and 2.7% of boys and girls aged 12 years, respectively, and in 2.7% and 1% of boys and girls aged 15 years, respectively. Among children aged 15 years, 1.4% were newly classified with stage 2 hypertension, and 15.6% exhibited improvements to a normal BP. A binomial logistic regression analysis of high BP and BMI category changes revealed odds ratios (OR) in the group with a deteriorated BMI category of 1.51 (95% confidence interval (CI), 1.17-1.94), 2.30 (95%CI, 1.66-3.17), and 6.83 (95%CI, 4.14-11.29) for elevated BP, stage 1 hypertension, and stage 2 hypertension, respectively. Conclusion High BP in puberty positively correlated with BMI category changes. Considering the presence of the tracking phenomenon in hypertension, BP monitoring is an essential part of the early strategy for the prevention of lifestyle-related diseases in childhood, and improvements in BP control are crucial in early life.
Collapse
|
20
|
Bai L, Zhou J, Tong L, Ding W. Association between body composition and blood pressure in normal-weight Chinese children and adolescents. BMC Pediatr 2022; 22:240. [PMID: 35501836 PMCID: PMC9063238 DOI: 10.1186/s12887-022-03289-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to assess the associations of body fat distribution and lean body mass (LBM) with blood pressure (BP) in normal-weight Chinese children and adolescents. Methods A total of 898 normal-weight Chinese children and adolescents, aged 10–18 years, were included this cross-sectional study via a cluster sampling method. The bioelectrical impedance analysis (BIA) was used to measure body composition. The participants were measured for blood pressure (BP) using a calibrated electronic sphygmomanometer according to the standard method by the "American Hypertension Education Project Working Group". Results Body composition was related to abnormal BP in normal-weight children and adolescents. After the model adjusted for age, smoking, and drinking, regression analysis showed that fat mass percentage (FMP) was negatively associated with abnormal BP, while LBM was positively associated with abnormal BP in boys(P < 0.05). Whereas FMP and visceral fat level (VFL) were positively associated with abnormal BP in girls (P < 0.05). Conclusions There are sex differences in the relationships between total body fat, visceral fat and lean body mass with abnormal BP in normal-weight youths. Therefore, it is of great significance to pay attention to the relative influence of the body composition of the boys and girls in the prevention and treatment of hypertension in youths.
Collapse
Affiliation(s)
- Ling Bai
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China
| | - Jinyu Zhou
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China
| | - Lingling Tong
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China
| | - Wenqing Ding
- School of Public Health and Management, Ningxia Medical University, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China. .,Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.
| |
Collapse
|
21
|
Gomwe H, Seekoe E, Lyoka P, Marange CS. Blood pressure profile of primary school children in Eastern Cape province, South Africa: prevalence and risk factors. BMC Pediatr 2022; 22:207. [PMID: 35421965 PMCID: PMC9009017 DOI: 10.1186/s12887-022-03221-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
Abstract Background The problem of cardiovascular diseases and lack of adequate information about the blood pressure profiles among children in South Africa has enormous consequences for public health and the general well-being of communities. Aim The aim of this study is to determine the blood pressure profiles and associated risk factors of primary school children in South Africa. Methods A cross sectional study was conducted among 876 children aged 9 to 14 years from 18 randomly selected schools in the Eastern Cape province of South Africa. Standardised blood pressure measuring instruments were used and an average of three readings was considered. Blood pressure status was classified according to the percentiles of systolic blood pressure (SBP). Results The overall prevalence of hypertension was 5.2% and pre-hypertension was 18.5% while normal blood pressure was 76.3%. The multilevel binary logistic regression’s crude and adjusted analysis revealed that increase in age was significantly associated with elevated BP in children ([crude OR = 1.17 [1.05 – 1.29] and [adjusted OR = 1.12 [1.01 – 1.25]). In addition, increase in BMI was significantly associated with elevated BP in children ([crude OR = 1.08 [1.04 – 1.12] and [adjusted OR = 1.06 [1.02 – 1.11]). There was no statistically significant association between elevated BP and gender for both the univariate and multivariate models. There was also no statistical significant risk for elevated BP associated with place of residence. Conclusions In this sampled population the established proportion of primary school children with elevated BP is of great concern. In addition, older children and those with high BMI (that is, overweight/obesity) were associated with elevated BP. Interventions towards promoting healthy lifestyles among school learners is a necessity if we are to prevent cardiovascular diseases.
Collapse
|
22
|
Kobayashi MA, Lee TK, St George SM, Lebron C, Dorcius D, Prado G, Messiah SE. Intergenerational cardiovascular disease risks among Hispanics living in the United States. Pediatr Obes 2022; 17:e12870. [PMID: 34751514 DOI: 10.1111/ijpo.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/02/2021] [Accepted: 09/20/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Few studies have assessed intergenerational associations of obesity and cardiovascular disease risks from parents to their children among Hispanic Americans. OBJECTIVES To assess intergenerational cardiovascular associations among Hispanic families. METHODS Using baseline data from an obesity-focused efficacy trial targeting Hispanic adolescents (n = 280) and their parents, we conducted a series of logistic regression analyses to investigate the effects of parental BMI and blood pressure on adolescents' BMI and blood pressure, respectively. RESULTS After adjusting for significant socio-demographic variables and adolescents' lifestyle behaviours, adolescents were more than twice as likely to be in the severely obese versus overweight range when their parents had obesity (vs. non-obese; OR = 2.55, 95% CI = 1.20, 5.39) and more than twice as likely to be in the severely obese versus obese weight range (OR = 2.44, 95% CI = 1.22, 4.87) when their parents had obesity. When compared to those with normal blood pressure, adolescents who had parents with elevated blood pressure/hypertension were more than twice as likely to have elevated blood pressure (OR = 2.05, 95% CI = 1.04, 4.00) or be classified as hypertensive stage 1/2 (OR = 2.81, 95% CI = 1.31, 6.01). CONCLUSIONS Both severe obesity and elevated blood pressure are highly associated among Hispanic parent-child dyads. Findings underscore the potential benefits of intervening with the family system.
Collapse
Affiliation(s)
- Marissa A Kobayashi
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Tae K Lee
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Cynthia Lebron
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - David Dorcius
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Sarah E Messiah
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas, Texas, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas, USA
| |
Collapse
|
23
|
Wang X, Hu J, Huang S, Yang Z, Dong Y, Dong B, Ma J, Liang W. Exploring Overweight Risk Trajectories During Childhood and Their Associations With Elevated Blood Pressure at Late Adolescence: a Retrospective Cohort Study. Hypertension 2022; 79:1605-1613. [PMID: 35094521 DOI: 10.1161/hypertensionaha.121.18714] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Overweight during childhood is significantly associated with higher risk of high blood pressure (HBP) in later life. However, recognition of critical intervention period is limited. We aimed to analyze the changes in overweight risk during school-age and its relationship with HBP. METHODS Seventeen thousand eight hundred sixteen school-aged children (53.9% boys) with a mean follow-up time of 8.2 years were involved. Children's overweight was defined as body mass index Z score ≥1 and was fitted with a group-based trajectory model. The 4 trajectories were labeled as constant low, high decreasing, low rising, and constant high according to the change of overweight risk during follow-up. Population-averaged logit model and log-binomial regression models were used to analyze HBP risk. Cox proportional hazard model was used to analyze the HBP incidence among distinct groups. RESULTS Children with higher overweight risk generally had higher HBP risk during follow-up. However, the HBP risk in low rising group was low at baseline and increased to 3.14 (95% CI, 2.54-3.88; P<0.001) for boys and 3.23 (95% CI, 2.08-5.01; P=0.004) for girls at end point, which were comparable to the relative risk in the constant high group (4.60 [95% CI, 4.02-5.27] for boys and 5.28 [95% CI, 3.94-7.07] for girls). CONCLUSIONS Findings of this study provide insights on patterns of overweight risks during childhood. Children with transition from normal to overweight during teen years would be high-risk in HBP incidence.
