Obesity in children: criteria for predicting the development of hypertension

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T.V. Sorokman
N.O. Popeliuk


Background. Obesity in childhood causes a wide range of serious complications and increased risk of diabetes, hypertension, cardiovascular and other diseases. Formation of various types of hypertension in adolescents with overweight and obesity is cha­racterized by imbalance in the production of biologically active substances. Materials and methods. One hundred and sixty people were examined: with overweight (n = 35), obesity (abdominal (n = 35), uniform (n = 35)), and 55 healthy people. Blood lipids (total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol), endothelin-1, β2-micro­globulin were studied, as well as 6-hydroxymelatonin sulfate in the urine. Results. A significant increase in the average daily va­lues of systolic, diastolic, mean hemodynamic and pulse blood pressure was established. Obese children had a tendency to react excessively in the form of an increase in the daily rate of systolic blood pressure elevations. In 57.1 % of patients with obesity, pathological abnormalities of the blood lipids were found: levels of total cholesterol, LDL cholesterol, triglycerides were higher, and HDL cholesterol was lower in both groups of patients. A significant increase in the content of endothelin-1 and β2-microglobulin in the blood plasma of obese children and a tendency towards an increase in children with overweight, disturbances of the circadian rhythm of 6-hydroxymelatonin sulfate secretion were revealed. Conclusions. Metabolic risk factors for the development of hypertension have been identified in children with obesity and overweight: dyslipidemia (hypertriglyceridemia, increased LDL cholesterol, reduced HDL cholesterol), increased β2-microglobulin and endothelin-1 levels, and an imbalance of melatonin secretion. Patients with these adverse factors should be closely monitored by a physician. A special attention should be paid to children with overweight as potential candidates for the development of obesity and its complications, including arterial hypertension.

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How to Cite
Sorokman, T., and N. Popeliuk. “Obesity in Children: Criteria for Predicting the Development of Hypertension”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 2, Mar. 2020, pp. 138-44, doi:10.22141/2224-0721.16.2.2020.201299.
Original Researches


World Health Organization (WHO). Consideration of the evidence on childhood obesity for the Commission on Ending Childhood Obesity: report of the ad hoc working group on science and evidence for ending childhood obesity. Geneva, Switzerland: WHO-press; 2016. 218 p.

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–2642. doi:10.1016/S0140-6736(17)32129-3.

Roberto CA, Swinburn B, Hawkes C, et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet. 2015;385(9985):2400–2409. doi:10.1016/S0140-6736(14)61744-X.

Lobstein T, Jackson-Leach R, Moodie ML, et al. Child and adolescent obesity: part of a bigger picture. Lancet. 2015;385(9986):2510–2520. doi:10.1016/S0140-6736(14)61746-3.

Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med. 2014;370(17):1660–1661. doi:10.1056/NEJMc1402397.

Dzhumagaziev AA, Bezrukova DA, Bogdanyants MV, et al. Obesity in Children in the Modern World: Realities and Possible Solutions. Voprosy sovremennoj pediatrii. 2016;15(3):250–256. doi:10.15690/vsp.v15i3.1561. (in Russian).

Dhuper S, Abdullah RA, Weichbrod L, Mahdi E, Cohen HW. Association of obesity and hypertension with left ventricular geometry and function in children and adolescents. Obesity (Silver Spring). 2011;19(1):128–133. doi:10.1038/oby.2010.134.

Senatorova AS, Chaichenko TV, Boichenko AD. Anthropometric predictors of myocardial remodeling in overweight and obese adolescents. Zdorovʹe rebenka. 2011;(35):25–29. (in Russian).

Posokhova NV. Mechanisms of arterial hypertension formation in obese children. Bulletin of Medical Internet Conferences. 2013;3(2):331. (in Russian).

Netrebenko OK. Obesity in children: the origins of problems and finding solutions. Pediatria. 2011;90(6):104–113. (in Russian).

Pavlovskaya EV, Strokova TV, Surkov AG, Bogdanov AR, Kaganov BS. Metabolic disturbances in preschool children with obesity. Rossiiskii vestnik perinatologii i pediatrii. 2013;58(6):91–97. (in Russian).

Kvashnina LV, Ignatova TB. Prophylaxis of disturbances of endothelial function within the children during transition from health to a syndrome of vegetative dysfunction. Sovremennaya pedyatriya. 2016;(77):16–24. (in Russian).

Minakova VA. Markers level of endothelial dysfunction (endotelin-1 and nitrogen oxide) in blood syrovists and albuminuria in children with erythrocyturia. Ukrainian Journal of Nephrology and Dialysis. 2017;(55):49–54. (in Ukrainian).

Shadrin SA, Statova AV. Prevalence and characteristics of lipid metabolism disorders in children from Krasnodar region of Russia. Obesity and metabolism. 2014;11(1):38–41. (in Russian).

Real de Asúa D, Puchades R, García-Polo I, Suárez C. A Study on the Relationship between Serum Beta 2-Microglobulin Levels, Underlying Chronic Kidney Disease, and Peripheral Arterial Disease in High-Vascular-Risk Patients. Int Cardiovasc Res J. 2012;6(4):107–112.

Dionne JM, Harris KC, Benoit G, et al. Hypertension Canada's 2017 Guidelines for the Diagnosis, Assessment, Prevention, and Treatment of Pediatric Hypertension. Can J Cardiol. 2017;33(5):577–585. doi:10.1016/j.cjca.2017.03.007.

