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Association between nocturnal blood pressure dipping and insulin resistance in children affected by NAFLD

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Abstract

The aim of this study was to analyse the relationship between insulin–glucose metabolism, nocturnal blood pressure dipping and nonalcoholic fatty liver disease (NAFLD) in obese adolescents without diabetes. One hundred one consecutive children, with biopsy-proven NAFLD, were included in this study. Blood samples were drawn for the analyses of liver function tests, insulin–glucose metabolism and lipid profile appraisal. An ambulatory blood pressure measurement (ABPM) was performed. Seventy-six children (75.3 %) were systolic nondippers, and 23 of them were diastolic nondippers (30.3 %). No differences were found in the anthropometric parameters between the two groups. When compared to the systolic dippers, the systolic nondippers had higher medians of mean nocturnal blood pressure, glucose at 0, 60 and 120 min in the oral glucose tolerance test (OGTT), OGTT insulin at all time points and insulin-resistance values. No correlation of histopathological features with dipping/nondipping statuses was found. Conclusions: We found an association between a nocturnal blood pressure fall and measures of insulin levels, independent of obesity, or daytime blood pressure levels, among the obese patients with NAFLD. Although no association between nondipping profiles and NAFLD was observed in our study, further studies with a longer term follow-up are needed, to better elucidate the complex link between these particular entities.

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Abbreviations

ALT:

Alanine transferases

AST:

Aspartate transferases

ABPM:

Ambulatory blood pressure measurement

BP:

Blood pressure

GGT:

Gamma-glutamyl-transpeptidase

HSC:

Hepatic stellate cells

HOMA:

Homeostatic model assessment

IQR:

Interquartile range

ISI:

OGTT-derived insulin sensitivity index

LDL:

Low-density lipoprotein

HDL:

High-density lipoprotein

NAFLD:

Nonalcoholic fatty liver disease

OGTT:

Oral glucose tolerance test

RAAS:

Renin–angiotensin–aldosterone system

NASH:

Steatohepatitis

SNS:

Sympathetic nervous system

TG:

Total triglycerides

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Conflict of interest

No author has any conflict of interest, financial or otherwise related to the content of the paper.

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Authors and Affiliations

  1. Sport Medicine Unit, Bambino Gesù Children’s Hospital-IRCCS, Rome, Italy

    Ugo Giordano, Giulia Cafiero & Attilio Turchetta

  2. Hepato-Metabolic Department, Liver Research Unit, Bambino Gesù Children’s Hospital-IRCCS, P.zza S. Onofrio, 4-00165, Rome, Italy

    Claudia Della Corte, Daniela Liccardo, Giorgio Bedogni & Valerio Nobili

  3. ASL Rome G, Rome, Italy

    Kazem Mohammad Hoshemand

  4. Pediatric Nephrology and Urology Department, Bambino Gesù Children’s Hospital-IRCCS, Rome, Italy

    Maria Chiara Matteucci

  5. Endocrinology and Diabetology Unit, Bambino Gesù Children’s Hospital-IRCCS, Rome, Italy

    Danilo Fintini

  6. Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy

    Giorgio Bedogni

Authors
  1. Ugo Giordano
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  2. Claudia Della Corte
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  3. Giulia Cafiero
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  4. Daniela Liccardo
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  5. Attilio Turchetta
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  6. Kazem Mohammad Hoshemand
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  7. Danilo Fintini
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  8. Giorgio Bedogni
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  9. Maria Chiara Matteucci
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  10. Valerio Nobili
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Corresponding author

Correspondence to Claudia Della Corte.

Additional information

Communicated by Peter de Winter

Ugo Giordano and Claudia Della Corte have contributed equally to the manuscript.

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Giordano, U., Della Corte, C., Cafiero, G. et al. Association between nocturnal blood pressure dipping and insulin resistance in children affected by NAFLD. Eur J Pediatr 173, 1511–1518 (2014). https://doi.org/10.1007/s00431-014-2342-2

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  • DOI: https://doi.org/10.1007/s00431-014-2342-2

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