Association of obesity with hypertension amongst school-age children belonging to lower income group and middle income group in national capital territory of delhi

Assessment of the Performance of Obesity Measures in the Screening of Hypertension in a South African Adolescent Population

Obesity is known to be one of the most significant risk factors for essential hypertension in childhood. However, whether obesity cut-offs may predict hypertension screening in adolescents remains controversial. This study investigated the performance of obesity cut-off values for the screening of hypertension in a South African adolescent population. In this cross-sectional study, 1144 adolescents aged between 11 and 17 years were recruited from the Eastern Cape Province of South Africa. Anthropometric and blood pressure (BP) parameters including diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) were measured. Assessment of the sensitivity and specific of obesity cut-off values in predicting hypertension was performed using receiver operating characteristic (ROC) analysis. Obesity was positively associated (p < 0.01) with hypertension. Obese individuals, based on the predicted obesity using BMI percentile cut-off (pBMI85.2%), were more likely to develop hypertension (odds ratio: 2.070; p < 0.001) than their counterparts based on the observed obesity cut-off (pBMI95%) (Odd ratio: 1.748 p = 0.004). The area under the curve (AUC) of BMI percentile and WHtR for screening SBP percentile, and DBP percentile and HR as per ROC analysis, was low (<0.65). Equally, the sensitivity and specificity were low (<0.6) for all BP measures (SBP, DBP, and HR). Furthermore, the cut-off values for blood pressure measures, as established by ROC analysis using anthropometric measures, were far below the recommended cut-off values for hypertension screening. The obesity cut-offs for BMI percentile and WHtR established in this populations showed poor performance in diagnosing hypertension even though they were strong predictors of hypertension.

A Cross-Sectional Study on Correlates of High Blood Pressure among School-Going Children in an Urban Area

CONTEXT

School-going children are documenting the increasing incidence of high blood pressure (BP). Compared to adults, the prevalence of hypertension (HT) is low among children, but high BP among them can lead to HT in their adult life.

AIM

The aim of was to study the risk factors and correlates of high BP among school-going children.

MATERIALS AND METHODS

A cross-sectional study was carried out for 1½ years among 892 randomly selected school children of 6^th-10^th class. Measurements such as height, weight, and BP were recorded and classified as per the standard guidelines for given age and sex.

STATISTICAL ANALYSIS

Correlation and linear regression analysis were done for continuous variables. For dichotomous variables, mean and standard deviation were calculated and t-test was used in this study.

RESULTS

Higher age group, being male, and obesity were found to be significantly associated with elevated systolic BP (SBP) and elevated diastolic BP (DBP). Family history of diabetes and HT was significantly associated with elevated DBP. On linear regression analysis, the studied factors explained 30% variation in SBP and only 12% variation in DBP. Weight and body mass index explained the maximum variation in both SBP and DBP.

CONCLUSION

Overweight or obesity, being male, family history of HT, and increasing age were important risk factors of elevated BP.

Vitamin D Receptor Gene Haplotype and Late-Onset Obesity in Iranian Azeri Turkish Women

INTRODUCTION

A large body of literature has revealed the association between vitamin D3-VDR complex and obesity. The aim of the present study was to survey the rate of the VDR polymorphisms in obese women and to determine whether there may be an association between VDR BsmI and Tru9I haplotypes and obesity in Iranian Azeri Turkish women.

MATERIAL AND METHODS

65 Iranian Azeri Turkish women were enrolled in the study and PCR amplification and direct sequencing of PCR products were used for genotypings.

RESULTS

The findings of this study showed that VDR BsmIG allele, VDR BsmI G/G genotype, VDR BsmI A/A genotype, Tru9IA allele and Tru9I A/A genotype were more frequent in obese women compared to controls. The frequency of VDR BsmIG/Tru9IA (GA), VDR BsmIG/Tru9IG (GG), VDR BsmIA/Tru9IG (AG), and VDR BsmIA/Tru9IA (AA) haplotypes were 19.74%, 42.11%, 38.16% and 0% in cases, and 11.11%, 40.74%, 42.59 and 5.56% in controls. Statistically significant differences were found between cases and controls regarding the VDR AA haplotype (P=0.03).

CONCLUSIONS

Our findings demonstrated that the VDR AA haplotype frequency was significantly lower in subjects with obesity compared with normal controls. This study shows that the VDR AA haplotype is significantly associated with a decreased risk of obesity in the tested group. This report is the first of its kind in the West Azerbaijani population.

BMI is a Better Indicator of Cardiac Risk Factors, as against Elevated Blood Pressure in Apparently Healthy Female Adolescents and Young Adult Students: Results From a Cross-Sectional Study in Tripura

BACKGROUND

Anthropometric measures are used as indicators of elevated blood pressure, but reported to have variable sensitivity among populations. This study was undertaken to identify the better indicator of Cardiac-risk factors by statistical comparison of BMI, Waist circumference, and Waist to Height (WtHr) ratio in apparently healthy adolescents and young adult female students of Tripura.

