Hypertension in a cohort of obese Caucasian children and adolescents and its association with glycometabolic indices: A proposed screening tool
Hypertension (HTN) is common among obese children and adolescents and increases their cardiovascular risk later in adulthood. The aim of the study was to evaluate the prevalence of HTN identified by office blood pressure (BP) measurement and ambulatory BP monitoring (ABPM) in a cohort of obese child...
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| Veröffentlicht in: | Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2023-04, Vol.33 (4), p.900-912 |
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| creator | Vizzuso, S. Del Torto, A. Fiore, G. Milanta, C. Locatelli, G. D'Errico, A. Diamanti, A. Bosetti, A. Colli, A.M. Carugo, S. Zuccotti, G. Verduci, E. |
| description | Hypertension (HTN) is common among obese children and adolescents and increases their cardiovascular risk later in adulthood. The aim of the study was to evaluate the prevalence of HTN identified by office blood pressure (BP) measurement and ambulatory BP monitoring (ABPM) in a cohort of obese children and adolescents and its association with anthropometric and glycometabolic indices.
Seventy consecutive obese Caucasian children and adolescents aged 7–16 years were enrolled. Patients underwent ABPM, echocardiogram and carotid ultrasonography. Sex- and age-adjusted logistic multivariable analysis models were used to assess the association between HOMA-IR, HOMA-β, QUICKI with HTN at ABPM. Receiver Operation Curve (ROC) analysis with Youden J statistics was used to identify the optimal HOMA-IR, HOMA-β and QUICKI cut-off to predict HTN at ABPM. Hypertensive office BP was found in 25.7% of obese patients. ABPM diagnosed HTN in 34.9% of patients: 20.6% of obese patients had masked HTN (MHTN), and 12.7% had white coat HTN (WCH). Hypertensive obese patients (according to ABPM) had higher HOMA-IR and HOMA-β, and a lower QUICKI than normotensive subjects. HOMA-IR, HOMA-β and QUICKI predicted HTN at ABPM in obese patients in age- and sex-adjusted logistic multivariable models. Optimal cut-offs to predict HTN at ABPM in obese patients were: HOMA-IR ≥ 3.30, HOMA-β ≥ 226.7 and QUICKI |
| doi_str_mv | 10.1016/j.numecd.2023.01.001 |
| format | Article |
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Seventy consecutive obese Caucasian children and adolescents aged 7–16 years were enrolled. Patients underwent ABPM, echocardiogram and carotid ultrasonography. Sex- and age-adjusted logistic multivariable analysis models were used to assess the association between HOMA-IR, HOMA-β, QUICKI with HTN at ABPM. Receiver Operation Curve (ROC) analysis with Youden J statistics was used to identify the optimal HOMA-IR, HOMA-β and QUICKI cut-off to predict HTN at ABPM. Hypertensive office BP was found in 25.7% of obese patients. ABPM diagnosed HTN in 34.9% of patients: 20.6% of obese patients had masked HTN (MHTN), and 12.7% had white coat HTN (WCH). Hypertensive obese patients (according to ABPM) had higher HOMA-IR and HOMA-β, and a lower QUICKI than normotensive subjects. HOMA-IR, HOMA-β and QUICKI predicted HTN at ABPM in obese patients in age- and sex-adjusted logistic multivariable models. Optimal cut-offs to predict HTN at ABPM in obese patients were: HOMA-IR ≥ 3.30, HOMA-β ≥ 226.7 and QUICKI <0.33, with high sensitivity.
A sequential testing strategy applying office BP and glycometabolic indices can identify hypertensive obese pediatric patients with high diagnostic accuracy and potentially reducing costs. This strategy needs validation in an external and larger cohort.
•Hypertension is common among obese children and adolescents.•Masked hypertension in common obese children and adolescents and can only be diagnosed using ambulatory blood pressure monitoring (ABPM).•Hypertension is strongly associated with altered glycometabolic indices (HOMA-IR, HOMA-β and QUICKI).•Altered HOMA-IR, HOMA-β and QUICKI can identify obese pediatric subjects with hypertension with high sensitivity.•Combining office blood pressure and glycometabolic assessment can accurately diagnose obese children and adolescents with hypertension.</description><identifier>ISSN: 0939-4753</identifier><identifier>EISSN: 1590-3729</identifier><identifier>DOI: 10.1016/j.numecd.2023.01.001</identifier><identifier>PMID: 36710109</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adolescent ; Blood Pressure - physiology ; Blood Pressure Determination ; Blood Pressure Monitoring, Ambulatory ; Cardiovascular risk ; Child ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - diagnosis ; Hypertension - epidemiology ; Pediatric obesity ; Pediatric Obesity - complications ; Pediatric Obesity - diagnosis ; Pediatric Obesity - epidemiology</subject><ispartof>Nutrition, metabolism, and cardiovascular diseases, 2023-04, Vol.33 (4), p.900-912</ispartof><rights>2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University</rights><rights>Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-deef3cacd0d806e237e7c524a5ee55f421e3ebd29997323831368e7119edc3ec3</citedby><cites>FETCH-LOGICAL-c362t-deef3cacd0d806e237e7c524a5ee55f421e3ebd29997323831368e7119edc3ec3</cites><orcidid>0000-0002-6100-5687 ; 0000-0001-7188-8391 ; 0000-0002-3001-0387 ; 0000-0001-5074-2078</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0939475323000066$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36710109$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vizzuso, S.</creatorcontrib><creatorcontrib>Del Torto, A.</creatorcontrib><creatorcontrib>Fiore, G.</creatorcontrib><creatorcontrib>Milanta, C.</creatorcontrib><creatorcontrib>Locatelli, G.</creatorcontrib><creatorcontrib>D'Errico, A.</creatorcontrib><creatorcontrib>Diamanti, A.</creatorcontrib><creatorcontrib>Bosetti, A.</creatorcontrib><creatorcontrib>Colli, A.M.</creatorcontrib><creatorcontrib>Carugo, S.</creatorcontrib><creatorcontrib>Zuccotti, G.</creatorcontrib><creatorcontrib>Verduci, E.</creatorcontrib><title>Hypertension in a cohort of obese Caucasian children and adolescents and its association with glycometabolic indices: A proposed screening tool</title><title>Nutrition, metabolism, and cardiovascular diseases</title><addtitle>Nutr Metab Cardiovasc Dis</addtitle><description>Hypertension (HTN) is common among obese children and adolescents and increases their cardiovascular risk later in adulthood. The aim of the study was to evaluate the prevalence of HTN identified by office blood pressure (BP) measurement and ambulatory BP monitoring (ABPM) in a cohort of obese children and adolescents and its association with anthropometric and glycometabolic indices.
Seventy consecutive obese Caucasian children and adolescents aged 7–16 years were enrolled. Patients underwent ABPM, echocardiogram and carotid ultrasonography. Sex- and age-adjusted logistic multivariable analysis models were used to assess the association between HOMA-IR, HOMA-β, QUICKI with HTN at ABPM. Receiver Operation Curve (ROC) analysis with Youden J statistics was used to identify the optimal HOMA-IR, HOMA-β and QUICKI cut-off to predict HTN at ABPM. Hypertensive office BP was found in 25.7% of obese patients. ABPM diagnosed HTN in 34.9% of patients: 20.6% of obese patients had masked HTN (MHTN), and 12.7% had white coat HTN (WCH). Hypertensive obese patients (according to ABPM) had higher HOMA-IR and HOMA-β, and a lower QUICKI than normotensive subjects. HOMA-IR, HOMA-β and QUICKI predicted HTN at ABPM in obese patients in age- and sex-adjusted logistic multivariable models. Optimal cut-offs to predict HTN at ABPM in obese patients were: HOMA-IR ≥ 3.30, HOMA-β ≥ 226.7 and QUICKI <0.33, with high sensitivity.
A sequential testing strategy applying office BP and glycometabolic indices can identify hypertensive obese pediatric patients with high diagnostic accuracy and potentially reducing costs. This strategy needs validation in an external and larger cohort.
