title: Ambulatory blood pressure monitoring and cardiac hypertrophy in children with metabolic syndrome.
abstract: BACKGROUND
  The metabolic syndrome (MS), a cluster of potent risk factors for cardiovascular disease, is composed of insulin resistance, obesity, hypertension and hyperlipidemia. The aim of our study was to investigated the relationships between MS and left ventricular mass index (LVMI) in childhood MS. This study included 50 children and adolescents with MS aged between 7-18 years.
  
  
  METHODS
  Thirty age- and sex-matched healthy children served as a control group. The diagnosis of MS was made according to the criteria adapted from the World Health Organization. They underwent clinical examination with causal blood pressure (BP) measurements, 24-hour ambulatory blood pressure monitoring (ABPM) and echocardiogram. Patients underwent echocardiography to detect left ventricular hypertrophy (LVH). LVMI was calculated as left ventricular mass/height(2.7).
  
  
  RESULTS
  The mean age of MS group was 12.0 ± 3.1 years. The mean value of LVMI was 46.5 ± 11.5 g/m(2.7) in the MS group and it was significantly higher than those in the healthy children. The prevalence of severe LVH was 12 % using adult criteria (LVM > 51 g/m(2.7)) and 44 % using pediatric criteria (LVM > 95th percentile). The mean daytime systolic BP load (β = 0.315, p = 0.003) and HOMA-IR (β = 0.368, p = 0.006) were found as the independent predictors of LVMI.
  
  
  CONCLUSIONS
  In conclusion, LVH occurs commonly in pediatric MS and is associated with systolic hypertension and insulin resistance. LVMI should be measured routinely for the predicting of cardiovascular risks in these patients.
authors.affiliation: Department of Pediatrics, Haseki Educational and Research Hospital, Istanbul, Turkey.
authors.forename: Berna Kamaci
authors.initials: BK
authors.lastname: Bostanci
authors.forename: Mahmut
authors.initials: M
authors.lastname: Civilibal
authors.forename: Murat
authors.initials: M
authors.lastname: Elevli
authors.forename: Nilgun Selcuk
authors.initials: NS
authors.lastname: Duru
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D007333:Insulin Resistance; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013599:Systole; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography
chemical_list: D015415:Biomarkers