Collapse
Affiliation(s)
- Xijie Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China. (X.W., W.L.).,Institute for Healthy China, Tsinghua University, Beijing, China. (X.W., W.L.).,Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Australia (J.H.)
| | - Sizhe Huang
- Zhongshan Health Care Centers for Primary and Secondary School, Guangdong, China (S.H.)
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China (X.W., Z.Y., Y.D., B.D., J.M.)
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China. (X.W., W.L.).,Institute for Healthy China, Tsinghua University, Beijing, China. (X.W., W.L.)
| |
Collapse
|
24
|
Corken A, Thakali KM. Maternal Obesity Programming of Perivascular Adipose Tissue and Associated Immune Cells: An Understudied Area With Few Answers and Many Questions. Front Physiol 2022; 12:798987. [PMID: 35126181 PMCID: PMC8815821 DOI: 10.3389/fphys.2021.798987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022] Open
Abstract
At present, the worldwide prevalence of obesity has become alarmingly high with estimates foreshadowing a continued escalation in the future. Furthermore, there is growing evidence attributing an individual’s predisposition for developing obesity to maternal health during gestation. Currently, 60% of pregnancies in the US are to either overweight or obese mothers which in turn contributes to the persistent rise in obesity rates. While obesity itself is problematic, it conveys an increased risk for several diseases such as diabetes, inflammatory disorders, cancer and cardiovascular disease (CVD). Additionally, as we are learning more about the mechanisms underlying CVD, much attention has been brought to the role of perivascular adipose tissue (PVAT) in maintaining cardiovascular health. PVAT regulates vascular tone and for a significant number of individuals, obesity elicits PVAT disruption and dysregulation of vascular function. Obesity elicits changes in adipocyte and leukocyte populations within PVAT leading to an inflammatory state which promotes vasoconstriction thereby aiding the onset/progression of CVD. Our current understanding of obesity, PVAT and CVD has only been examined at the individual level without consideration for a maternal programming effect. It is unknown if maternal obesity affects the propensity for PVAT remodeling in the offspring, thereby enhancing the obesity/CVD link, and what role PVAT leukocytes play in this process. This perspective will focus on the maternal contribution of the interplay between obesity, PVAT disruption and CVD and will highlight the leukocyte/PVAT interaction as a novel target to stem the tide of the current obesity epidemic and its secondary health consequences.
Collapse
Affiliation(s)
- Adam Corken
- Arkansas Children’s Nutrition Center, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Keshari M. Thakali
- Arkansas Children’s Nutrition Center, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- *Correspondence: Keshari M. Thakali,
| |
Collapse
|
25
|
Haddad LSP, Fernandes KA, Lopes GB, Veloso FBR, Caniçali SC, Poton WL. Determinantes antropométricos da pressão arterial elevada em escolares do ensino fundamental. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2021. [DOI: 10.5712/rbmfc16(43)2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introdução: A hipertensão arterial infantil vem recebendo atenção especial dos pediatras, pois o aumento da pressão arterial na infância contribui para o início precoce da hipertensão arterial essencial na idade adulta e para a mortalidade por doenças cardiovasculares. As medidas antropométricas têm sido úteis para o diagnóstico de sobrepeso e obesidade na infância, e tais condições são consideradas de risco para hipertensão arterial na idade adulta. Quanto mais precoce a identificação desses fatores de risco, seja no ambiente escolar, seja nos serviços de saúde, mais ações preventivas poderão ser desenvolvidas para minimizar tal problemática. Objetivo: Identificar a incidência de pressão arterial elevada e sua associação com medidas antropométricas em escolares do ensino fundamental. Métodos: Estudo longitudinal com 1.116 escolares; destes, 133 participaram de três avaliações no período de 2017 a 2019. As informações demográficas, as medidas antropométricas (peso, altura, circunferência abdominal, índice de massa corporal) e as pressóricas (sistólica e diastólica ajustadas de acordo com os parâmetros do Centro de Controle e Prevenção de Doenças para sexo e idade) foram registradas em formulário. A associação das variáveis com a pressão arterial elevada foi analisada por meio da regressão de Poisson, com ajuste robusto da variância. Resultados: Dos estudantes, 51,6% eram meninos com, em média, 7,9 anos, e 45,4% tinham pressão arterial elevada conforme os critérios do Centro de Controle e Prevenção de Doenças. Entre os que apresentaram circunferência abdominal elevada, 19,4% evoluíram de pressão sistólica normal para elevada e 35,5% de pressão diastólica normal para elevada ao longo dos três anos de acompanhamento. Nos escolares com sobrepeso ou obesidade, a pressão sistólica normal evoluiu para elevada em 20,7 e 21,2%, respectivamente, e a pressão diastólica normal evoluiu para elevada em 24,1 e 42,4%, respectivamente. Os escolares com circunferência abdominal (risco relativo – RR 1,51; intervalo de confiança – IC95% 1,20–1,91; RR 1,58; IC95% 1,25–2,00), peso (RR 1,37; IC95% 1,08–1,74; RR 1,34; IC95% 1,05–1,71) e índice de massa corporal elevado (RR 1,51; IC95% 1,21–1,87; RR 1,50; IC95% 1,20–1,88) apresentaram maior risco para hipertensão sistólica e diastólica, respectivamente. Conclusão: A circunferência abdominal, o peso e o índice de massa corporal estiveram associados com o aumento da pressão arterial sistólica e diastólica nos escolares, e o risco foi maior entre os que tinham circunferência abdominal aumentada.
Collapse
|
26
|
Pool LR, Krefman AE, Labarthe DR, Greenland P, Juonala M, Kähönen M, Lehtimäki T, Day RS, Bazzano LA, Van Horn L, Liu L, Fernandez-Alonso C, Webber LS, Pahkala K, Laitinen TT, Raitakari OT, Lloyd-Jones DM, Allen NB. The Timing and Sequence of Cardiovascular Health Decline. Am J Prev Med 2021; 61:545-553. [PMID: 34238623 DOI: 10.1016/j.amepre.2021.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Childhood declines in cardiovascular health have been linked to the development of subclinical atherosclerosis; however, less is known about the timing and sequence of the decline of the specific cardiovascular health components. The study objective is to identify the patterns of decline and associations with adulthood subclinical atherosclerosis. METHODS Data were pooled from 5 cardiovascular cohorts. Clinical components of cardiovascular health (BMI, blood pressure, cholesterol, and blood glucose) were categorized as ideal or nonideal using American Heart Association definitions. Multitrajectory models simultaneously fitted the probability ideal for each factor. Adjusted associations between trajectory groups and carotid intima-media thickness were modeled. Data were pooled from December 1, 2015 to June 1, 2019; statistical analysis occurred between June 1, 2019 and June 1, 2020. RESULTS This study included 9,388 individuals (55% female, 66% White). A total of 5 distinct trajectory groups were created: 1 maintained the ideal levels of all the 4 health factors, 2 had risk onset of a single factor in childhood, 1 had risk onset of multiple factors in childhood, and 1 had risk onset in adulthood. Those with childhood multiple risk onset had 8.1% higher carotid intima-media thickness (95% CI=0.067, 0.095) than those in the ideal group, childhood cholesterol risk onset had 5.9% higher carotid intima-media thickness (95% CI=0.045, 0.072), childhood BMI risk onset had 5.5% higher carotid intima-media thickness (95% CI=0.041, 0.069), and early adulthood multiple risk onset had 2.7% higher carotid intima-media thickness (95% CI=0.013, 0.041). CONCLUSIONS Those who lost the ideal status of cardiovascular health in childhood and early adulthood had more subclinical atherosclerosis than those who retained the ideal cardiovascular health across the life course, underscoring the importance of preserving the ideal cardiovascular health beginning in childhood and continued into adulthood.
