title: Ambulatory Blood Pressure Monitoring in Lean, Obese and Diabetic Children and Adolescents.
abstract: OBJECTIVE
  To determine if children and adolescents who have obesity (Ob) or type 2 diabetes (T2DM) of relatively short duration have impaired cardiovascular function compared with lean subjects using 24-hour ambulatory blood pressure as a surrogate measure of evaluation.
  
  
  METHODS
  We enrolled 100 African-Caribbean subjects (45 males/55 females), mean ages 14.4-15.2 years (range 11.8-18.5 years) and Tanner stage 4.2-4.8. Mean BMI for the Ob (n = 40), T2DM (n = 39) and lean (n = 21) groups were 40.3, 34.2 and 20.8, respectively (p < 0.01, Ob and T2DM vs. lean). Mean hemoglobin A1c in lean and Ob was 5.4 and 5.5% compared to 8.8% in T2DM (p < 0.001, T2DM vs. lean and Ob). Ambulatory blood pressure was recorded every 20 min over 24 h using Spacelabs 70207.
  
  
  RESULTS
  Mean 24-hour, daytime and nighttime systolic blood pressure was significantly higher in Ob and T2DM compared with lean subjects (mean 24-hour 117 and 120 vs. 109 mm Hg; daytime 121 and 123 vs. 113 mm Hg; and nighttime 109 and 115 vs. 101 mm Hg; p < 0.01 for all time periods). The nocturnal systolic dip in Ob and T2DM did not differ from that of lean, whereas nocturnal diastolic dip decreased significantly in Ob and T2DM compared to lean (11.5 and 10.4 vs. 20.6 mm Hg; p < 0.01). Mean pulse pressure was significantly increased in the Ob and T2DM groups compared to lean subjects (51 and 54 vs. 45 mm Hg; p < 0.01).
  
  
  CONCLUSIONS
  Adolescent Ob and T2DM groups share adverse risk factors, which may be harbingers of adult cardiovascular events.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
authors.forename: Deep
authors.initials: D
authors.lastname: Shikha
authors.affiliation: Department of Internal Medicine, Mount Sinai St. Luke's Hospital, New York, N.Y., USA.
authors.forename: Montish
authors.initials: M
authors.lastname: Singla
authors.affiliation: Division of Endocrinology, Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
authors.forename: Rachna
authors.initials: R
authors.lastname: Walia
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
authors.forename: Natia
authors.initials: N
authors.lastname: Potter
authors.affiliation: Division of Endocrinology, Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
authors.forename: Vatcharapan
authors.initials: V
authors.lastname: Umpaichitra
authors.affiliation: Division of Endocrinology, Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
authors.forename: Arlene
authors.initials: A
authors.lastname: Mercado
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Winer
keywords: Ambulatory blood pressure; Ambulatory blood pressure monitoring; Children; Homeostasis model assessment of insulin resistance; Obesity; Type 2 diabetes