Insulin resistance is a risk factor for high blood pressure regardless of body size and fat distribution in obese children

Maffeis, C.; Banzato, C.; Brambilla, P.; Cerutti, F.; Corciulo, N.; Cuccarolo, G.; Di Pietro, M.; Franzese, A.; Gennari, M.; Balsamo, A.; Grugni, G.; Iughetti, L.; Del Giudice, E. Miraglia; Petri, A.; Trada, M.; Yiannakou, P.; : Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology,

doi:10.1016/j.numecd.2009.04.005

« Previous Next »Nutrition, Metabolism & Cardiovascular Diseases
Volume 20, Issue 4 , Pages 266-273, May 2010

Insulin resistance is a risk factor for high blood pressure regardless of body size and fat distribution in obese children

C. Maffeis
- Department of Mother & Child, Biology-Genetics, Section of Pediatrics, University of Verona, Verona, Italy
- Corresponding author. Department of Mother & Child, Biology-Genetics, Section of Pediatrics, University of Verona, P.zzale LA Scuro 10, 37134 Verona, Italy. Tel.: +39 045 807 4688; fax: +39 045 812 4005.
C. Banzato
- Department of Mother & Child, Biology-Genetics, Section of Pediatrics, University of Verona, Verona, Italy
P. Brambilla
- ASL Milano 2, Lombardia, Italy
F. Cerutti
- Department of Pediatric and Adolescents Science, University of Turin, Turin, Italy
N. Corciulo
- Section of Pediatrics, Hospital of Gallipoli, Gallipoli (Lecce), Italy
G. Cuccarolo
- Section of Pediatrics, Hospital S. Giovanni e Paolo, Venice, Italy
M. Di Pietro
- Section of Pediatrics and Neonatology, Hospital S. Liberatore, Atri, Teramo, Italy
A. Franzese
- Department of Pediatrics, University Federico II Naples, Naples, Italy
M. Gennari
- Department of Pediatrics, Paediatric Endocrinology, Hospital S. Orsola-Malpighi, Bologna, Italy
A. Balsamo
- Department of Pediatrics, Paediatric Endocrinology, Hospital S. Orsola-Malpighi, Bologna, Italy
G. Grugni
- Italian Auxological Institute Foundation, Research Institute, S Giuseppe Hospital, Verbania, Italy
L. Iughetti
- Pediatric Clinic, University of Modena and Reggio Emilia, Modena, Italy
E. Miraglia Del Giudice
- Department of Pediatrics, Second University of Naples, Naples, Italy
A. Petri
- Department of Medical Science, Section of Pediatrics, University of West Piedmont, Novara, Italy
M. Trada
- Department of Medical Science, Section of Pediatrics, University of West Piedmont, Novara, Italy
P. Yiannakou
- Section of Pediatrics, Hospital Regina Apostolorum, Albano Laziale (Rome), Italy
: Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology

Received 14 October 2008; received in revised form 11 February 2009; accepted 1 April 2009. published online 14 September 2009.

Summary

Background and aim

The prevalence of children with hypertension is increasing, especially in obese children. This study was to assess the relationship between blood pressure, indexes of adiposity, body fat distribution and insulin resistance.

Methods and results

Sample: 1044 children (M/F: 484/560; aged 6–11years). Anthropometry and blood pressure were measured and fasting blood samples were tested for triacylglycerol, total cholesterol, HDL cholesterol, glucose, insulin and ALT.

The prevalence of high blood pressure in overweight males and females was 14.3 and 6.4%, respectively (χ²=16.73, p<0.001) and in obese it was 40.4 and 32.8%, respectively (χ²=5.56, p<0.001). High blood pressure increased progressively with BMI z-score categories (χ²=67.99, p<0.001) as well as with waist/height ratio (W/Hr) categories (χ²=23.51, p<0.001). Hypertensive subject had significantly higher insulin (15.6±9.8 vs 11.9±7.2, p<0.001 and 20.63±14.7 vs 15.26±9.8, p<0.001 in males and females respectively) and HOMA_IR (3.23±2.1 vs 2.42±1.49, p<0.001 and 4.12±2.87 vs 3.07±1.98, p<0.001 in males and in females, respectively) than non-hypertensive ones. Among metabolic and cardiovascular risk factors, HOMA_IR was the only variable able to predict high blood pressure in obese boys and girls, in addition to BMI or body fat distribution (waist, W/Hr). The highest HOMA_IR category was the most important predicting factor of high blood pressure in overweight and obese children in addition to body size or body fat distribution.

Conclusions

Blood pressure is associated with the degree of overweight and the indices of body fat distribution. Insulin resistance is an independent additional risk factor for hypertension.

Keywords: Obesity, Body fat distribution, Children, Hypertension, Insulin