Impact of insulin resistance, dyslipidemia, oxidative stress and adipokines on blood pressure and cardiovascular diseases in obese children and adolescents.

[D. Paripović]

77 listova

medicina - pedijatrija / Medicine - Pediatrics

Uvod: Gojaznost je postala jedan od najvažnijih globalnih zdravstvenih problema. Globalna epidemija gojaznosti je udružena sa porastom prevalencije arterijske hipertenzije. Sa porastom broja dece sa hipertenzijom, očekuje se porast broja komplikacija hipertenzije u detinjstvu. Najvažnija komplikacija arterijske hipertenzije je hipertrofija miokarda leve komore koja se nalazi u oko 30% dece sa hipertenzijom. Hipertrofija leve komore je poznat faktor rizika za kardiovaskularnu bolest odraslih. Metabolički činioci udruženi sa gojaznošću kao što su insulinska rezistencija, inflamacija i oksidativni stres mogu uticati na kardiovaskularna oštećenja kod dece i adolescenata. Cilj: Cilj rada je ispitati faktore rizika kardiovaskularnih obolenja kod gojazne dece i adolescenata sa i bez hipertenzije. Radi ostvarenja cilja ispitivanja postavljeni su sledeći zadaci istraživanja: ispitivati povezanost parametara oksidativnog stresa i adipokina sa debljinom intime i medije karotidne arterije i sa insulinskom rezistencijom; odrediti prevalenciju hipertrofije miokarda leve komore i poremećene geometrije leve komore; otkriti faktore koji utiču na povećanje indeksa mase leve komore i na poremećenu geometriju leve komore. Metodologija: Studija presek izvedena na Univerzitetskoj dečjoj klinici, uključila je 103 gojazna pacijenta i 30 zdrave normalno uhranjene dece. Gojazni pacijenti su na osnovu rezultata ambulatornog monitoringa krvnog pritiska podeljeni u 2 grupe: gojazne sa i bez hipertenzije. Učinjena su sledeća ispitivanja: odreĎivanje debljine intime i medije karotidnih arterija, ehokardiografija, test opterećenja fizičim naporom, i laboratorijske analize krvi i urina. Laboratorijske analize su uključivale oralni glukoza tolerans test sa insulinom, glikozilirani hemoglobin (HbA1c), serumske elektrolite, ureju, kreatinin, mokraćnu kiselinu, C reaktivni protein, holesterol, trigliceride, lipoproteine velike gustine (HDL-holesterol), lipoproteine male gustine (LDL-holesterol), markere oksidativnog stresa, leptin i adiponektin. Parametri oksidativnog stresa koji su odreĎeni su prooksidativno-antioksidativni balans, uznapredovali produkti oksidacije proteina, malondialdehid, i superoksidni anjon...

Introduction: Obesity has become one of the most important global health problems. The global epidemic of obesity is associated with an increase in the prevalence of hypertension. Increase of the number of children with hypertension is expected to increase the number of complications of hypertension in childhood. The most important complication of hypertension is left ventricular hypertrophy which is found in about 30% of children with hypertension. Left ventricular hypertrophy is a known risk factor for cardiovascular disease of adults. Metabolic factors associated with obesity such as insulin resistance, inflammation and oxidative stress may affect the cardiovascular damage in children and adolescents. Aim: to investigate the risk factors of cardiovascular disease in obese children and adolescents with and without hypertension. In order to realize the aim the following tasks were assigned: analyze the relationship of oxidative stress parameters and adipokines with intima-media thickness of the carotid artery (cIMT), and with insulin resistance; determine the prevalence of left ventricular mass and impaired left ventricular geometry; discover the factors affecting the increase in left ventricular mass index, and abnormal left ventricular geometry. Methodology: The cross-sectional study performed at the University Children’s Hospital, included 103 obese patients and 30 healthy nonobese children. Obese patients were divided into 2 groups based on the results of ambulatory monitoring of blood pressure: obese with and without hypertension. We performed the following tests: the determination of the intima and media thickness of the carotid artery, echocardiography, exercize stress test, and laboratory analysis of blood and urine. Laboratory analysis included oral glucose tolerance test with insulin, glycosylated hemoglobin (HbA1c), serum electrolytes, urea, creatinine, uric acid, C-reactive protein, cholesterol, triglycerides, high-density lipoproteins (HDL-cholesterol), low density lipoprotein (LDL-cholesterol), markers of oxidative stress, leptin and adiponectin. Parameters of oxidative stress, which are determined included prooxidant-antioxidant balance, advanced oxidation protein products, malondialdehyde, and superoxide anion...

deca, adolescenti, gojaznost, hipertenzija, oksidativni stress, adipokini, insulinska rezistencija, ehokargrafija, kardiovaskularne bolesti

children, adolescents, obesity, hypertension, oxidative stress, adipokines, insulin resistance, echocardiography, cardiovascular disease

616.1-053.2(043.3)

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