Collapse
Affiliation(s)
- Lindsay R Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Amy E Krefman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Darwin R Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland; Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; Department of Clinical Chemistry, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Rena Sue Day
- Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lei Liu
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Camilo Fernandez-Alonso
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Larry S Webber
- Department of Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Health and Physical Activity, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Health and Physical Activity, University of Turku, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
27
|
Abstract
Pediatric hypertension is becoming of increasing concern as the incidence rate increases alongside pediatric obesity. Practitioners need to be aware of the screening recommendations for early recognition and management of this disorder. Lifestyle modifications should be addressed early and specialty referral considered if the child is not improving. Further work-up to rule out secondary causes of pediatric hypertension should also be considered in any child with stage 2 hypertension and in those with persistently elevated blood pressures. Early recognition and management are key to not only preventing present complications but also future cardiovascular disease in adulthood.
Collapse
Affiliation(s)
- Christopher Fox
- University of Missouri-Kansas City, School of Medicine, Kansas City, MO, USA; Department of Community and Family Medicine, Truman Medical Centers, Kansas City, MO, USA.
| |
Collapse
|
28
|
Tocci ND, Collier SR, Meucci M. Measures of ejection duration and subendocardial viability ratio in normal weight and overweight adolescent children. Physiol Rep 2021; 9:e14852. [PMID: 33991440 PMCID: PMC8123553 DOI: 10.14814/phy2.14852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/29/2021] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
The aim of our study was to determine how being overweight (OW) affects measures of ejection duration (ED), subendocardial viability ratio (SEVR), and central arterial health in a sample of adolescent children. Thirty‐four sex and age‐matched adolescent children (n = 34, 17 OW, age = 14 ± 2 years) participated in one laboratory visit. Anthropometric measures, body composition, and cardiovascular measures including resting heart rate, aortic systolic blood pressure (ASBP), carotid‐femoral pulse wave velocity (cf‐PWV), ED (EDms absolute vs. relative ED%), and the SEVR were ascertained. Transfer functions were applied to obtain ASBP. ED was measured as the time from the beginning of the upstroke of the pulse wave and the dicrotic notch, SEVR as the quotient of the diastolic pressure‐time area to the systolic pressure‐time area, and cf‐PWV as the quotient of distance between carotid‐femoral measurement sites and the transit time of the pulse wave. cf‐PWV was significantly higher in OW compared to normal weight participants (5.13 ± 0.85 vs. 4.53 ± 0.46 m/s respectively; p = 0.015, d = 0.51). OW adolescents also reported significantly higher values for ASBP (103.1 ± 11.8 vs. 95.7 ± 8.2 mmHg respectively; p = 0.043, d = 0.72) and significantly lower values of SEVR (114.4 ± 25.9% vs. 132.2 ± 22.0% respectively; p = 0.038; d = 0.33). Overweight adolescents demonstrated higher cf‐PWV, ASBP, and SEVR then normal weight peers.
Collapse
Affiliation(s)
- Nicholas D Tocci
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Scott R Collier
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Marco Meucci
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| |
Collapse
|
29
|
Life-Course Implications of Pediatric Risk Factors for Cardiovascular Disease. Can J Cardiol 2021; 37:766-775. [PMID: 33581191 DOI: 10.1016/j.cjca.2021.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/19/2022] Open
Abstract
The concept that origins of cardiovascular disease (CVD) begin in childhood is supported by substantial evidence. Prospective studies beginning in childhood report associations of childhood obesity, abnormal blood pressure (BP), dyslipidemia, diabetes, and tobacco use with intermediate CVD markers, including left ventricular hypertrophy and vascular stiffness in young adulthood. Trajectory analyses from longitudinal studies describe discrete BP pathways from childhood to young adult status of hypertension and prehypertension. Among individuals with familial hypercholesterolemia, abnormal low-density lipoprotein cholesterol levels are present in childhood. Some children are at risk for future CVD owing to hereditary factors, psychosocial stress, race, low birth weight, or other nonmodifiable exposures. Behavioural factors, including suboptimal diet, sedentary activity, and tobacco use, in childhood augment risk and can be modified to reduce risk. Pharmacologic treatments are reserved for those at high levels of the BP and cholesterol distributions and for those with diabetes and additional risk factors.
Collapse
|
30
|
Pileggi C, Papadopoli R, De Sarro C, Nobile CGA, Pavia M. Obesity, Blood Pressure, and Intraocular Pressure: A Cross-Sectional Study in Italian Children. Obes Facts 2021; 14:169-177. [PMID: 33794545 PMCID: PMC8138192 DOI: 10.1159/000514096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/23/2020] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Several studies in the adult population have shown that obesity is an independent risk factor for elevated intraocular pressure (IOP), whereas data in the paediatric population are sparse and controversial. The purpose of the present study is to investigate the relationship between body mass index (BMI), blood pressure (BP), and IOP in healthy school children. METHODS The survey was conducted among a random sample of 8-year-old Italian students. Data were collected on their health status and behaviours related to obesity (physical activity, food and drinking habits, etc.). Physical examinations, conducted at school, included measurements of height, weight, BP, and IOP. RESULTS Five hundred and seventy-six subjects were recruited (92.8% response rate); 42.4% were overweight or obese, 58.9% consumed inadequate daily servings of fruit and vegetables, and 87.5% were involved in sedentary activities. Elevated BP/hypertension (HTN) affected 3.6% and high IOP was revealed in 12.5% of the children. In the multivariate analysis, elevated BP/HTN was the only significant determinant of ocular HTN (OR 5.36, 95% CI 1.95-14.73, p = 0.001). CONCLUSIONS Our results show that high IOP affects 12.5% of 8-year-old school children and appears to be associated with high BP related to a high BMI.
Collapse
Affiliation(s)
- Claudia Pileggi
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Rosa Papadopoli
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Caterina De Sarro
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | | | - Maria Pavia
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
31
|
Kaelber DC, Localio AR, Ross M, Leon JB, Pace WD, Wasserman RC, Grundmeier RW, Steffes J, Fiks AG. Persistent Hypertension in Children and Adolescents: A 6-Year Cohort Study. Pediatrics 2020; 146:peds.2019-3778. [PMID: 32948657 PMCID: PMC7786824 DOI: 10.1542/peds.2019-3778] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine the natural history of pediatric hypertension. METHODS We conducted a 72-month retrospective cohort study among 165 primary care sites. Blood pressure measurements from two consecutive 36 month periods were compared. RESULTS Among 398 079 primary care pediatric patients ages 3 to 18, 89 347 had ≥3 blood pressure levels recorded during a 36-month period, and 43 825 children had ≥3 blood pressure levels for 2 consecutive 36-month periods. Among these 43 825 children, 4.3% (1881) met criteria for hypertension (3.5% [1515] stage 1, 0.8% [366] stage 2) and 4.9% (2144) met criteria for elevated blood pressure in the first 36 months. During the second 36 months, 50% (933) of hypertensive patients had no abnormal blood pressure levels, 22% (406) had elevated blood pressure levels or <3 hypertensive blood pressure levels, and 29% (542) had ≥3 hypertensive blood pressure levels. Of 2144 patients with elevated blood pressure in the first 36 months, 70% (1492) had no abnormal blood pressure levels, 18% (378) had persistent elevated blood pressure levels, and 13% (274) developed hypertension in the second 36-months. Among the 7775 patients with abnormal blood pressure levels in the first 36-months, only 52% (4025) had ≥3 blood pressure levels recorded during the second 36-months. CONCLUSIONS In a primary care cohort, most children initially meeting criteria for hypertension or elevated blood pressure had subsequent normal blood pressure levels or did not receive recommended follow-up measurements. These results highlight the need for more nuanced initial blood pressure assessment and systems to promote follow-up of abnormal results.
Collapse
Affiliation(s)
- David C. Kaelber
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Center for Clinical Informatics Research and Education and,Departments of Internal Medicine, Pediatrics, Population and Quantitative Health Sciences, The MetroHealth System, Case Western Reserve University, Cleveland, Ohio
| | - A. Russell Localio
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michelle Ross
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Janeen B. Leon
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Center for Clinical Informatics Research and Education and
| | - Wilson D. Pace
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,American Academy of Family Physicians, National Research Network, Leawood, Kansas
| | - Richard C. Wasserman
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, Illinois;,Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Robert W. Grundmeier
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, Illinois;,The Pediatric Research Consortium, Philadelphia, Pennsylvania;,Department of Biomedical and Health Informatics, Philadelphia, Pennsylvania;,Center for Pediatric Clinical Effectiveness, Philadelphia, Pennsylvania; and,PolicyLab at The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jennifer Steffes
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, Illinois
| | - Alexander G. Fiks
- Comparative Effectiveness Research through Collaborative Electronic Reporting Consortium Research Team, Elk Grove Village, Illinois;,Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, Illinois;,The Pediatric Research Consortium, Philadelphia, Pennsylvania;,Department of Biomedical and Health Informatics, Philadelphia, Pennsylvania;,Center for Pediatric Clinical Effectiveness, Philadelphia, Pennsylvania; and,PolicyLab at The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| |
Collapse
|
32
|
The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res 2020; 42:1235-1481. [PMID: 31375757 DOI: 10.1038/s41440-019-0284-9] [Citation(s) in RCA: 997] [Impact Index Per Article: 249.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
33
|
Association of Weight Loss from Early to Middle Adulthood and Incident Hypertension Risk Later in Life. Nutrients 2020; 12:nu12092622. [PMID: 32872103 PMCID: PMC7551896 DOI: 10.3390/nu12092622] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 12/11/2022] Open
Abstract
Background: The effect of obesity in early adulthood and weight loss on incident hypertension in older age has not been well characterized. This study aimed to examine the association of weight loss from young adulthood to midlife with risk of incident hypertension later in life. Methods: We performed a retrospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES). Five weight change groups were categorized: stable normal, weight loss, weight gain, maximum overweight and stable obese. The hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between weight change and risk of hypertension in later life were estimated using Cox regression models. Results: Compared with participants who maintained normal weight, the stable obese, weight gain, maximum overweight and weight loss groups exhibited significantly higher risks of incident hypertension, with HR of 3.28 (95% CI = 2.71 to 3.96), 2.93 (95% CI = 2.62 to 3.28), 1.76 (95% CI = 1.55 to 2.00) and 1.97 (95% CI = 1.17 to 3.31), respectively. We also observed a lower risk among those in the weight loss group (HR = 0.60, 95% CI = 0.35 to 1.02) compared with those who were stable obese. Conclusions: Weight loss from early to middle adulthood was associated with lower risk of incident hypertension as compared to those who stayed obese and higher risk of incident hypertension as compared to those who maintained normal weight. Thus, maintaining normal weight throughout adulthood may be important for the primary prevention of hypertension.
Collapse
|
34
|
Fan H, Zhang X. Body mass index trajectory across childhood and subsequent risk of elevated blood pressure. J Clin Hypertens (Greenwich) 2020; 22:1902-1907. [PMID: 33245623 DOI: 10.1111/jch.14001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/25/2020] [Accepted: 07/26/2020] [Indexed: 12/26/2022]
Abstract
We investigated the relationship between the body mass index (BMI) trajectory across childhood and the subsequent occurrence of elevated blood pressure (BP) in the Chinese pediatric population. The study cohort from the China Health and Nutrition Survey comprised 1484 children, each of whom underwent three BP and BMI assessments during childhood and had a non-elevated BP during the first childhood assessment. A group-based trajectory model was used to identify four distinct BMI trajectories across childhood: lean-stable increase, medium-marked increase, heavy marked decrease, and heavy marked increase. Elevated BP in childhood was as defined in the China's national BP reference for children. Covariate-adjusted logistic regression models were used to assess the associations of BMI trajectories with elevated BP. Overall, 27.6% of all participants between 3 and 13 years of age during the first childhood assessment developed elevated BP during a mean 6.5-year follow-up. Compared with participants in the lean-stable increase group, those in the medium-marked increase and heavy marked increase groups were more likely to have elevated BP (odds ratio [95% confidence interval], OR [95% CI]: 1.46 [1.08, 1.96] and 5.29 [2.44, 11.48], respectively; Ps < .05). The OR for the heavy marked decrease group was not statistically significant (OR [95% CI]: 1.58 [0.80, 3.13]; P = .192). In summary, distinct BMI trajectories conferred significantly different odds of elevated BP upon children, thus underscoring the importance of weight management in early life.
Collapse
Affiliation(s)
- Hui Fan
- Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China
| | - Xingyu Zhang
- Applied Biostatistics Laboratory, University of Michigan School of Nursing, Ann Arbor, MI, USA
| |
Collapse
|
35
|
Brasil I, Monteiro W, Lima T, Seabra A, Farinatti P. Effects of judo training upon body composition, autonomic function, and cardiorespiratory fitness in overweight or obese children aged 8- to 13 years. J Sports Sci 2020; 38:2508-2516. [PMID: 32646282 DOI: 10.1080/02640414.2020.1792189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Physical training is recommended for obese paediatric populations. We investigated the effects of recreational judo training (JT) upon body composition and distribution, cardiorespiratory fitness, and heart rate variability (HRV) in overweight or obese children. A controlled trial (RBR-9d94td) was conducted with 35 children (8-13 years) assigned into groups according to their body mass index (BMI): eutrophic (EU; n = 15; z-BMI ≤ +l and ≥ -2) and overweight or obese (OB; n = 20; z-BMI > +1 and ≤ +3). The 12-week JT included 60-min sessions performed 2 times/week at 65-75% maximal heart rate (HR). BMI, waist circumference, blood pressure, HRV, peak oxygen uptake (VO2peak), gas exchange threshold (GET), and body fractioning were assessed. Significant reductions in OB (P < 0.05) occurred for whole body and trunk fat (~3%), trunk/limb fat-ratio (~4%), resting HR (~3%), and sympathovagal balance (log LF:HF, ~85%). Increases (P < 0.05) occurred in lean mass (~8%), parasympathetic modulation (log HF, ~4%), VO2peak (~5-10%), and VO2 (~15%), speed (~10%) and slope (~13%) at GET. Markers of cardiorespiratory fitness (relative VO2, slope and speed at GET) in OB approached EU after JT. In conclusion, a relatively short JT intervention to improved body composition, autonomic modulation, and physical fitness in obese children.
