Abstract:Objective: To explore the relationship between childhood obesity and adult hypertension(HP) and left ventricular hypertrophy(LVH). Methods: A total of 450 hypertensive adults and 350 non-hypertensive adults who were examined in the second Affiliated Hospital of Shenyang Medical College from 2018 to 2019 were selected as research subjects. Patients' age range between 19 and 48, whose general data, laboratory examination index and Doppler echocardiography were completed. Retrospective survey was conducted toward selected subjects with at least 6 physical examination reports of them from childhood (6-18 years old) to adulthood. BMIs of childhood age brackets and adulthood were recorded and the trajectory curve equation of childhood BMI was constructed with the mixed effect model. The area under the curve (AUC) was recorded as AUCBMI, which represents the average level of BMI for individuals throughout childhood. Results: Spearman correlation analysis showed that childhood obesity was significantly correlated with HP and LVH in adults(r=0.545,r=0.478). Non-conditional logistic analysis showed excluding age, gender and other possible confounding factors, childhood obesity could increase the risk of HP and LVH in adults (P<0.05).The risk of adult HP and LVH was the highest when childhood obesity was extended to adult obesity (P<0.05).Conclusion: Childhood obesity is significantly related to HP and LVH in adults, so the window of opportunity for prevention and treatment of cardiovascular chronic diseases related to obesity should be moved from adulthood to childhood. It is advocated to identify high-risk children with obesity early, control risk factors from childhood, achieve prevention and treatment window "move down" , in order to reduce the risk of cardiovascular disease in adults. The quantification of the regulatory effect of childhood obesity on adult blood pressure and left ventricular remodeling will promote the development of new prevention and intervention strategies.
吴桂平, 刘兆奕, 林瑶瑶. 儿童期肥胖与其成人高血压和左心室肥厚的相关性研究[J]. 河北医学, 2022, 28(1): 127-130.
WU Guiping, LIU Zhaoyi, et al. Study on the Relationship Between Childhood Obesity and Adult Hypertension and Left Ventricular Hypertrophy. HeBei Med, 2022, 28(1): 127-130.
[1] 杨丽丽,席波.儿童期肥胖与靶器官损害关系的研究进展[J].中华预防医学杂志,2019,53(7):731~736. [2] 米杰.预防高血压从控制儿童肥胖开始[J].慢性病学杂志,2015,16(3):256~257. [3] Cuspidi C,Rescaldani M,Sala C,et al.Left-ventricular hypertrophy and obesity:a systematic review and meta-analysis of echocardiographic studies[J].Hypertens,2014,32(1):16~25. [4] Gottdiener John S,Kop Willem J.Body and heart:effects of weight gain and loss on left ventricular size and function.[J].Circulation Cardiovascular imaging,2017,10(3):e6084. [5] Dhiper S,Abdullah RA,Weichbrod L,et al.Association of obesity and hypertension with left ventricular geometry and function in children and adolescents[J].Obesity (Silver Spring,Md.),2011,19(1):128~133. [6] Agirbasli M,Tanrikulu AM,Berenson GS.Metabolic syndrome:bridging the gap from childhood to adulthood[J].Cardiovascular therapeutics,2016,34(1):30~36. [7] Bayer O,Kr GH,Von KR,et al.Factors associated with tracking of BMI:a meta-regression analysis on BMI tracking[J].Obesity,2010,19(5):1069~1076. [8] Lai CC,Sun DJY,Cen RQ,et al.Impact of long-term burden of excessive adiposity and elevated blood pressure from childhood on adulthood left ventricular remodeling patterns:the Bogalusa Heart Study.[J].Journal of the American College of Cardiology,2014,64(15):1580~1587. [9] Li XR,Li SX,Eralp U,et al.Childhood adiposity as a predictor of cardiac mass in adulthood:the bogalusa heart study[J].Circulation,2004,110(22):3488~3492.