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Blood pressure from childhood to adolescence in obese youths in relation to insulin resistance and asymmetric dimethylarginine

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Abstract

Background and propose

Hypertension is the most important cardiovascular complication of obesity, even during childhood. Several studies have demonstrated that there is a natural progression of hypertension from childhood to adulthood. However, there are no data reporting a potential worsening in blood pressure (BP) already moving from the pre-pubertal to the pubertal period in obese youths. The aim of this study was to evaluate early change in BP and its relation to insulin resistance (IR) and asymmetric dimethylarginine (ADMA).

Methods

Thirty obese children underwent a first assessment when they were pre-pubertal (visit_1) and were re-evaluated after a mean of 4.5 years (visit_2). At both visits, anthropometric parameters were assessed, blood samples were collected for measurement of insulin, glucose and ADMA and a 24-h ambulatory BP monitoring was performed.

Results

At visit_2, the study participants presented increased HOMA-IR and ADMA compared to visit_1 (HOMA-IR: 3.6 ± 2.8 vs 2.8 ± 1.4, p = 0.01; ADMA: 1.57 ± 0.78 vs 0.77 ± 0.52 μmol/l, p < 0.001). Values of 24-h systolic and diastolic BP SDS (0.86 ± 0.79 vs 0.42 ± 0.83, p = 0.001; −0.45 ± 0.82 vs 0.08 ± 0.51, p = 0.001) were significantly increased at visit_2 compared to visit_1. At both visits, BMI-SDS, HOMA-IR and ADMA were associated with 24-h BP. In addition, over-time changes in IR and ADMA influenced changes in systolic blood pressure and diastolic blood pressure from childhood to adolescence (p < 0.05).

Conclusions

Changes in BP already occur moving from the pre-pubertal to the pubertal period in obese children, and modifications in insulin resistance and ADMA seem to be implicated in this early progression in BP.

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Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by Ethical Committee of University of Chieti. All procedures included in this study were performed in the respect of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all parents and oral consent from children at visit_1. At visit_2, written informed consent was obtained both from all parents and adolescents.

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Authors and Affiliations

  1. Department of Pediatrics, University of Chieti, Ospedale Policlinico, Via dei Vestini 5, 66100, Chieti, Italy

    T. de Giorgis, M. L. Marcovecchio, C. Giannini, V. Chiavaroli, F. Chiarelli & A. Mohn

  2. Clinical Research Center, ‘G. d’Annunzio’ Foundation, University of Chieti, Chieti, Italy

    T. de Giorgis, M. L. Marcovecchio, C. Giannini, V. Chiavaroli, F. Chiarelli & A. Mohn

Authors
  1. T. de Giorgis
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  2. M. L. Marcovecchio
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  3. C. Giannini
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  4. V. Chiavaroli
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  5. F. Chiarelli
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  6. A. Mohn
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Corresponding author

Correspondence to A. Mohn.

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de Giorgis, T., Marcovecchio, M.L., Giannini, C. et al. Blood pressure from childhood to adolescence in obese youths in relation to insulin resistance and asymmetric dimethylarginine. J Endocrinol Invest 39, 169–176 (2016). https://doi.org/10.1007/s40618-015-0351-2

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  • DOI: https://doi.org/10.1007/s40618-015-0351-2

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