Collapse
Affiliation(s)
- Iedda Brasil
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil
| | - Walace Monteiro
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University , Niterói, Brazil
| | - Tainah Lima
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil
| | - André Seabra
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto , Porto, Portugal
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University , Niterói, Brazil
| |
Collapse
|
36
|
Zhao M, Bovet P, Xi B. Weight Status Change From Adolescence to Young Adulthood and the Risk of Hypertension and Diabetes Mellitus. Hypertension 2020; 76:583-588. [PMID: 32594799 DOI: 10.1161/hypertensionaha.120.14882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
It is still unclear whether the risk of hypertension and diabetes mellitus in adulthood remains increased if excess weight in adolescence recedes later in life. This study examines the effect of change in weight status from adolescence to young adulthood on the risk of hypertension and diabetes mellitus. A total of 4454 adolescents aged 12 to 19 years from the US National Longitudinal Study of Adolescent Health (1994-1995) were followed up to young adulthood (25-32 years, 2007-2008). After a median follow-up time of 13 years, compared with normal weight in both adolescence and young adulthood (n=1328, 29.8%), excess weight in the 2 periods (n=1077, 24.2%) was associated with an increased risk of hypertension (odds ratio, 3.72 [95% CI, 2.86-4.84]) and diabetes mellitus (3.32 [2.11-5.21]). Normal weight in adolescence but excess weight in young adulthood (n=1983, 44.5%) was associated with a lower but still significant risk of hypertension (2.49 [1.98-3.15]) and diabetes mellitus (1.59 [1.01-2.51]). In contrast, the risk of hypertension (1.37 [0.64-2.95]) and diabetes mellitus (1.65 [0.45-6.05]) was low in the few participants with excess weight in adolescence but normal weight in young adulthood (n=66, 1.5%). In conclusion, excess weight in young adulthood was associated with an increased risk of hypertension and diabetes mellitus, irrespective of weight status in adolescence. In contrast, excess weight in adolescence but normal weight in young adulthood did not seem to be associated with an increased cardiovascular risk in young adulthood.
Collapse
Affiliation(s)
- Min Zhao
- From the Department of Nutrition and Food Hygiene (M.Z.), School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Pascal Bovet
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland (P.B.)
| | - Bo Xi
- Department of Epidemiology (B.X.), School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| |
Collapse
|
37
|
The prevalence of overweight and obesity in Irish children between 1990 and 2019. Public Health Nutr 2020; 23:2512-2520. [DOI: 10.1017/s1368980020000920] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:The present study aimed to examine the temporal prevalence of overweight and obesity in Irish children through different methodologies and evaluate the change in rates between 1990 and 2019.Design:Anthropometric data from three Irish national food consumption surveys were used to examine the change in the prevalence of BMI and waist circumference-derived overweight and obesity levels.Setting:Three cross-sectional food consumption surveys from the Republic of Ireland: the Irish National Nutrition Survey (1990), the National Children’s Food Survey (2005) and The Second National Children’s Food Survey (2019).Participants:A demographically representative sample of Irish children aged 5–12 years: 1990 (n 148), 2005 (n 594) and 2019 (n 596).Results:Twelve percentage of children had overweight/obesity in 1990, which was significantly higher in 2005 at 25 % and significantly lower in 2019 at 16 % (P = 0·003). In 2019, more girls had overweight/obesity in comparison with boys (19 v. 14 %), whilst children from the lowest social class group had the highest levels of overweight/obesity (P = 0·019). Overall, the proportion of children with abdominal overweight/obesity was significantly lower in 2019 in comparison with 2005 (P ≤ 0·001).Conclusions:Evidence from the most recent national survey suggests that overweight and obesity levels are plateauing and in some cases reducing in children in Ireland. Despite this, rates remain high, with the highest prevalence in 2019 observed in girls and in those from the lowest social class group. Thus, overweight/obesity prevention and intervention policies are necessary and should be continued.
Collapse
|
38
|
Bendor CD, Bardugo A, Pinhas-Hamiel O, Afek A, Twig G. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovasc Diabetol 2020; 19:79. [PMID: 32534575 PMCID: PMC7293793 DOI: 10.1186/s12933-020-01052-1] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023] Open
Abstract
Severe obesity among children and adolescents is a significant global public health concern. The prevalence has markedly increased over the last decades, becoming common in many countries. Overwhelming rates of obesity among youth have prompted efforts to identify an evidence-based immediate- and long-term cardiometabolic risk factor profile in childhood-onset severe obesity, and to highlight gaps that require further investigation. The PubMed database was systematically searched in accordance with PRISMA guidelines. The search yielded 831 results, of which 60 fulfilled stringent criteria and were summarized in this review. The definition of severe obesity was variable, with only one half the publications using the definition BMI > 120% of the 95th percentile. Point estimates of the prevalence of at least one cardiometabolic risk factor in children with severe obesity reportedly range from 67 to 86%. Cross-sectional studies indicate that children and adolescents with severe obesity are at greater risk than those with mild obesity for type 2 diabetes, hypertension, fatty liver disease and dyslipidemia, already at childhood and adolescence. Robust epidemiological data on the long-term risk and actual point estimates in adulthood are lacking for these diseases as well as for other diseases (coronary heart disease, stroke, chronic kidney disease and cancer). Recent longitudinal studies indicate an increased risk for cardiomyopathy, heart failure, cardiovascular mortality and all-cause mortality in adulthood for adolescents with severe obesity compared to those with mild obesity. Given the alarming increase in the prevalence of severe obesity, the persistence of adiposity from childhood to adulthood and the precarious course of young adults with chronic comorbidities, the economic and clinical services burden on the healthcare system is expected to rise.
Collapse
Affiliation(s)
- Cole D Bendor
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel
| | - Aya Bardugo
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel.
