BLOOD LIPIDS DISORDERS IN THE PRESENCE OF METABOLIC SYNDROME AT DIFFERENT STAGES OF ESSENTIAL ARTERIAL HYPERTENSION IN TEENAGERS
https://doi.org/10.29001/2073-8552-2016-31-4-30-34
Abstract
The aim of this study was to assess dyslipidemia in teenagers with essential arterial hypertension (EAH) at different stages of the disease and its correlation with cardiovascular risk factors and arterial pressure (AP) daily profile. A total of 230 teenagers with EAH aged from 12 to 18 years (mean age of 14.9±2.0 years) were examined. All patients underwent 24 hour blood pressure monitoring. According to monitoring results, the following study groups were formed: group 1 comprised 68 patients with phenomenon of “white coat hypertension”; group 2 comprised 82 patients with labile arterial hypertension; group 3 comprised 80 patients with stable arterial hypertension. Control group included 27 healthy teenagers whose age and sex were similar to those in study groups. Blood lipids study was performed according to practical standards. To detect hyperlipidemias, the National Cholesterol Educational Program (NCEP peds) criteria revised in 1992 were used. Triglycerides (TC) level over 100 mg/dL (1.1 mmol/L) was criterion for hypertriglyceridemia in teenagers. Only teenagers with stable AH had clinically significant difference in the average values of TC and very low density lipoprotein cholesterol compared with control group adjusted for sex and age (р=0.027 and р=0.029 correspondingly). The covariance analysis showed that overweight, family history of hypertensive disease, smoking, and mean values of diastolic AP for all time intervals contribute to blood lipids disorders. Conclusions. Blood lipid disorders in teenagers with EAH can manifest at early stages of the disease and are the early markers of both metabolic syndrome and atherosclerosis requiring appropriate preventive measures.
About the Authors
I. V. PlotnikovaRussian Federation
T. E. Suslova
Russian Federation
L. I. Svintsova
Russian Federation
O. Yu. Dzhaffarova
Russian Federation
Yu. G. Lugacheva
Russian Federation
References
1. Jolliffe C.J., Janssen I. Development of age specific adolescent metabolic syndrome criteria that are linked to the adult treatment panel III and International Diabetes Federation Criteria // J. Am. Coll. Cardiol. – 2007. – Vol. 49. – P. 891–898.
2. Titmuss A.T., Srinivasan S. Metabolic syndrome in children and adolescents: Old concepts in a young population [Electronic resource] // J. Pediatric. Child Health. – 2016 Jun. 14. – DOI: 10.1111/jpc.13190.
3. Sun S.S., Grave G.D., Siervogel R.M. et al. Systolic blood pressure in chilhood predicts hypertension and metabolic syndrome later in life // Pediatrics. – 2007. – Vol. 119 (2). – P. 237–246.
4. Вarkai L., Paragh G. Metabolic syndrome in childhood and adolescence // Orv. Hetil. – 2006. – Vol. 147 (6). – P. 243–250.
5. Caceres M., Teran C.G., Rodriguez S. et al. Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity [Electronic resource] // Pediatr. – 2008, Aug. 12. – Vol. 8. – P. 31. – DOI: 10.1186/14712431831.
6. Holst Schumacher I., Nunez Rivas H., Monge Rojas R. et al. Components of the metabolic syndrome among a sample of overweight and obese Costa Rican schoolchildren // Food Nutr. Bull. – 2009. –Vol. 30 (2) – P. 161–170.
7. Gidding S.S. Dyslipidemia in the metabolic syndrome in children // JCMS. – 2006. – Vol. 1. – P. 282–285.
8. Диагностика, лечение и профилактика артериальной гипертензии у детей и подростков: Национальные клинические рекомендации / под ред. Р.Г. Оганова. – М. : Силицея Полиграф, 2009. – С. 251–288.
9. Петров В.И., Ледяев М.Я. Оценка суточного ритма артериального давления у детей. – Волгоград – Нижний Новгород : ДЕКОМ, 2006. – 76 с.
10. Friedwald W.T., Levy R.J., Fredrickson D.S. Estimation of low density lipoprotein cholesterol in plasma without use of preparative ultracentrifuge // Clin. Chem. – 1972. – Vol. 256. – P. 2835–2838.
11. American Academy of Pediatrics. National Cholesterol Educational Program. Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents // Pediatrics. – 1992. – Vol. 89, Suppl. 3, Pt. 2. – P. 525–584.
12. De Ferranti S.D., Gauvreau K., Ludwig D.S. et al. Prevalence of the metabolic syndrome in American adolescents. Findings from the Third National Health and Nutrition Examination Survey // Circulation. – 2004. – Vol. 110. – P. 2494–2497.
