Cardiovascular regulation in children and adolescents with overweight and obesity
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Cardiovascular complications contribute to higher morbidity and mortality in patients with anorexia nervosa. We aimed to study biomarkers of cardiovascular risk in anorexic, normal-weight, and obese adolescents with focus on complex cardiovascular autonomic regulation and early arteriosclerotic damage. We examined 20 adolescent girls with anorexia nervosa, 20 obese girls, and 20 healthy normal-weight controls. Collected data: body composition analysis, 5 min recordings of R-R intervals and beat-to-beat blood pressure (BP), and arterial stiffness evaluated using cardio-ankle vascular index (CAVI). Evaluated parameters: beat-to-beat heart rate and BP variability, haemodynamic parameters (total peripheral resistance (TPR) cardiac output), CAVI, and anthropometric indices, including novel body roundness index (BRI). Adolescents with anorexia nervosa had increased CAVI associated with lower arterial constriction indexed by low-frequency band of BP variability compared with normal-weight peers (p = 0.03, p = 0.04, respectively) and obese adolescents (p < 0.01, p = 0.01, respectively). After normalization of CAVI and TPR by BRI, the relationship between CAVI and TPR was significant for all groups with the highest slope in the anorexia nervosa group (R2 = 0.724, p < 0.01). This is the first study revealing early arteriosclerotic damage in anorexic girls with increased CAVI. Complex analysis of cardiovascular autonomic regulation, and early arteriosclerotic, hemodynamic, and anthropometric changes in spectrum anorexia nervosa, normal weight, and obesity could help to understand the mechanisms of increased cardiovascular risk in malnutrition. Novelty Girls with anorexia nervosa showed signs of early arteriosclerotic damage indexed by CAVI. Insufficient sympathetic cardiovascular control was found already in adolescents with anorexia nervosa. The effect of body composition on CAVI was best predicted by novel body roundness index.
- Klíčová slova
- anorexia nervosa, anorexie mentale, arterial stiffness, arteriosclerosis, artériosclérose, blood pressure, malnutrition, obesity, obésité, pression artérielle, rigidité artérielle,
- MeSH
- dítě MeSH
- hemodynamika fyziologie MeSH
- lidé MeSH
- mentální anorexie * epidemiologie patofyziologie MeSH
- mladiství MeSH
- obezita dětí a dospívajících * epidemiologie patofyziologie MeSH
- průřezové studie MeSH
- tuhost cévní stěny fyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: The purpose of this study is to determine the prevalence of obesity and to compare the associated risk factors between the adolescent children living in rural and urban areas. MATERIALS: This cross-sectional study conducted among 3,918 high school students getting education in the city centre and rural areas of Eskisehir. A specially designed questionnaire form included questions about socio-demographic characteristics as well as cardiovascular risk factors including smoking status, diet habits (breakfasting, consumption of sugar-sweetened beverages and fruit and vegetable consumption), physical activity and time spent on computer and/or television. RESULTS: The prevalence of being overweight was 10.4% and 12.2% and the prevalence of obesity was 7.9% and 11.3% in rural and urban areas, respectively. In urban areas, being overweight was accompanied by prehypertension (OR=2.3, 95% Cl 1.6-3.3), hypertension (OR= 2.3, 95% CI 1.6-3.2), and family history of cardiovascular disease (OR =1.3, 95% CI 1-1.7), and obesity was accompanied by prehypertension (OR= 2.3, 95% CI 1.6-3.3), hypertension (OR=3.9, 95% Cl 2.9-5.3), excessive use of computer/TV (OR=1.3, 95% CI 1.1-1.7), having no breakfast (OR=1.3, 95% CI 1.1-1.7), physician-diagnosed diabetes mellitus (OR=4.2, 95% CI 1.3-14.1) and consumption of sugar-sweetened beverages (OR=0.6, 95% CI 0.5-0.8). In rural areas, although the variables accompanying being overweight were parallel with those in urban areas, obesity was only associated with prehypertension (OR=6.1, 95% CI 2.6-14.1), hypertension (OR=22.1, 95% Cl 9.9-49.3) and family history of cardiovascular disease (OR=1.6, 95% CI 1.1-2.6). CONCLUSION: Risk factors may differ in the adolescents from rural and urban areas. It is important in overweight and obese children to assess the family history of cardiovascular disease, blood pressure and blood glucose, to ask about the habit of regularly breakfasting, and to evaluate time spent on computer/TV. As in urban areas, environmental regulations also become important in rural areas. Appropriate social activities for children to spent more time outdoor, e.g. in parks or playgrounds, are important in urban as well as in rural areas.
- MeSH
- kardiovaskulární nemoci etiologie MeSH
- lidé MeSH
- městské obyvatelstvo MeSH
- mladiství MeSH
- obezita dětí a dospívajících epidemiologie MeSH
- prevalence MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- venkovské obyvatelstvo MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Turecko epidemiologie MeSH
BACKGROUND: Obesity and hypertension represent serious health issues affecting the pediatric population with increasing prevalence. Hypovitaminosis D has been suggested to be associated with arterial hypertension. Serotonin by modulating nitric oxide synthase affect blood pressure regulation. The biological mechanism by which vitamin D specifically regulates serotonin synthesis was recently described. The aim of this paper is to determine the associations between vitamin D, serotonin, and blood pressure in obese children. METHODS: One hundred and seventy-one children were enrolled in the prospective cross-sectional study. Two groups of children divided according to body mass index status to obese (BMI ≥95th percentile; n = 120) and non-obese (n = 51) were set. All children underwent office and ambulatory blood pressure monitoring and biochemical analysis of vitamin D and serotonin. Data on fasting glucose, insulin, HOMA, uric acid, and complete lipid profile were obtained in obese children. RESULTS: Hypertension was found only in the group of obese children. Compared to the control group, obese children had lower vitamin D and serotonin, especially in winter. The vitamin D seasonality and BMI-SDS were shown as the most significant predictors of systolic blood pressure changes, while diastolic blood pressure was predicted mostly by insulin and serotonin. The presence of hypertension and high-normal blood pressure in obese children was most significantly affected by vitamin D deficiency and increased BMI-SDS. CONCLUSIONS: Dysregulation of vitamin D and serotonin can pose a risk of the onset and development of hypertension in obese children; therefore, their optimization together with reducing body weight may improve the long-term cardiovascular health of these children.
- Klíčová slova
- Children, Hypertension, Obesity, Serotonin, Vitamin D,
- MeSH
- ambulantní monitorování krevního tlaku MeSH
- dítě MeSH
- hypertenze * epidemiologie MeSH
- index tělesné hmotnosti MeSH
- inzulin MeSH
- inzulinová rezistence * MeSH
- lidé MeSH
- nedostatek vitaminu D * MeSH
- obezita dětí a dospívajících * komplikace epidemiologie MeSH
- prospektivní studie MeSH
- průřezové studie MeSH
- serotonin MeSH
- vitamin D MeSH
- vitaminy MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- inzulin MeSH
- serotonin MeSH
- vitamin D MeSH
- vitaminy MeSH