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
| |
Collapse
|
39
|
Liu Y, Yin Z. Understanding Weight Loss via Online Discussions: Content Analysis of Reddit Posts Using Topic Modeling and Word Clustering Techniques. J Med Internet Res 2020; 22:e13745. [PMID: 32510460 PMCID: PMC7308899 DOI: 10.2196/13745] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 12/24/2019] [Accepted: 02/26/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Maintaining a healthy weight can reduce the risk of developing many diseases, including type 2 diabetes, hypertension, and certain types of cancers. Online social media platforms are popular among people seeking social support regarding weight loss and sharing their weight loss experiences, which provides opportunities for learning about weight loss behaviors. OBJECTIVE This study aimed to investigate the extent to which the content posted by users in the r/loseit subreddit, an online community for discussing weight loss, and online interactions were associated with their weight loss in terms of the number of replies and votes that these users received. METHODS All posts that were published before January 2018 in r/loseit were collected. We focused on users who revealed their start weight, current weight, and goal weight and were active in this online community for at least 30 days. A topic modeling technique and a hierarchical clustering algorithm were used to obtain both global topics and local word semantic clusters. Finally, we used a regression model to learn the association between weight loss and topics, word semantic clusters, and online interactions. RESULTS Our data comprised 477,904 posts that were published by 7660 users within a span of 7 years. We identified 25 topics, including food and drinks, calories, exercises, family members and friends, and communication. Our results showed that the start weight (β=.823; P<.001), active days (β=.017; P=.009), and median number of votes (β=.263; P=.02), mentions of exercises (β=.145; P<.001), and nutrition (β=.120; P<.001) were associated with higher weight loss. Users who lost more weight might be motivated by the negative emotions (β=-.098; P<.001) that they experienced before starting the journey of weight loss. In contrast, users who mentioned vacations (β=-.108; P=.005) and payments (β=-.112; P=.001) tended to experience relatively less weight loss. Mentions of family members (β=-.031; P=.03) and employment status (β=-.041; P=.03) were associated with less weight loss as well. CONCLUSIONS Our study showed that both online interactions and offline activities were associated with weight loss, suggesting that future interventions based on existing online platforms should focus on both aspects. Our findings suggest that online personal health data can be used to learn about health-related behaviors effectively.
Collapse
Affiliation(s)
- Yang Liu
- College of Computer Science and Technology, Changchun Normal University, Changchun, China
| | - Zhijun Yin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.,Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, United States
| |
Collapse
|
40
|
Dionne JM. Evidence Gaps in the Identification and Treatment of Hypertension in Children. Can J Cardiol 2020; 36:1384-1393. [PMID: 32502426 DOI: 10.1016/j.cjca.2020.02.076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/06/2020] [Indexed: 01/03/2023] Open
Abstract
The ultimate goal of recognizing and treating hypertension in childhood is to prevent target-organ damage during childhood and to reduce the risk of adulthood cardiovascular disease. The quality of evidence to guide blood pressure management in children is lower than in adult medicine, yet some common findings support clinical practice recommendations. Oscillometric devices are increasingly replacing manual blood pressure measurements, but evidence shows that readings are not equivalent between the 2 methods. In addition, multiple blood pressure readings are needed before diagnosing a child with hypertension, but the optimal number and timing are still being determined. The recent American Academy of Pediatrics blood pressure guideline has revised the normative data tables and included threshold blood pressure limits which seem to identify children with higher cardiovascular risks. Threshold limits vary between guidelines, and the most accurate threshold has yet to be determined. Lifestyle modifications are a cornerstone of hypertension management, but the optimal diet and physical activity changes for beneficial effect are not known. When pharmacotherapy is needed, physicians have used drugs from all antihypertensive classes in children, yet only a few classes have been systematically studied. The long-term cardiovascular consequences of elevated blood pressure during childhood are under investigation and it seems that the lower the childhood blood pressure the better and that the rate of change during childhood is predictive of adulthood disease. With much still to learn, this article summarizes the evidence and the evidence gaps for the diagnosis, investigation, management, and outcomes of pediatric hypertension.
Collapse
Affiliation(s)
- Janis M Dionne
- Division of Nephrology, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada.
| |
Collapse
|
41
|
Silberstein J, Gwynn L, Mathew MS, Arheart KL, Messiah SE. Evidence to Support Universal Blood Pressure Screening in School-Based Clinical Settings. THE JOURNAL OF SCHOOL HEALTH 2020; 90:474-481. [PMID: 32236966 DOI: 10.1111/josh.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/28/2019] [Accepted: 07/04/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states "there is limited evidence to support school-based measurement of children's BP." We explored the utility school-based BP screening. METHODS A cross-sectional sample of 4096 students ages 6 to 17 from Title 1 Miami-Dade Public Schools (50% female, 71% non-Hispanic black, 26% Hispanic) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016 to 2017 or 2017 to 2018 school years. Relative risks (RRs) ratios were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and sex. RESULTS Overall, 26.4% had at least one elevated BP measurement, of which 59% were not obese. RR for obese status was significant for all categories of elevated BP (RRs > 1.88, p < .0001). Being either female (RR = 1.34, p = .009) or Hispanic (RR = 1.31, p = .014) was significantly associated with elevated DBP. BMI accounted for <10% of the variation in BP (SBP: F(1, 4095) = 367.6, adjusted R2 = .08, p < .0001; DBP: F(1, 4095) = 93.3, adjusted R2 = .02, p < .0001). CONCLUSION These findings support providing BP screenings in school settings. Low-income and minority students often have limited access to health care, higher obesity rates, and unhealthy behaviors. Our findings support universal school-based BP screening regardless of weight status, particularly among ethnically diverse populations.
Collapse
Affiliation(s)
- Juliet Silberstein
- University of Miami Miller School of Medicine, 1601 NW 12th Ave. #403, Miami, FL 33136., USA
| | - Lisa Gwynn
- Clinical Pediatrics and Public Health Sciences, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miami, FL 33136., USA
| | - M Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miami, FL 33136., USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miami, FL 33136., USA
| | - Sarah E Messiah
- Department of Pediatrics and Department Public Health Sciences, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miaxsmi, FL 33136., USA
- University of Texas Health, School of Public Health, Dallas Campus, Dallas, TX, USA
- Center for Pediatric Population Health, UT Health School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| |
Collapse
|
42
|
Yazdi M, Assadi F, Qorbani M, Daniali SS, Heshmat R, Esmaeil Motlagh M, Kelishadi R. Validity of anthropometric indices in predicting high blood pressure risk factors in Iranian children and adolescents: CASPIAN-V study. J Clin Hypertens (Greenwich) 2020; 22:1009-1017. [PMID: 32506679 PMCID: PMC8029738 DOI: 10.1111/jch.13895] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 01/21/2023]
Abstract
Anthropometric indices have been used as indicators for predicting hypertension (HTN) in children and adolescents but it is not clear which anthropometric measures are a better index for identifying elevated blood pressure (EBP) risk factors in pediatric population. Body mass index (BMI), waist circumference (WC), weight-height ratio (WHR), a body shape index (ABSI) and blood pressure were measured in 14 008 children and adolescents aged 7-18 years in a national school-aged survey CASPIN V. Hypertension (HTN) was defined according to the 2017 American Academy of Pediatrics guidelines, using the 95th percentile. The predictive power of anthropometric indices for HTN risk factors was examined using receiver operating characteristic (ROC) analyses. Multivariate logistic regression analysis was used to compare areas under ROC curves (AUCs) among the four anthropometric indices. BMI, WC, WHR, and ABSI were significantly higher in adolescents than in children. EBP was more prevalent in boys (7.2%) than girls (5.5%), whereas the prevalence of HTN was higher in girls (11.3%) than boys 10.4%. Prevalence odds ratio was around 2 for BMI, WC, and WHR with AUCs scores of nearly 0.6 to predict EBP in both children and adolescents of both sexes. Thus, the ability of BMI z-score, WC, WHR or ASBI to identify Iranian children and adolescents at higher risk of EBP was week. WC, WHR or ASBI in combination with BMI did not improve predictive power to identify subjects at higher risk of EBP.
