Obesity in children: criteria for predicting the development of hypertension
Keywords:children, obesity, overweight, hypertension, prognostic criteria
AbstractBackground. Obesity in childhood causes a wide range of serious complications and increased risk of diabetes, hypertension, cardiovascular and other diseases. Formation of various types of hypertension in adolescents with overweight and obesity is characterized by imbalance in the production of biologically active substances. Materials and methods. One hundred and sixty people were examined: with overweight (n = 35), obesity (abdominal (n = 35), uniform (n = 35)), and 55 healthy people. Blood lipids (total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol), endothelin-1, β2-microglobulin were studied, as well as 6-hydroxymelatonin sulfate in the urine. Results. A significant increase in the average daily values of systolic, diastolic, mean hemodynamic and pulse blood pressure was established. Obese children had a tendency to react excessively in the form of an increase in the daily rate of systolic blood pressure elevations. In 57.1 % of patients with obesity, pathological abnormalities of the blood lipids were found: levels of total cholesterol, LDL cholesterol, triglycerides were higher, and HDL cholesterol was lower in both groups of patients. A significant increase in the content of endothelin-1 and β2-microglobulin in the blood plasma of obese children and a tendency towards an increase in children with overweight, disturbances of the circadian rhythm of 6-hydroxymelatonin sulfate secretion were revealed. Conclusions. Metabolic risk factors for the development of hypertension have been identified in children with obesity and overweight: dyslipidemia (hypertriglyceridemia, increased LDL cholesterol, reduced HDL cholesterol), increased β2-microglobulin and endothelin-1 levels, and an imbalance of melatonin secretion. Patients with these adverse factors should be closely monitored by a physician. A special attention should be paid to children with overweight as potential candidates for the development of obesity and its complications, including arterial hypertension.
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