title: Nocturnal blood pressure non-dipping is prevalent in severely obese, prepubertal and early pubertal children.
abstract: OBJECTIVE
  To investigate the prevalence of nocturnal blood pressure dipping among obese prepubertal and early pubertal children and to analyse the relationship between dipping and measures of insulin-glucose metabolism or sleep-disordered breathing.
  
  
  METHODS
  We studied 76 obese children (41% girls) under clinical care, with an average age of 10.4 ± 1.7 and a body mass index Z-score (BMI Z-score) of 6.2 ± 1.6. We performed a 24-h ambulatory blood pressure measurement. Non-dipping was defined as a nocturnal blood pressure reduction of <10%. We calculated measures of insulin-glucose metabolism from the performed frequently sampled intravenous glucose-tolerance test and from fasting blood samples. Overnight sleep polygraph recordings were performed to assess sleep-disordered breathing.
  
  
  RESULTS
  Forty-two percent of the children were systolic non-dippers, and 17% were diastolic non-dippers. There were no associations between systolic or diastolic dipping and measures of insulin-glucose metabolism after adjustments for BMI Z-score, gender and pubertal status. There were no associations between dipping and measures of sleep-disordered breathing.
  
  
  CONCLUSIONS
  Nocturnal non-dipping was two times higher among severely obese, prepubertal and early pubertal children, compared to previous reports among children in general. There were no associations between nocturnal dipping and insulin-glucose metabolism or measures of sleep-disordered breathing in this group.
authors.affiliation: Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Paediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Westerståhl
authors.forename: P
authors.initials: P
authors.lastname: Hedvall Kallerman
authors.forename: E
authors.initials: E
authors.lastname: Hagman
authors.forename: A E
authors.initials: AE
authors.lastname: Ek
authors.forename: S M
authors.initials: SM
authors.lastname: Rössner
authors.forename: C
authors.initials: C
authors.lastname: Marcus
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008297:Male; D063766:Pediatric Obesity / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D015995:Prevalence; D011627:Puberty; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Ambulatory; Blood pressure monitoring; Child; Circadian rhythm; Insulin sensitivity; Obesity