MATERIALS AND METHODS

A cross-sectional study was conducted in a resource limited setup on 210 apparently healthy female adolescents and young adult students in Tripura. Mean (±SD) of all parameters were compared (ANOVA) to recognize significant independent (anthropometric measures) and dependent factors (blood pressure indices and so on). Correlation (r) analysis was used to identify the better (p) indicator of blood pressure indices (dependent variable) and its impact was assessed by Multiple Regression analysis.

RESULTS

blood pressure indices are comparatively higher in obese and overweight participants with statistically significant (95.5% confidence) mean differences. Significant correlation with dependent factors is observed with BMI followed by WtHr and Waist Circumference. Impact of anthropometric measures with blood pressure Indices is most significant for BMI (P ≤ 0.020) followed by WtHr (P ≤ 0.500) and waist circumference (P ≤ 0.520).

CONCLUSION

BMI is a superior indicator of blood pressure indices and can identify participants at risk even in apparently healthy adolescent and young adult females.

Budding adult hypertensives with modifiable risk factors: "Catch them young"

BACKGROUND

Since the data of primary hypertension (HT) in children is scanty in India, this study attempted to evaluate HT by a multidimensional investigation of the various risk factors in children and adolescents.

MATERIALS AND METHODS

A total of 3906 subjects were recruited, all of whom lived in Chennai, an urban area of Tamil Nadu. The children and adolescents aged from 10 to 17 years were selected by random sampling. The children/adolescents were randomized into one control and further divided into two groups. The National High Blood Pressure Education Program fourth report (2004) and anthropometric body mass index (BMI), food frequency questionnaire (PURE) were followed in the study.

RESULTS

Out of 3906 children, 2107 were girls and 1799 boys. On screening, we found 9.5% to be hypertensive with the prevalence rate of boys and girls 8% and 10.8%, respectively. Overall obesity was 2.7%, (boys 2%, girls 3.32%); hypertensives and normotensives were 8.4% and 2.1%, respectively. We found that overweight (odds ratio [OR]: 2.06 [1.40-3.01] 95% confidence interval [CI]), obese children (OR: 1.21 [2.72-6.48] 95% CI), and those with a family history of HT (OR: 1.66 [1.20-2.30] 95% CI) had increased risk of hypertension. Females were 1.39 times (OR: 1.39 [1.11-1.72] 95% CI) more at risk of getting HT. Multivariate analysis showed that obese children/adolescent were four times more likely to have HT than children with normal BMI (OR: 4.67 [3.00-7.26] 95% CI].

CONCLUSION

Family history of HT, obesity, and female gender are associated with a high risk of HT. The prevalence of HT was higher among obese adolescents than among slender subjects. This may be related to their sedentary lifestyle, faulty eating habits, high fat content in the diet and little physical activity.

Anxiety and depression levels in prepubertal obese children: a case-control study

INTRODUCTION

Childhood obesity has become a worldwide epidemic in Western and in developing countries and has been accompanied by many serious and severe comorbidities, such as diabetes, hypertension, sleep apnea syndrome, depression, dyslipidemia, impaired glucose homeostasis, steatohepatitis, and intracranial hypertension, as well as medical concerns unique to youth, such as accelerated pubertal and skeletal development and orthopedic disorders. To date, no specific studies about the psychological assessment in pediatric obesity are present. Therefore, the aim of this study was to evaluate the putative relationship between psychological troubles and obesity in a sample of school-aged children.

MATERIALS AND METHODS

The study population consists of 148 obese subjects (body mass index [BMI] >95th percentile) (69 males, mean age 8.9±1.23 years) consecutively referred from clinical pediatricians to the Child and Adolescent Neuropsychiatry department at the Second University of Naples. In all subjects, weight, height, and BMI z-score were evaluated. In order to assess the anxiety levels and the presence of depressive symptoms, the Children Depression Inventory (CDI) and the Italian Self-Administered Psychiatric Scales for Children and Adolescents (SAFA) were administered. The control group consisted of 273 healthy children (129 males and 144 females) (mean age 9.1±1.8 years), enrolled in schools within the Campania region of Italy.

RESULTS

No significant differences between the two study groups were found for age (8.9±1.23 years in the obese sample and 9.1±1.8 years in the control group) (P=0.228) or sex (ratio male/female: 69/79 in the obese group versus 129/144 in the control group) (P=0.983). Obviously, significant difference was found for the BMI z-score (2.46±0.31 in the obese group vs 0.73±0.51 in the control group) (P<0.001). The obese subjects showed significant higher level of depressive symptoms (CDI total score) (16.82±7.73 vs 8.2±2.9) (P<0.001) and anxiety (SAFA - Anxiety [SAFA-A]) scale score (58.71±11.84 vs 27.75±11.5) (P<0.001) compared with the control group. Moreover, the Pearson's correlation analysis showed a significantly positive relationship between the BMI z-score and both the CDI (r=0.677; P<0.001) and SAFA-A scores (r=0.591; P<0.001).

CONCLUSION

Our findings highlighted the importance of assessing the presence of internalizing problems, such as anxiety and depression, in the common management of childhood obesity.