Cardiometabolic Phenotype in Children with Obesity

Bonito, Procolo Di; Moio, Nicola; Sibilio, Gerolamo; Cavuto, Luigi; Sanguigno, Eduardo; Forziato, Claudia; Simone, Giovanni de; Capaldo, Brunella

doi:10.1016/j.jpeds.2014.08.007

Cited by 23 publications

(17 citation statements)

References 37 publications

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“…In our previous study, after multivariate analysis, we demonstrated that LV compliance indices correlated significantly with serum insulin levels in nondiabetic children with EH . Obesity along with elevated triglycerides was seen in association with LVH in our current study, indicating a potential role of cardiometabolic phenotype in the development of LVH among children with EH.…”

Section: Discussionsupporting

confidence: 69%

“…We found that LVH phenotype was significantly associated with higher body size, triglycerides, and arterial thickening. From previous studies, we know that LVH is prevalent among obese children and is seen in association with both elevated BP and without elevated BP . Therefore, it is not surprising that even in children with EH in our study, obesity plays a role in the development of LVH.…”

Section: Discussionmentioning

confidence: 49%

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Left Ventricular Hypertrophy Phenotype in Childhood‐Onset Essential Hypertension

Gupta-Malhotra

Hashmi

Poffenbarger

et al. 2015

J of Clinical Hypertension

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Our aim was to determine the risk factors associated with left ventricular hypertrophy (LVH) among 89 untreated children with primary hypertension (HTN). Clinic hypertension was confirmed by 24-hour ambulatory BP monitoring. Left ventricular mass index was calculated as LVM (g)/height (m) 2.7, and LVH was defined as LVMI >95th percentile. Children with (n = 32) and without LVH (n = 57) were compared. Both obesity and systolic BP were independently associated with LVH, with a higher contribution by the BMI. Obesity contributed significantly, with a nearly 9 fold increased risk of LVH. There was evidence of effect modification by the presence or absence of obesity on the relationship between systolic BP and LVH, whereby the relationship existed mainly in the non-obese rather than the obese children. Hence, to achieve reversal of LVH, clinicians should take into account both BP control and weight management.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 49%

Left Ventricular Hypertrophy Phenotype in Childhood‐Onset Essential Hypertension

Gupta-Malhotra

Hashmi

Poffenbarger

et al. 2015

J of Clinical Hypertension

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“…Similarly, other thematically close, recently published studies point to such an indirect relation of MPBW with cardiometabolic risk factors such as metabolic syndrome (including BP, high‐density lipoprotein, triglycerides, waist circumference, and HbA1c; Delpierre et al, ) and cardiac structure (including left ventricular mass, left ventricular mass index, relative wall thickness, fractional shorting, and eccentric left ventricular hypertrophy; Toemen et al, ); the association attenuated into nonsignificance after adding participants' BMI to the multivariate model. Previous studies already described a strong relation of MPBW with higher rates of offspring's overweight or obesity (Pacce et al, ; Yu et al, ), whereas childhood BMI is in turn related to cardiometabolic outcomes (Black et al, ; Di Bonito et al, ), including BP (Friedemann et al, ; Onis et al, ). Hence, it could be concluded that MPBW is associated with offspring's BMI, which in turn affects cardiometabolic outcomes and the risk of CVD.…”

Section: Discussionmentioning

confidence: 96%

“…for an indirect or mediated association: (Pacce et al, 2015;Yu et al, 2013), whereas childhood BMI is in turn related to cardiometabolic outcomes (Black et al, 2014;Di Bonito et al, 2014), including BP (Friedemann et al, 2012;Onis et al, 2013). Hence, it could be concluded that MPBW is associated with offspring's BMI, which in turn affects cardiometabolic outcomes and the risk of CVD.…”

Section: Association Of Mpbw and Offspring's Later Mapmentioning

confidence: 99%

Maternal prepregnancy BMI or weight and offspring's blood pressure: Systematic review

Ludwig-Walz

Schmidt

Günther

et al. 2017

Maternal & Child Nutrition

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Emerging evidence suggests that maternal prepregnancy body mass index or weight (MPBW) may be associated with offspring's blood pressure (BP). Therefore, we conducted a systematic review-following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement-to assess and judge the evidence for an association between MPBW with offspring's later BP. Five data bases were searched without limits. Risk of bias was assessed using the "Tool to Assess Risk of Bias in Cohort Studies," and an evidence grade was allocated following the World Cancer Research Fund criteria. Of 2,011 publications retrieved, 16 studies (all cohort studies) were included in the systematic review; thereof, 5 studies (31%) were rated as good-quality studies. Overall, data from 63,959 participants were enclosed. Systolic BP was analysed in 15 (5 good quality), diastolic BP in 12 (3 good quality), and mean arterial pressure in 3 (no good quality) studies. Five good-quality studies of MPBW with offspring's systolic BP as the outcome and 1 good-quality study with offspring's diastolic BP as the outcome observed a significant association. However, after adding offspring's anthropometry variables to the statistical model, the effect attenuated in 4 studies with systolic BP to nonsignificance, the study with diastolic BP remained significant. No good-quality studies were found with respect to offspring's later mean arterial pressure. In conclusion, this systematic review found suggestive, but still limited, evidence for an association between MPBW with offspring's later BP. The available data suggest that the effect might be mainly mediated via offspring's anthropometry.

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“…If stage I hypertension is confirmed on 3 different visits, the following diagnostic work-up is recommended: 1) assessment of blood urea nitrogen, creatinine, glycemia, electrolytes, lipids, urine examination, microalbuminuria (may be influenced by physical activity) ( LOE II-A ); 2) measurement of glomerular filtration by formulas for renal function monitorig ( LOE III-B ); 3) echocardiography to assess organ damage (left ventricular hypertrophy, altered cardiac structure) ( LOE III-A ) [ 35 ]. Left ventricular remodeling or concentric hypertrophy are associated with high BP levels and other comorbidities such as visceral obesity and atherogenic dyslipidemia [ 36 , 37 ]. Weight loss and reduced sodium intake are recommended.…”

Section: Comorbiditiesmentioning

confidence: 99%

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

et al. 2018

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The Italian Consensus Position Statement on Diagnosis, Treatment and Prevention of Obesity in Children and Adolescents integrates and updates the previous guidelines to deliver an evidence based approach to the disease. The following areas were reviewed: (1) obesity definition and causes of secondary obesity; (2) physical and psychosocial comorbidities; (3) treatment and care settings; (4) prevention.The main novelties deriving from the Italian experience lie in the definition, screening of the cardiometabolic and hepatic risk factors and the endorsement of a staged approach to treatment. The evidence based efficacy of behavioral intervention versus pharmacological or surgical treatments is reported. Lastly, the prevention by promoting healthful diet, physical activity, sleep pattern, and environment is strongly recommended since the intrauterine phase.Electronic supplementary materialThe online version of this article (10.1186/s13052-018-0525-6) contains supplementary material, which is available to authorized users.

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Cardiometabolic Phenotype in Children with Obesity

Cited by 23 publications

References 37 publications

Left Ventricular Hypertrophy Phenotype in Childhood‐Onset Essential Hypertension

Left Ventricular Hypertrophy Phenotype in Childhood‐Onset Essential Hypertension

Maternal prepregnancy BMI or weight and offspring's blood pressure: Systematic review

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

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