Obesity and overweight have been associated with increased carotid intima- media thickness and stiffness in adults and children. Overweight and obesity have also been associated with an increased prevalence of the met...Obesity and overweight have been associated with increased carotid intima- media thickness and stiffness in adults and children. Overweight and obesity have also been associated with an increased prevalence of the metabolic syndrome(MS). The aim of the study was to test the hypothesis that obese children with the MS have increased rigidity of their arteries compared with obese children without the MS. We studied 100 obese children(age range 6 to 14 years; 61 males, 39 females) consecutively seen in the outpatient clinic of a hospital department of pediatrics. Anthropometric measures and biochemical tests were performed in all children. Quantitative B- mode ultrasound scans were used to measure intima- media thickness and diameters of the common carotid artery. Common carotid arterial stiffness was significantly higher in the group of obese children with the MS(n=38) at 1.29± 0.06 mm(values log transformed) versus 1.12± 0.04 mm(p< 0.03) compared with those without the MS(n=62). These differences persisted even after adjustment for age, gender, and C- reactive protein. Obese children with the MS had significantly higher plasma concentrations of C- reactive protein(1.57± 0.06 μ g/L, values log transformed) compared with obese children without the MS(1.38± 0.05 μ g/L, p< 0.03). In conclusion, obese children who met the diagnostic criteria for the MS had higher common carotid artery stiffness and higher C- reactive protein plasma concentration s than obese children without the MS.展开更多
Background: Little information is available on the reproducibility of nocturna l variations in blood pressure in type 2 diabetic hypertensive patients. Objecti ve: We aimed to compare the intrasubject short-term repro...Background: Little information is available on the reproducibility of nocturna l variations in blood pressure in type 2 diabetic hypertensive patients. Objecti ve: We aimed to compare the intrasubject short-term reproducibility of a noctur nal non-dipping pattern and the prevalence of cardiac and extracardiac signs of target organ damage, in a group of type 2 diabetic hypertensive patients and in an age/gender-matched group of non-diabetic hypertensive subjects. Methods: T hirty-six treated hypertensive patients with long-lasting type 2 diabetes(>10 years duration) consecutively attending our hospital out-patient hypertension c linic(group I; mean age, 65±9 years), and 61 untreated non-diabetic subjects w ith grade 1 and grade 2 uncomplicated essential hypertension,matched for age and gender,and chosen from patients attending an outpatient clinic(group II; mean a ge, 65±5 years), were considered for this analysis. All patients underwent bloo d sampling for routine blood chemistry, 24-h urine collection for microalbuminu ria, two 24-h periods of ambulatory blood pressure monitoring(ABPM) within a 4 -week period, echocardiography, and carotid ultrasonography. A dipping pattern was defined as a greater than 10%reduction in the average systolic and diastolic blood pressure at night compared with average daytime v alues. Results: A reproducible nocturnal dipping and non-dipping profile was fo und in 11(30.6%) and 21(58.3%) diabetic patients, respectively; while only in four(11.1%) patients was a variable dipping profile observed. Of the 23 patient s with a non-dipping pattern during the first ABPM period, 21(91.3%) also had this type of pattern during the second ABPM recording. In group II(non-diabetic hypertensive patients), 30 patients(49.2%, P< 0.05) had a dipping pattern, 13 patients(21.3%, P< 0.01)had a non-dipping profile pattern and 18 patients(29.5 %, P< 0.01) had a variable dipping pattern. Of the 20 patients with a non-dipp ing pattern during the first ABPM period, 13(65.0%) confirmed this type of patt ern during the second ABPM recording. Finally, the prevalence of left ventricula r hypertrophy(77.7 versus 41.4%, P< 0.01), carotid plaques(80.5 versus 38.3%, P< 0.01), carotid intima-media thickening(54.3 versus 44.0%, P< 0.05) and micr oalbuminuria(11.1 versus 2.0%, P< 0.01) was significantly higher in group I tha n in group II. According to a logistic regression analysis, diabetes, left ventr icular hypertrophy and carotid plaques were the main independent predictors of t he non-dipping pattern in the overall population. Conclusions: These findings i ndicate that intrasubject variability of non-dipper pattern is lower in diabeti c than in non-diabetic hypertensive patients, that classification of diabetic h ypertensive patients as dipper or non-dipper on the basis of a single ABP recor ding is more reliable than in nondiabetic patients, and that the more frequent a nd reproducible non-dipping pattern in diabetic patients is associated with a m ore prominent cardiac and extracardiac target organ damage.展开更多
文摘Obesity and overweight have been associated with increased carotid intima- media thickness and stiffness in adults and children. Overweight and obesity have also been associated with an increased prevalence of the metabolic syndrome(MS). The aim of the study was to test the hypothesis that obese children with the MS have increased rigidity of their arteries compared with obese children without the MS. We studied 100 obese children(age range 6 to 14 years; 61 males, 39 females) consecutively seen in the outpatient clinic of a hospital department of pediatrics. Anthropometric measures and biochemical tests were performed in all children. Quantitative B- mode ultrasound scans were used to measure intima- media thickness and diameters of the common carotid artery. Common carotid arterial stiffness was significantly higher in the group of obese children with the MS(n=38) at 1.29± 0.06 mm(values log transformed) versus 1.12± 0.04 mm(p< 0.03) compared with those without the MS(n=62). These differences persisted even after adjustment for age, gender, and C- reactive protein. Obese children with the MS had significantly higher plasma concentrations of C- reactive protein(1.57± 0.06 μ g/L, values log transformed) compared with obese children without the MS(1.38± 0.05 μ g/L, p< 0.03). In conclusion, obese children who met the diagnostic criteria for the MS had higher common carotid artery stiffness and higher C- reactive protein plasma concentration s than obese children without the MS.
文摘Background: Little information is available on the reproducibility of nocturna l variations in blood pressure in type 2 diabetic hypertensive patients. Objecti ve: We aimed to compare the intrasubject short-term reproducibility of a noctur nal non-dipping pattern and the prevalence of cardiac and extracardiac signs of target organ damage, in a group of type 2 diabetic hypertensive patients and in an age/gender-matched group of non-diabetic hypertensive subjects. Methods: T hirty-six treated hypertensive patients with long-lasting type 2 diabetes(>10 years duration) consecutively attending our hospital out-patient hypertension c linic(group I; mean age, 65±9 years), and 61 untreated non-diabetic subjects w ith grade 1 and grade 2 uncomplicated essential hypertension,matched for age and gender,and chosen from patients attending an outpatient clinic(group II; mean a ge, 65±5 years), were considered for this analysis. All patients underwent bloo d sampling for routine blood chemistry, 24-h urine collection for microalbuminu ria, two 24-h periods of ambulatory blood pressure monitoring(ABPM) within a 4 -week period, echocardiography, and carotid ultrasonography. A dipping pattern was defined as a greater than 10%reduction in the average systolic and diastolic blood pressure at night compared with average daytime v alues. Results: A reproducible nocturnal dipping and non-dipping profile was fo und in 11(30.6%) and 21(58.3%) diabetic patients, respectively; while only in four(11.1%) patients was a variable dipping profile observed. Of the 23 patient s with a non-dipping pattern during the first ABPM period, 21(91.3%) also had this type of pattern during the second ABPM recording. In group II(non-diabetic hypertensive patients), 30 patients(49.2%, P< 0.05) had a dipping pattern, 13 patients(21.3%, P< 0.01)had a non-dipping profile pattern and 18 patients(29.5 %, P< 0.01) had a variable dipping pattern. Of the 20 patients with a non-dipp ing pattern during the first ABPM period, 13(65.0%) confirmed this type of patt ern during the second ABPM recording. Finally, the prevalence of left ventricula r hypertrophy(77.7 versus 41.4%, P< 0.01), carotid plaques(80.5 versus 38.3%, P< 0.01), carotid intima-media thickening(54.3 versus 44.0%, P< 0.05) and micr oalbuminuria(11.1 versus 2.0%, P< 0.01) was significantly higher in group I tha n in group II. According to a logistic regression analysis, diabetes, left ventr icular hypertrophy and carotid plaques were the main independent predictors of t he non-dipping pattern in the overall population. Conclusions: These findings i ndicate that intrasubject variability of non-dipper pattern is lower in diabeti c than in non-diabetic hypertensive patients, that classification of diabetic h ypertensive patients as dipper or non-dipper on the basis of a single ABP recor ding is more reliable than in nondiabetic patients, and that the more frequent a nd reproducible non-dipping pattern in diabetic patients is associated with a m ore prominent cardiac and extracardiac target organ damage.
