Epidemiological aspects of obesity and systemic hypertension amongschool children of Western Ukraine

Pavlyshyn, Halyna; Furdela, Victoriya; Kovalchuk, T. A.; Haliyash, Nataliya; Luchyshyn, Nataliia

doi:10.18544/pedm-23.04.0091

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…Increasing evidence has suggested that childhood OSAS is associated with childhood hypertension and a cluster of cardiometabolic risk factors 2,31,32 . Consistent with a previous report, 3 we found a high prevalence rate of elevated BP in the children with OSAS (26.9%) compared with that in the general population (ranging from 0.8% to 13.3% 33 ). Furthermore, children with OSAS have been reported to be at risk of impaired BP control and increased endothelial dysfunction 34 ; therefore, elevated BP in childhood is frequently sustained into adulthood.…”

Section: Discussionsupporting

confidence: 92%

Effect of Preoperative Weight Status and Disease Presentation on Postoperative Elevated Blood Pressure After Childhood Adenotonsillectomy

Hsieh

Chuang

Hsin

et al. 2023

Otolaryngol.--head neck surg.

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Objective To investigate the risk factors of postoperative elevated blood pressure (BP) in children with childhood obstructive sleep apnea syndrome (OSAS) after adenotonsillectomy (AT). Study Design Case series with planned data collection. Setting Tertiary referral center. Methods Two hundred forty‐five consecutive children (180 boys and 65 girls, median age 6.6 years) with polysomnography‐diagnosed OSAS who underwent AT between January 2010 and August 2019. Clinical, polysomnographic, and evening BP data were assessed preoperatively and postoperatively (≥3 months after AT). Changes in the variables before and after AT and between individuals with and without hypertension were compared. Results Postoperatively, the median (interquartile range) apnea‐hypopnea index significantly decreased from 10.4 (5.3‐22.6) to 2.2 (1.0‐3.8) events/h. In addition, the mean (standard deviation) evening diastolic BP z‐score significantly decreased from 0.7 (0.94) to 0.5 (0.81) in the overall cohort, and both systolic (2.1 [0.94]‐1.0 [1.31]) and diastolic BP z‐scores (1.6 [0.98]‐0.7 [0.85]) significantly decreased in the preoperative elevated BP subgroup. Multivariate logistic regression analysis showed that preoperative obesity (adjusted odds ratio = 4.36, 95% confidence interval = 2.24‐8.49) and mean peripheral oxygen saturation <95% during sleep (adjusted odds ratio = 2.73, 95% confidence interval = 1.29‐5.79) were independently associated with postoperative elevated BP. Conclusion Preoperative obesity and mean peripheral oxygen saturation <95% during sleep were significantly associated with postoperative elevated BP in the children with OSAS, further indicating the importance of careful BP monitoring in this subgroup despite AT treatment.

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Section: Discussionsupporting

confidence: 92%

Effect of Preoperative Weight Status and Disease Presentation on Postoperative Elevated Blood Pressure After Childhood Adenotonsillectomy

Hsieh

Chuang

Hsin

et al. 2023

Otolaryngol.--head neck surg.

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“…Early interventions are recommended to attain optimal BP control through multidisciplinary approaches, such as lifestyle modification, weight reduction, or anti-hypertensive drugs [ 36 ]. The estimated prevalence of pediatric hypertension varies widely, ranging from 0.8% to 13.3% [ 9 , 37 ]. However, in this sample of children with OSAS, the prevalence of hypertension was alarmingly higher, 27.1% for the overall cohort and 43.9% for the obese patients.…”

Section: Discussionmentioning

confidence: 99%

“…Some previous investigations have shown a sex difference in the prevalence of pediatric hypertension. For example, the rates of pre-hypertension and first stage systemic hypertension were observed to be two-fold higher in boys than in girls among school children in a study from Western Ukraine [ 37 ], and a systematic review found that boys were more likely to have high BP than girls [ 40 ]. In the current study, there was a significantly larger proportion of boys in the hypertensive group than in the normotensive group.…”