Collapse
Affiliation(s)
- Mayram Yazdi
- Child Growth and Development Research CenterResearch Institute for Primordial Prevention of Non‐Communicable DiseaseIsfahan University of Medical SciencesIsfahanIran
| | - Farahnak Assadi
- Department of PediatricsRush University Medical CollegeChicagoILUSA
| | - Mostafa Qorbani
- Non‐Communicable Diseases Research CenterAlborz University of Medical SciencesKarajIran
- Chronic Research CenterEpidemiology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Seyede Shahbanoo Daniali
- Child Growth and Development Research CenterResearch Institute for Primordial Prevention of Non‐Communicable DiseaseIsfahan University of Medical SciencesIsfahanIran
| | - Ramin Heshmat
- Chronic Diseases Research CenterEndocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | | | - Roya Kelishadi
- Child Growth and Development Research CenterResearch Institute for Primordial Prevention of Non‐Communicable DiseaseIsfahan University of Medical SciencesIsfahanIran
| |
Collapse
|
43
|
Abstract
The prevalence of pediatric hypertension is growing. Hypertension during childhood remains a major risk factor for adverse cardiovascular events later in life. NPs should be aware of current guidelines on screening, diagnosis, and treatment of hypertension in children to improve care for this patient population.
Collapse
|
44
|
Dong Y, Song Y, Zou Z, Ma J, Dong B, Prochaska JJ. Updates to pediatric hypertension guidelines: influence on classification of high blood pressure in children and adolescents. J Hypertens 2020; 37:297-306. [PMID: 30044314 PMCID: PMC6365252 DOI: 10.1097/hjh.0000000000001903] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Supplemental Digital Content is available in the text Objective: The American Academy of Pediatrics updated Clinical Practice Guidelines (CPG) for screening high blood pressure (HBP) in children and adolescents in 2017. This study aimed to assess differences in HBP classification applying this updated HBP definition in a large sample of Chinese youth. Methods: Data from 50 336 youth aged 6–17 participating in the 2013 Chinese national survey were analyzed. HBP was diagnosed according to the established (Fourth Report) and updated (2017 CPG) definitions. The associations between HBP with BMI, height, early life factors and behavioral factors were investigated using logistic regression models. Results: Applying the CPG definition, 16.7% of children (6–12 years) and 7.9% of adolescents (13–17 years) had HBP, compared with 10.8 and 6.3% applying the Fourth Report definition. Prevalence estimates for HBP differed the greatest for boys, children aged 11, those with high BMI, and those of tall stature. The odds ratios (ORs) for HBP with BMI, height, hip and waist circumference, early life factors and behavioral factors were comparable for the two definitions. Conclusion: The new criteria for HBP in young people will lead healthcare providers to diagnose more children as hypertensive. Notably, associations between HBP with BMI and other medical and behavioral factors remained strong, supporting validity of the new definition.
Collapse
Affiliation(s)
- Yanhui Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China.,Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| | - Zhiyong Zou
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Bin Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| |
Collapse
|
45
|
Sun J, Wu L, Zhang Y, Li C, Wang Y, Mei W, Zhang J. Association of breastfeeding duration, birth weight, and current weight status with the risk of elevated blood pressure in preschoolers. Eur J Clin Nutr 2020; 74:1325-1333. [PMID: 32203240 DOI: 10.1038/s41430-020-0608-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Few studies have examined the effects of the weight status at birth and preschool age on the risk of elevated blood pressure (EBP) in early childhood, and whether the effects can be modified by breastfeeding duration remains unclear. We aimed to evaluate the effects of high birth weight (HBW) with overweight/obese or abdominal obesity on the risk of EBP in preschoolers, and further evaluate the effects classified by breastfeeding duration (<6 and ≥6 months). SUBJECTS/METHODS This cross-sectional study was conducted in 2018 in Zhuhai, China. Out of 2390 3-4-year-old preschoolers originally recruited, a total of 1899 were included in the analysis. Logistic regression analysis was performed to examine the effects of the weight status at the two age points and breastfeeding duration on the risk of EBP. RESULTS Preschoolers with current overweight/obese had a 1.13-fold increased risk of EBP than those with persistent normal weight, irrespective of their birth weight. However, the preschoolers with HBW had no increased risk of EBP, when they became normal weight (OR 1.70, 0.78-3.72). Similar results were found for the current abdominal obesity and the risk of EBP. In addition, the EBP risk of obese status was minimized if preschoolers were breastfed for ≥6 months. CONCLUSIONS Obesity status at preschool age can increase the risk of EBP, irrespective of birth weight. However, this EBP risk can be mitigated if HBW changes to current normal weight. Longer breastfeeding duration can partially offset the risk of EBP in preschoolers with obesity status.
Collapse
Affiliation(s)
- Jiahong Sun
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Lisha Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Chunan Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Yake Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Wenhua Mei
- Department of Information, Zhuhai Public Hospital Administration, 41 Jiaoyu Rd., Zhuhai, 519000, Guangdong, China.,Department of Epidemiology, Jinan University, 601 Huangpu Western Rd., Guangzhou, 510632, Guangdong, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China.
| |
Collapse
|
46
|
Lee JW, Kim N, Park B, Park H, Kim HS. Blood pressure trajectory modeling in childhood: birth-cohort study. Clin Hypertens 2020; 26:2. [PMID: 31956424 PMCID: PMC6961282 DOI: 10.1186/s40885-019-0133-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/18/2019] [Indexed: 01/04/2023] Open
Abstract
Background Systolic blood pressure (SBP) and diastolic blood pressure (DBP) tends to increase with age and increase in proportion to body weight and height. Recent epidemiological and longitudinal cohort studies have found that high BP in children can be progressed into hypertension (HTN) in adulthood. Therefore, the aim of this study is that we monitor and analyze the tendency of the BP trajectory in children from the age of 3 years to the age of 10 years. Method A total of 767 subjects were gathered from Ewha Birth and Growth cohort study. We observed and analyzed the data of 65 subjects which were completely repeated measures for 6 times as 3, 5, 7, 8, 9, 10 years old follow-up. We collected retrospective information such as BP and anthropometric data measured for children and constructed the trajectory models of SBP and DBP in early stage of life. Results Three distinct trajectories on SBP and DBP from 3 to 10 years old were identified. As a result of SBP, 82.7% (n = 54) of subjects experienced moderate SBP levels maintained stable levels; 13.7% (n = 9) of subjects experienced a rapid increase as the age increase; 3.6% (n = 2) of subjects experienced high SBP levels throughout follow-up as moderate grade. For DBP, 6.7% (n = 4) of subjects started with low levels and experienced generally a gradual grade; 61.7% (n = 41) of subjects started with moderate levels and experienced a steep increase at 7-years-old; 31.6% (n = 20) of subjects experienced a rapid increase on DBP levels. Conclusion The result of study shows tendency of increase BP as the age increase. This research inspires that we verify risk group and risk factor in early stage of life with trajectory modeling for the HTN prevention in adulthood.