13. Безляк В.В., Ковалев И.В., Плотникова И.В. Методы многомерного моделирования в детской кардиологии // Педиатрия. – 2010. – Т. 89, № 3. – С. 38–45.
14. Everitt B.S., Pickles A. Statistical aspects of the design and analysis of clinical trials. – London : Imperial College Press, 2004. – 323 p.
15. Granjeiro P.A., da Silva T.M., Dos Santos D.D.R. et al. Frequency of metabolic syndrome in children and adolescents from public schools of Divinopolis, Minas Gerais, Brazil, according to three international diagnostic criteria [Электронный ресурс] // Sci Med. – 2016. – Vol. 26 (3). – ID 22854. – URL: http://dx.doi.org/10.15448/19806108.2016.3.22854.
16. Guijarro de Armas M.A., Monereo Megias S., Merino Viveros M. et al. Prevalence of metabolic syndrome in a population of obese children and adolescents // Endocrinol. Nutr. – 2012. – Vol. 59(3). – Р. 155–159.
17. Srinivasan S.R., Myers L., Berenson G.S. Changes in metabolic syndrome variables since childhood in prehypertensive and hypertensive subjects: the Bogalusa Heart Study // Hypertension. – 2006. – Vol. 48(1). – P. 21–35.
18. Соболева М.К., Чупрова А.В., Нефедова Ж.В. и др. Маркеры метаболического синдрома у детей и подростков с артериальной гипертензией различного генеза // Педиатрия. – 2004. – № 3. – С. 23–28.
19. Нагорная Г.Ю., Микашинович З.И., Коваленко Т.Д. Маркеры метаболического синдрома у подростков с эссенциальной артериальной гипертензией в сочетании с дисфункцией желчевыводящих путей // Мед. вестн. юга России. – 2014. – № 3. – С. 125–129.
20. Kniazewska M.H., Zmudzinska Kitczak J., Urban K. Characteristics of metabolic syndrome in children and adolescents with arterial hypertension // Wiad. Lek. – 2005. – Vol. 58, Suppl. 1. – P. 25–28.
21. Ойноткинова О.Ш., Дедов Е.И. Дислипидемия и ассоциированные метаболические заболевания // Архивъ внутренней медицины. – 2011. – № 1. – С. 67–73.
22. Wang Q., Yin J., Xu L. et al Prevalence of metabolic syndrome in a cohort of Chinese schoolchildren: comparison of two definitions and assessment of adipokines as components by factor analysis [Electronic resource] // BMC Public Health. – 2013. – Vol. 13. – P. 249. – DOI: 10.1186/1471245813249.
23. Ranasinghe P., Cooray D.N., Jayawardena R. et al. The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults [Electronic resource] // BMC Public Health. – 2015. – Vol. 15. – P. 576. – DOI: 10.1186/s1288901519277.
24. Liu J., Sekine M., Tatsuse T. et al. Family history of hypertension and the risk of overweight in Japanese children: Results from the Toyama Birth Cohort Study // J. Epidemiol. – 2014. – Vol. 24 (4). – P. 304–311.
25. Slagter S.N., van Vliet Ostaptchouk J.V., Vonk J.M. et al. Associations between smoking, components of metabolic syndrome and lipoprotein particle size [Electronic resource] // BMC Med. – 2013, Sep. 3. – Vol. 11. – P. 195. – DOI: 10.1186/1741701511195.
26. Kelishadi R., Noori A., Qorbani M. et al. Are active and passive smoking associated with cardiometabolic risk factors in adolescents? The CASPIAN III Study // Pediatr. Int. Child Health. – 2016, Jan. 29. – P. 1–8.
27. Bondo P. Distribution of lipidic volume in teenagers that smoke // An. Esp. Pediatr. – 1997. – Vol. 46 (3). – P. 245–251.
28. Кисляк О.А. Артериальная гипертензия в подростковом возрасте. – М. : Миклош, 2007. – 208 с.
29. De Caterina R., Libby P. Endothelial Dysfunction and Vascular Disease. – Oxford : Blackwell Futura, 2007. – 432 p.
Review
For citations:
Plotnikova I.V., Suslova T.E., Svintsova L.I., Dzhaffarova O.Yu., Lugacheva Yu.G. BLOOD LIPIDS DISORDERS IN THE PRESENCE OF METABOLIC SYNDROME AT DIFFERENT STAGES OF ESSENTIAL ARTERIAL HYPERTENSION IN TEENAGERS. Siberian Journal of Clinical and Experimental Medicine. 2016;31(4):30-34. (In Russ.) https://doi.org/10.29001/2073-8552-2016-31-4-30-34