Prehypertension in outpatient obese children.
BACKGROUND
The aim of the study was to analyze the prevalence of prehypertension (PH) in obese (OB) children and its relation with estimated glomerular filtration rate (eGFR) and left ventricular (LV) function.


METHODS
The study included 447 OB and 131 normal-weight children. PH was defined according to the criteria proposed by the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Insulin sensitivity was evaluated by HOMA(IR), and eGFR was calculated by Schwartz's formula. LV function was analyzed by echocardiography in 165 OB children.


RESULTS
PH was observed in 79 OB children (17.7%) and in 2 (1.5%) controls. Among OB children, those with PH had greater percentage of males (P < 0.05), higher level of body mass index (BMI) (P < 0.001), waist circumference (WC) (P < 0.005), and HOMA(IR) (P < 0.001), compared to PH- children. The two groups did not differ for eGFR and LV function. At logistic regression analysis, PH was independently associated with male gender (P < 0.025) and HOMA(IR) (P < 0.002). Gender analysis showed that boys with PH presented higher levels of BMI (P < 0.005), WC (P < 0.01), HOMA(IR) (P < 0.001), and triglycerides (P < 0.005) compared to PH- boys. Females with PH were older and in more advanced postpubertal stage, had higher BMI, WC (P < 0.05, for all), and HOMA(IR) (P < 0.025), compared to PH- girls.


CONCLUSIONS
In a population of outpatient OB children, the prevalence of PH was 17.7% and boys were more likely than girls to have PH. This condition is characterized by insulin resistance in both sexes but no impairment in glomerular and LV function.
Di Bonito
Procolo
P
Department of Internal Medicine, S. Maria delle Grazie, Pozzuoli Hospital, Naples, Italy. procolodibonito@alice.it
Forziato
Claudia
C
Sanguigno
Eduardo
E
Di Fraia
Teresa
T
Saitta
Francesco
F
Iardino
Maria Rosaria
MR
Scilla
Carolina
C
Cavuto
Luigi
L
Sibilio
Girolamo
G
Moio
Nicola
N
Capaldo
Brunella
B
D000293:Adolescent; D000553:Ambulatory Care; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D014280:Triglycerides / Q000097:blood; D016277:Ventricular Function, Left; D055105:Waist Circumference
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides