Procolo Di Bonito1, Lucia Pacifico2, Maria Rosaria Licenziati3, Claudio Maffeis4, Anita Morandi4, Melania Manco5, Emanuele Miraglia Del Giudice6, Anna Di Sessa6, Giuseppina Campana3, Nicola Moio7, Marco Giorgio Baroni8, Claudio Chiesa9, Giovanni De Simone10, Giuliana Valerio11. 1. Department of Internal Medicine, "S. Maria delle Grazie", Pozzuoli Hospital, Naples, Italy. 2. Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy. 3. Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy. 4. Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy. 5. IRCCS Bambino Gesù Children's Hospital, Rome, Italy. 6. Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy. 7. Department of Cardiology, "S. Maria delle Grazie", Pozzuoli Hospital, Naples, Italy. 8. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy. 9. Institute of Translational Pharmacology, National Research Council, Rome, Italy. 10. Hypertension Research Centre, Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy. 11. Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy. Electronic address: giuliana.valerio@uniparthenope.it.
Abstract
BACKGROUND AND AIM: To compare cardiometabolic risk profile and preclinical signs of target organ damage in youth with normal and elevated blood pressure (BP), according to the American Academy of Pediatrics (AAP) guidelines. METHODS AND RESULTS: This cross-sectional multicenter study included 2739 youth (5-17 year-old; 170 normal-weight, 610 overweight and 1959 with obesity) defined non hypertensive by the AAP guidelines. Anthropometric, biochemical and liver ultrasound data were available in the whole population; carotid artery ultrasound and echocardiographic assessments were available respectively in 427 and 264 youth. Elevated BP was defined as BP ≥ 90th to <95th percentile for age, gender and height in children or BP ≥ 120/80 to <130/80 in adolescents. The overall prevalence of elevated BP was 18.3%, and significantly increased from normal-weight to obese youth. Young people with elevated BP showed higher levels of body mass index (BMI), insulin resistance and a higher prevalence of liver steatosis (45% vs 36%, p < 0.0001) than normotensive youth, whilst they did not differ for the other cardiometabolic risk factors, neither for carotid intima media thickness or left ventricular mass. Compared with normotensive youth, individuals with elevated BP had an odds ratio (95%Cl) of 3.60 (2.00-6.46) for overweight/obesity, 1.46 (1.19-1.78) for insulin-resistance and 1.45 (1.19-1.77) for liver steatosis, controlling for centers, age and prepubertal stage. The odds for insulin resistance and liver steatosis persisted elevated after correction for BMI-SDS. CONCLUSION: Compared to normotensive youth, elevated BP is associated with increased BMI, insulin resistance and liver steatosis, without significant target organ damage.
BACKGROUND AND AIM: To compare cardiometabolic risk profile and preclinical signs of target organ damage in youth with normal and elevated blood pressure (BP), according to the American Academy of Pediatrics (AAP) guidelines. METHODS AND RESULTS: This cross-sectional multicenter study included 2739 youth (5-17 year-old; 170 normal-weight, 610 overweight and 1959 with obesity) defined non hypertensive by the AAP guidelines. Anthropometric, biochemical and liver ultrasound data were available in the whole population; carotid artery ultrasound and echocardiographic assessments were available respectively in 427 and 264 youth. Elevated BP was defined as BP ≥ 90th to <95th percentile for age, gender and height in children or BP ≥ 120/80 to <130/80 in adolescents. The overall prevalence of elevated BP was 18.3%, and significantly increased from normal-weight to obese youth. Young people with elevated BP showed higher levels of body mass index (BMI), insulin resistance and a higher prevalence of liver steatosis (45% vs 36%, p < 0.0001) than normotensive youth, whilst they did not differ for the other cardiometabolic risk factors, neither for carotid intima media thickness or left ventricular mass. Compared with normotensive youth, individuals with elevated BP had an odds ratio (95%Cl) of 3.60 (2.00-6.46) for overweight/obesity, 1.46 (1.19-1.78) for insulin-resistance and 1.45 (1.19-1.77) for liver steatosis, controlling for centers, age and prepubertal stage. The odds for insulin resistance and liver steatosis persisted elevated after correction for BMI-SDS. CONCLUSION: Compared to normotensive youth, elevated BP is associated with increased BMI, insulin resistance and liver steatosis, without significant target organ damage.
Authors: Maria Francesca Gicchino; Pierluigi Marzuillo; Sarah Zarrilli; Rosa Melone; Stefano Guarino; Emanuele Miraglia Del Giudice; Alma Nunzia Olivieri; Anna Di Sessa Journal: Eur J Pediatr Date: 2022-10-14 Impact factor: 3.860
Authors: Marco Carotenuto; Anna Di Sessa; Maria Esposito; Anna Grandone; Pierluigi Marzuillo; Ilaria Bitetti; Giuseppina Rosaria Umano; Francesco Precenzano; Emanuele Miraglia Del Giudice; Nicola Santoro Journal: Children (Basel) Date: 2021-11-01