•Hypertension is common among obese children and adolescents.•Masked hypertension in common obese children and adolescents and can only be diagnosed using ambulatory blood pressure monitoring (ABPM).•Hypertension is strongly associated with altered glycometabolic indices (HOMA-IR, HOMA-β and QUICKI).•Altered HOMA-IR, HOMA-β and QUICKI can identify obese pediatric subjects with hypertension with high sensitivity.•Combining office blood pressure and glycometabolic assessment can accurately diagnose obese children and adolescents with hypertension.</description><subject>Adolescent</subject><subject>Blood Pressure - physiology</subject><subject>Blood Pressure Determination</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Cardiovascular risk</subject><subject>Child</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Pediatric obesity</subject><subject>Pediatric Obesity - complications</subject><subject>Pediatric Obesity - diagnosis</subject><subject>Pediatric Obesity - epidemiology</subject><issn>0939-4753</issn><issn>1590-3729</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1uEzEUhS0EoqHwBgh5yWYG_8yMYxZIVURppUpsYG0513caRzN2sD1UeQpeGadpWbK6utJ3zv05hLznrOWMD5_2bVhmBNcKJmTLeMsYf0FWvNeskUrol2TFtNRNp3p5Qd7kvGdMKia71-RCDqp6ML0if26OB0wFQ_YxUB-opRB3MRUaRxq3mJFu7AI2exso7PzkElYoOGpdnDADhpIfe3-qOUfwtpy8HnzZ0fvpCHHGYrdx8lD9nQfMn-kVPaR4iBkdzZAQgw_3tMQ4vSWvRjtlfPdUL8nP668_NjfN3fdvt5uruwbkIErjEEcJFhxzazagkAoV9KKzPWLfj53gKHHrhNZaSSHXksthjYpzjQ4kgrwkH8--dY9fC-ZiZl-PmSYbMC7ZCFU_tO6rsqLdGYUUc044mkPys01Hw5k5RWH25hyFOUVhGDc1iir78DRh2c7o_omef1-BL2cA652_PSaTwWMAdD4hFOOi__-Ev8Zsn08</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Vizzuso, S.</creator><creator>Del Torto, A.</creator><creator>Fiore, G.</creator><creator>Milanta, C.</creator><creator>Locatelli, G.</creator><creator>D'Errico, A.</creator><creator>Diamanti, A.</creator><creator>Bosetti, A.</creator><creator>Colli, A.M.</creator><creator>Carugo, S.</creator><creator>Zuccotti, G.</creator><creator>Verduci, E.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6100-5687</orcidid><orcidid>https://orcid.org/0000-0001-7188-8391</orcidid><orcidid>https://orcid.org/0000-0002-3001-0387</orcidid><orcidid>https://orcid.org/0000-0001-5074-2078</orcidid></search><sort><creationdate>202304</creationdate><title>Hypertension in a cohort of obese Caucasian children and adolescents and its association with glycometabolic indices: A proposed screening tool</title><author>Vizzuso, S. ; Del Torto, A. ; Fiore, G. ; Milanta, C. ; Locatelli, G. ; D'Errico, A. ; Diamanti, A. ; Bosetti, A. ; Colli, A.M. ; Carugo, S. ; Zuccotti, G. ; Verduci, E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-deef3cacd0d806e237e7c524a5ee55f421e3ebd29997323831368e7119edc3ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Blood Pressure - physiology</topic><topic>Blood Pressure Determination</topic><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>Cardiovascular risk</topic><topic>Child</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - epidemiology</topic><topic>Pediatric obesity</topic><topic>Pediatric Obesity - complications</topic><topic>Pediatric Obesity - diagnosis</topic><topic>Pediatric Obesity - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vizzuso, S.</creatorcontrib><creatorcontrib>Del Torto, A.</creatorcontrib><creatorcontrib>Fiore, G.</creatorcontrib><creatorcontrib>Milanta, C.</creatorcontrib><creatorcontrib>Locatelli, G.</creatorcontrib><creatorcontrib>D'Errico, A.</creatorcontrib><creatorcontrib>Diamanti, A.</creatorcontrib><creatorcontrib>Bosetti, A.</creatorcontrib><creatorcontrib>Colli, A.M.</creatorcontrib><creatorcontrib>Carugo, S.</creatorcontrib><creatorcontrib>Zuccotti, G.</creatorcontrib><creatorcontrib>Verduci, E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vizzuso, S.</au><au>Del Torto, A.</au><au>Fiore, G.</au><au>Milanta, C.</au><au>Locatelli, G.</au><au>D'Errico, A.</au><au>Diamanti, A.</au><au>Bosetti, A.