Rapoport SI, Molchanov AYu, Golichenkov VA, Burlakova OV, Suprunenko ES, Savchenko ES. Metabolic syndrome and melatonin. Klinicheskaia meditsina. 2013;91(11):8–14. (in Russian).

Reiter RJ, Manchester LC, Fuentes-Broto L, Tan DX. Cardiac hypertrophy and remodelling: pathophysiological consequences and protective effects of melatonin. J Hypertens. 2010;28 Suppl 1:S7–S12. doi:10.1097/01.hjh.0000388488.51083.2b.

Ryznychuk MO, Pishak VP. Obesity: The role of desynchronosis and genetic factors in mechanisms of its development. Regulatory Mechanisms in Biosystems. 2017;8(1):23–29. doi: 10.15421/021705. (in Ukrainian).

Kaladze MM, Zyukova IB. Epiphysis implication in chronobiological features of arterial hypertension among children. Sovremennaya pedyatriya. 2014;(59):94–97. doi:10.15574/SP.2014.59.94. (in Russian).

Imenshahidi M, Karimi G, Hosseinzadeh H. Effects of melatonin on cardiovascular risk factors and metabolic syndrome: a comprehensive review. Naunyn Schmiedebergs Arch Pharmacol. 2020;393(4):521–536. doi:10.1007/s00210-020-01822-4.

Sun H, Gusdon AM, Qu S. Effects of melatonin on cardiovascular diseases: progress in the past year. Curr Opin Lipidol. 2016;27(4):408–413. doi:10.1097/MOL.0000000000000314.

Zisapel N. New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation. Br J Pharmacol. 2018;175(16):3190–3199. doi:10.1111/bph.14116.

Tordjman S, Chokron S, Delorme R, et al. Melatonin: Pharmacology, Functions and Therapeutic Benefits. Curr Neuropharmacol. 2017;15(3):434–443. doi:10.2174/1570159X14666161228122115.

Chaichenko TV. Optimization of physical activity among children and adolescents in the campaign to end childhood obesity. Zdorovʹe rebenka. 2015;(64):31–35. doi:10.22141/2224-0551.4.64.2015.75241. (in Russian).

Maskova GS, Chernaya NL, Shubina EV, Aleksandrova SV. The age features of primary obesity in children. Practical medicine. 2014;(85):126–130. (in Russian).

Pavlishin GA. Furdela WB, Samson OA. Just go to the diagnosis of childhood obesity. Fundamentalni doslidzhennia. 2012;(26-27):47–51. (in Ukrainian).

Zimmet P, Alberti KG, Kaufman F, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007;8(5):299–306. doi:10.1111/j.1399-5448.2007.00271.x.

McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM. Body fat reference curves for children. Int J Obes (Lond). 2006;30(4):598–602. doi:10.1038/sj.ijo.0803232.

Averiyanov AP, Bolotova NV, Zotova SA. Obesity obesity in childhood. Lechaschii Vrach. 2010;(2):69. (in Russian).

Strogiy VV, Abrosimowa NN, Koren IA, Sikora MP. Features of circadian blood pressure in children and adolescents with various forms of obesity. Belorusskii meditsinskii zhurnal. 2012;(39):125–129. (in Russian).

International Society for Chronobiology; American Association of Medical Chronobiology and Chronotherapeutics; Spanish Society of Applied Chronobiology, Chronotherapy, and Vascular Risk. 2013 ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals. Chronobiol Int. 2013;30(3):355–410. doi:10.3109/07420528.2013.750490.

Liu Y, Shi L, Lin Y, et al. Relationship Between Blood Pressure Variability and Target Organ Damage in Children With Essential Hypertension. Zhonghua Er Ke Za Zhi. 2019;57(2):93–97. doi:10.3760/cma.j.issn.0578-1310.2019.02.006.

Cardinali DP, Cano P, Jiménez-Ortega V, Esquifino AI. Melatonin and the metabolic syndrome: physiopathologic and therapeutical implications. Neuroendocrinology. 2011;93(3):133–142. doi:10.1159/000324699.

Cardinali DP, Hardeland R. Inflammaging, Metabolic Syndrome and Melatonin: A Call for Treatment Studies. Neuroendocrinology. 2017;104(4):382–397. doi:10.1159/000446543.

Liu J, Clough SJ, Hutchinson AJ, Adamah-Biassi EB, Popovska-Gorevski M, Dubocovich ML. MT1 and MT2 Melatonin Receptors: A Therapeutic Perspective. Annu Rev Pharmacol Toxicol. 2016;56:361–383. doi:10.1146/annurev-pharmtox-010814-124742.

Sychov RO. Changes in urinary excretion of beta-2-microglobulin in hypertension J Clin Exp Med Res. 2015;3(1):129-136. (in Ukrainian).

Tomlinson PA, Dalton RN, Turner C, Chantler C. Measurement of beta 2-microglobulin, retinol-binding protein, alpha 1-microglobulin and urine protein 1 in healthy children using enzyme-linked immunosorbent assay. Clin Chim Acta. 1990;192(2):99–106. doi:10.1016/0009-8981(90)90073-2.

Steubl D, Inker LA. How best to estimate glomerular filtration rate? Novel filtration markers and their application. Curr Opin Nephrol Hypertens. 2018;27(6):398–405. doi:10.1097/MNH.0000000000000444.

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