Collapse
Affiliation(s)
- Jung Won Lee
- 1Department of Pediatrics, Ewha Womans University College of Medicine, 25, Magokdong-ro 2-gil, Ganseo-gu, Seoul, 07804 South Korea
| | - Nameun Kim
- 2Department of Preventive Medicine, Ewha Womans University College of Medicine, 25, Magokdong-ro 2-gil, Ganseo-gu, Seoul, 07804 South Korea
| | - Bohyun Park
- 2Department of Preventive Medicine, Ewha Womans University College of Medicine, 25, Magokdong-ro 2-gil, Ganseo-gu, Seoul, 07804 South Korea
| | - Hyesook Park
- 2Department of Preventive Medicine, Ewha Womans University College of Medicine, 25, Magokdong-ro 2-gil, Ganseo-gu, Seoul, 07804 South Korea
| | - Hae Soon Kim
- 1Department of Pediatrics, Ewha Womans University College of Medicine, 25, Magokdong-ro 2-gil, Ganseo-gu, Seoul, 07804 South Korea
| |
Collapse
|
47
|
Fan H, Zhu Q, Zhang X. Child Excess Weight Status, Adult Excess Weight Status, and Cardiometabolic Risk Profile. Front Pediatr 2020; 8:301. [PMID: 32582597 PMCID: PMC7295978 DOI: 10.3389/fped.2020.00301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background: The potential effects of excess weight status in childhood on later adult cardiometabolic risk factors have been undetermined in a Chinese population. Additionally, the potential mitigation of these effects if adult weight status returns to normalcy has been unresolved. Accordingly, we aimed to assess the association of childhood excess weight status and its long-term change with adult cardiometabolic risk factors. Methods: A cohort study from the China Health and Nutrition Survey 1991-2009 consisted of 541 participants who were measured in childhood (≥6 and <18 years) and underwent laboratory assessment in adulthood (≥18 years). In childhood, the participants were classified into four groups as age-sex-specific body mass index (BMI) z-score quartiles. The adult cardiometabolic risk factors included overweight and obesity, hypertension, high total cholesterol, high triglyceride, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol, and high hemoglobin A1c. Results: The prevalence was 61.0, 36.2, and 19.0% for ≥1, 2, and 3 cardiometabolic risk factors, respectively, with a mean 14.9-year follow-up. There was a significant trend in the progression of the number of adult cardiometabolic risk factors across childhood BMI quartiles (P < 0.001). Additionally, participants with childhood BMI z-scores ≥ 75th percentile and adult BMI z-scores < 75th percentile did not have increased cardiometabolic risks compared with those with both childhood and adulthood BMI z-scores < 75th percentile. Conclusions: Our findings revealed that child excess weight status increased adult cardiometabolic risks. However, the effects of excess weight status in childhood on adult cardiometabolic risk factors were mitigated if adult weight status returned to normalcy.
Collapse
Affiliation(s)
- Hui Fan
- Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China
| | - Qi Zhu
- Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China
| | - Xingyu Zhang
- Applied Biostatistics Laboratory, University of Michigan School of Nursing, Ann Arbor, MI, United States
| |
Collapse
|
48
|
Abstract
PURPOSE OF REVIEW We aim to describe current concepts on childhood and adolescent obesity with a strong focus on its sequela. Childhood obesity is a national epidemic with increasing prevalence over the past three decades placing children at increased risk for many serious comorbidities, previously felt to be only adult-specific diseases, making this topic both timely and relevant for general pediatricians as well as for subspecialists. RECENT FINDINGS Childhood obesity develops through an interplay of genetics, environment, and behavior. Treatment includes lifestyle modification, and now metabolic and bariatric surgery is more commonly considered in carefully selected adolescents. The off-label use of adjunct medications for weight loss in childhood and adolescent obesity is still in its infancy, but will likely become the next logical step in those with lifestyle modification refractory obesity. Obesity can lead to several comorbidities, which can persist into adulthood potentially shortening the child's lifespan. SUMMARY Efforts should be focused primarily on reducing childhood and adolescent obesity, and when indicated treating its sequela in effort to reduce future morbidity and mortality in this precious population. VIDEO ABSTRACT: http://links.lww.com/MOP/A36.
Collapse
|
49
|
Towner EK, Kapur G, Carcone AI, Janisse J, Ellis DA, Catherine Jen KL, Naar S. Physical Activity as a Predictor of Changes in Systolic Blood Pressure for African-American Adolescents Seeking Treatment for Obesity. J Adolesc Health 2019; 65:430-432. [PMID: 31227385 DOI: 10.1016/j.jadohealth.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 02/15/2019] [Accepted: 04/01/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of the study was to examine changes in systolic blood pressure (SBP) and whether physical activity and obesity status predicted SBP change for African-American adolescents (n = 181) participating in a behavioral weight control trial. METHODS Data were collected at baseline, 7 months (end-of-treatment), and 9 months (2-month follow-up). RESULTS Nearly half of adolescents achieved clinically significant SBP reductions at 7 and 9 months. Significantly, fewer adolescents had elevated SBP at 7 and 9 months compared with baseline (both p < .001). Changes in percent overweight and moderate-to-vigorous activity predicted changes in SBP over time. CONCLUSIONS Obesity reduction and increases in moderate-to-vigorous physical activity may predict short-term, clinically meaningful reductions in SBP for African American adolescents with obesity.
Collapse
Affiliation(s)
- Elizabeth K Towner
- Division of Behavioral Sciences, Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan.
| | - Gaurav Kapur
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - April Idalski Carcone
- Division of Behavioral Sciences, Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan
| | - James Janisse
- Division of Population Health Sciences, Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Deborah A Ellis
- Division of Behavioral Sciences, Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan
| | | | - Sylvie Naar
- Division of Behavioral Sciences, Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan
| |
Collapse
|
50
|
Body mass index percentiles and elevated blood pressure among children and adolescents. J Hum Hypertens 2019; 34:319-325. [PMID: 31253844 DOI: 10.1038/s41371-019-0215-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/17/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023]
Abstract
It is well established that obesity is associated with an increased risk of elevated and high blood pressure (BP) in children and adolescents. However, it is uncertain whether there is an increase in the risk of elevated and high BP associated with an increase of body mass index (BMI) among children and adolescents whose BMI is in the accepted normal range. Data were available for 58 899 children and adolescents aged 6-17 years from seven national cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. The subjects were divided into eight percentile subgroups according to their BMI levels based on the World Health Organization recommendations. Elevated BP and high BP were defined using the 2016 international child BP criteria. Compared with the reference subgroup of the 5th-24th percentiles, the odds ratios (ORs) for high BP were 1.27 (95% confidence interval [CI], 1.14-1.41; P < 0.001) in the 25th-49th percentile subgroup, 1.55 (95% CI, 1.39-1.73; P < 0.001) in the 50th-74th percentile subgroup, and 2.17 (95% CI, 1.92-2.46; P < 0.001) in the 75th-84th percentile subgroup, respectively, after adjustment for sex, age, race/ethnicity, height and country. Additionally, the corresponding ORs for elevated BP were 1.21 (95% CI, 1.10-1.32; P < 0.001), 1.55 (95% CI, 1.42-1.69; P < 0.001), and 1.80 (95% CI, 1.62-2.01; P < 0.001), respectively. In conclusion, a BMI in the 25th-84th percentiles, within the accepted normal weight range, was associated with an increased risk of elevated and high BP among children and adolescents. It is important for children and adolescents to keep a BMI at a low level in order to prevent and control hypertension.
Collapse
|