</au><au>Colli, A.M.</au><au>Carugo, S.</au><au>Zuccotti, G.</au><au>Verduci, E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypertension in a cohort of obese Caucasian children and adolescents and its association with glycometabolic indices: A proposed screening tool</atitle><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle><addtitle>Nutr Metab Cardiovasc Dis</addtitle><date>2023-04</date><risdate>2023</risdate><volume>33</volume><issue>4</issue><spage>900</spage><epage>912</epage><pages>900-912</pages><issn>0939-4753</issn><eissn>1590-3729</eissn><abstract>Hypertension (HTN) is common among obese children and adolescents and increases their cardiovascular risk later in adulthood. The aim of the study was to evaluate the prevalence of HTN identified by office blood pressure (BP) measurement and ambulatory BP monitoring (ABPM) in a cohort of obese children and adolescents and its association with anthropometric and glycometabolic indices.
Seventy consecutive obese Caucasian children and adolescents aged 7–16 years were enrolled. Patients underwent ABPM, echocardiogram and carotid ultrasonography. Sex- and age-adjusted logistic multivariable analysis models were used to assess the association between HOMA-IR, HOMA-β, QUICKI with HTN at ABPM. Receiver Operation Curve (ROC) analysis with Youden J statistics was used to identify the optimal HOMA-IR, HOMA-β and QUICKI cut-off to predict HTN at ABPM. Hypertensive office BP was found in 25.7% of obese patients. ABPM diagnosed HTN in 34.9% of patients: 20.6% of obese patients had masked HTN (MHTN), and 12.7% had white coat HTN (WCH). Hypertensive obese patients (according to ABPM) had higher HOMA-IR and HOMA-β, and a lower QUICKI than normotensive subjects. HOMA-IR, HOMA-β and QUICKI predicted HTN at ABPM in obese patients in age- and sex-adjusted logistic multivariable models. Optimal cut-offs to predict HTN at ABPM in obese patients were: HOMA-IR ≥ 3.30, HOMA-β ≥ 226.7 and QUICKI <0.33, with high sensitivity.
A sequential testing strategy applying office BP and glycometabolic indices can identify hypertensive obese pediatric patients with high diagnostic accuracy and potentially reducing costs. This strategy needs validation in an external and larger cohort.
•Hypertension is common among obese children and adolescents.•Masked hypertension in common obese children and adolescents and can only be diagnosed using ambulatory blood pressure monitoring (ABPM).•Hypertension is strongly associated with altered glycometabolic indices (HOMA-IR, HOMA-β and QUICKI).•Altered HOMA-IR, HOMA-β and QUICKI can identify obese pediatric subjects with hypertension with high sensitivity.•Combining office blood pressure and glycometabolic assessment can accurately diagnose obese children and adolescents with hypertension.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>36710109</pmid><doi>10.1016/j.numecd.2023.01.001</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-6100-5687</orcidid><orcidid>https://orcid.org/0000-0001-7188-8391</orcidid><orcidid>https://orcid.org/0000-0002-3001-0387</orcidid><orcidid>https://orcid.org/0000-0001-5074-2078</orcidid></addata></record> |
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| ispartof | Nutrition, metabolism, and cardiovascular diseases, 2023-04, Vol.33 (4), p.900-912 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adolescent Blood Pressure - physiology Blood Pressure Determination Blood Pressure Monitoring, Ambulatory Cardiovascular risk Child Humans Hypertension Hypertension - complications Hypertension - diagnosis Hypertension - epidemiology Pediatric obesity Pediatric Obesity - complications Pediatric Obesity - diagnosis Pediatric Obesity - epidemiology |
| title | Hypertension in a cohort of obese Caucasian children and adolescents and its association with glycometabolic indices: A proposed screening tool |
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