Section: Discussionmentioning

confidence: 99%

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Chuang

Hsu

Wang

et al. 2021

IJERPH

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Older age, obesity, and obstructive sleep apnea syndrome (OSAS) are known to increase the risk of hypertension in adults. However, data for children are scarce. This study aimed to investigate the relationships between hypertension, age, weight status, and disease severity in 396 children with OSAS. The prevalence rates of hypertension, obesity, and severe OSAS (apnea-hypopnea index ≥10) were 27.0%, 28.0%, and 42.9%, respectively. Weight z-score and apnea-hypopnea index were independently correlated with systolic blood pressure z-score, and minimal blood oxygen saturation (SpO2) was independently associated with diastolic blood pressure z-score. Overall, late childhood/adolescence (odds ratio (OR) = 1.72, 95% CI = 1.05–2.81), obesity (OR, 2.58, 95% CI = 1.58–4.22), and severe OSAS (OR = 2.38, 95% CI = 1.48–3.81) were independent predictors of pediatric hypertension. Furthermore, late childhood/adolescence (OR = 2.50, 95% CI = 1.10–5.71) and abnormal SpO2 (mean SpO2 < 95%; OR = 4.91, 95% CI = 1.81–13.27) independently predicted hypertension in obese children, and severe OSAS (OR = 2.28, 95% CI = 1.27–4.10) independently predicted hypertension in non-obese children. In conclusion, obesity, OSAS severity, and abnormal SpO2 are potentially modifiable targets to improve hypertension while treating children with OSAS.

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“…За даними державної офіційної статистики в Україні поширеність ожиріння серед дітей від 0 до 17 років становить лише 1,34 % від дитячого населення, зокрема 1,79 % серед дітей 7-14 років і 3,01 % серед підлітків 15-17 років [7]. Хоча, як показують епідеміологічні дослідження проведені у під егідою Асоціації педіатрів України [10,11], ці цифри дещо вищі (3,2-4,8 %) серед дітей шкільного віку і залежать від регіону України [8,9]. Важливо пам'ятати, що не все ожиріння однорідне за причинами, наслідками і прогнозами для життя пацієнтів.…”

Section: вступunclassified

Metabolically Healthy and Unhealthy Obesity in Children From the Point of View of Evidence-Based Medicine

Furdela

Smiian

Furdela

2020

EUMJ

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Introduction. Childhood obesity and associated metabolic comorbidities is a major global health concern. Metabolic syndrome (MS) is a cluster of metabolic abnormalities that confers a substantial increase in cardiovascular disease risk. In the context of the childhood obesity pandemic, a distinct subgroup of youth with obesity less prone to the development of metabolic disturbances, called “metabolically healthy obese” (MHO), recently has come into focus. However, the diagnostic criteria of both conditions are still controversial in children. Therefore, the purpose of our research is to estimate the prevalence of metabolic syndrome and metabolically healthy obesity in school-age boys using international reference standards and to recognize the most sensitive metabolic markers. Materials and methods. This study was carried out at the Ternopil regional hospital (Western Ukraine) and involved randomly chosen 112 boys from rural and urban population; aged 10–17 years (mean ± SD, 14.6 ± 0.25). Height, weight and waist and hip circumferences were measured by standard methods in each patient. Body mass index (BMI, kg/m2), waist-to-height ratio (WtHR), waist-to-hip ratio (WHR) were calculated by common formulas. Obesity was defined as a BMI ≥ 2SD for age and gender. Blood pressure was measured and estimated according to European Society of Hypertension guidelines (2016). Biomarkers of carbohydrate and lipid metabolism were tested. Discussion. The study identified prominent physical and metabolic differences in groups of patients with MHO and manifested MS, as well as in the high-risk group for the realization of MS. As a result of this project, MHO and MS were confirmed in 49.11 % and 9.82 % surveyed boys, respectively. The rest of teenagers (32.14 %) based on metabolic disturbances, formed a cluster of the high-risk realization of MS. Moreover, fasting hyperglycemia and glucose intolerance were identified only in patients with manifested MS in 10.91 % and 5.45 % cases, respectively. It was found that the waist-to-height ratio > 0.5 is an informative test of obesity in general, and the waist-to-hip ratio > 0.9 is a sensitive screening tool for abdominal obesity in boys in our population. Based on the results, the triglyceride index is the most sensitive biomarker of insulin resistance compared to triglyceride-to-high density lipids cholesterol ratio and atherogenic coefficient in school-age boys. The results can be applied in pediatric practice for early identification of patients with metabolically unhealthy obesity with WHR and the triglyceride index at the early preclinical stage of MS manifestation. Keywords children, metabolically healthy obesity, metabolic syndrome, triglyceride index.

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Epidemiological aspects of obesity and systemic hypertension amongschool children of Western Ukraine

Cited by 5 publications

References 16 publications

Effect of Preoperative Weight Status and Disease Presentation on Postoperative Elevated Blood Pressure After Childhood Adenotonsillectomy

Effect of Preoperative Weight Status and Disease Presentation on Postoperative Elevated Blood Pressure After Childhood Adenotonsillectomy

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Metabolically Healthy and Unhealthy Obesity in Children From the Point of View of Evidence-Based Medicine

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