Overweight Hypertension Research Articles

The Assessment of Anthropometric Measures and Changes in Selected Biochemical Parameters in Obese Children in Relation to Blood Lead Level.

Our paper draws attention to the impact of lead (Pb) on the specificity of obesity development in children exposed to environmental pollution. An advantage of this paper is the homogeneous study group comprising children of identical age from a single geographic region. Moreover, while the influence of environmental toxins on adults has been extensively explored, this study delves into pediatric populations, which have yet to receive comprehensive scrutiny within the scientific literature. Initially, a group of 136 obese children (the research program lasted three consecutive years: 2016, 2017, and 2018) living in the north-western region of Poland, from whom biochemical tests and auxological data were obtained, were enrolled for analysis. Blood lead levels (BLLs) were determined in 115 children. The age of the children ranged from 7.1 to 10.4 years. The body mass index (BMI) of children averaged 21.5 ± 2.2. The results showed that a large proportion of the participants had BLLs above the threshold for Pb. BLLs ≤ 5 µg/dL (considered safe for children and pregnant women) were found in over 70% of the participants, with BLLs in the range of 5.01-10.00 µg/dL in over 26% of the children, and concentrations > 10 µg/dL (considered toxic threshold for adults) in nearly 2% of the children. The results of our research revealed a positive association between BLLs and average systolic and diastolic blood pressure in the studied children. Moreover, we found a negative correlation between BLLs and absolute fat tissue content and triglyceride concentration. Among the included biochemical factors, only insulin demonstrated a statistically significant relationship with fat mass. This result suggests that early carbohydrate metabolism disorders in overweight children involve decreased peripheral tissue insulin sensitivity. Lead exposure may significantly contribute to the development of hypertension, insulin resistance, and glucose metabolism disorders in overweight and obese children. It is essential to implement multidirectional actions to increase awareness of the harmful effects of xenobiotic exposure, including lead, in order to prevent early-life exposure.

P003 ASSOCIATION BETWEEN SERUM URIC ACID AND BLOOD PRESSURE IN BOYS, GIRLS AND ADOLESCENTS WITH OVERWEIGHT and OBESITY ATTENDED IN PEDIATRIC HOSPITALS IN THE AUTONOMOUS CITY OF BUENOS AIRES. “MULTICENTRIC STUDY

Introduction: Childhood overweight and obesity are modifiable risk factors for the development of Hypertension (HTN). Elevated serum uric acid (UA) is a known cardiovascular risk factor in adults. Objective: To evaluate whether there is an association between high serum UA values and elevated BP in overweight and obese children and adolescents. Methods: Multicenter prospective cross-sectional study. Overweight and obese patients aged 5 to 18 years attended in HTN outpatient clinics of three tertiary pediatric hospitals in Buenos Aires were included. Office BP control, 24-hours ambulatory BP monitoring (ABPM) and laboratory tests (metabolic and lipid profile and serum UA measurement) were performed. Results: 173 patients were enrolled, mean age 11.7±2.9 years, 63 women (36.4%), 50 were overweight (28.9%) and 123 obese (71.1%). 143 normotensive (NT) patients were registered, 14 with white-coat HTN, 11 with masked hypertension (MH) and 5 with sustained HTN. The mean value of serum UA was 5.1±1.2, 113 subjects were above the mean value and 24 were above 2SD. Taking serum UA higher than the average (n:113) according to BP we observed 89/143 in NT vs. 13/14 in white-coat HTN (OR 7.8 95% CI 1.1-62.1 p=0.04), 89/143 in NT vs. 8/11 in MH (OR 1.6 95% CI 0.4-6.3 p=0.7) and 89/143 in NT vs. 3/5 in sustained HTN (OR 0.9 95% CI 0.1-5.2 p=0.9). Using serum UA >2SD (n:24) 14/143 above this value in NT vs. 7/14 in white-coat HTN (OR 9.2 95% CI 2.8-30.1 p<0.001), 14/143 in NT vs. 3/11 MH (OR 3.4 95% CI 0.8-14.5 p=0.1) and no subject with sustained HTN had serum UA values >2SD. Conclusions: Elevated serum UA was observed in subjects with white-coat HTN. The number of subjects with sustained HTN was not sufficient to evaluate the association with serum UA values. These findings emphasize the importance of the systematic implementation of 24-hours ABPM for detection of white-coat HTN in overweight and obese children and adolescents.

Diagnosis and Management of Hypertension in Obese Children

The prevalence of hypertension in overweight and obese children is 14% and 33%, respectively. Additional information such as age, gender, and height needed to define hypertension in children. In addition, blood pressure measurement in obese children faces many challenges. Therefore, the diagnosis of hypertension in obese children needs to be carefully considered. Body weight reduction through diet management and physical activity remain the main management strategy for hypertension in obese children. Persistent hypertension after 6-12 months despite a healthy lifestyle needs additional medication.

Identification of risk factors for hypertension in overweight and obese people and analysis of risk factor interactions: an R-based analysis.

This study identified the independent risk factors for hypertension in overweight and obese people and also analyzed the interaction between the risk factors. A total of 5,098 overweight and obese people were enrolled in this study. First, the clinical metabolic characteristics of hypertension and control groups were compared. The logistic regression (LR) and classification and regression trees (CRT)-based decision tree (DT) models were used to screen the independent risk factors for hypertension in overweight and obese people. The multiplicative and additive scale analyses were used to analyze the two risk factors with interaction from the perspective of statistics and biological interaction. Finally, the receiver operating characteristic (ROC) and calibration curves were used to analyze the accuracy and identification ability of the LR and DT models. Age, UA, FPG, SBP, Cr, AST, TG, and FPG were higher in the hypertension group than in the control group (P < 0.05). The results of LR revealed that NAFLD, FPG, age, TG, LDL-c, UA, and Cr were positively correlated with hypertension in overweight and obese people, and GFR was negatively correlated with hypertension in overweight and obese people (P < 0.05). The DT model suggested that the risk factors of age, FPG, and UA interacted with each other. The multiplicative single and multiple factor analysis for FPG + UA, age + UA, age + FPG revealed a positive multiplicative interaction (P < 0.05, B ≠ 0, OR > 1). The additive single and multiple factor analysis for age + UA indicated a positive additive interaction. The ROC and calibration curve analysis indicated that the CRT decision tree, FPG + UA, age + UA, and age + FPG have certain accuracy and discrimination ability. The independent risk factors for hypertension in overweight and obese people included NAFLD, FPG, age, TG, LDL-c, UA, and Cr. Among these, age + UA exhibited synergistic interaction, thereby providing a reference for the prevention and control of hypertension in overweight and obese people.

High levels of blood pressure among Brazilian overweight and obese children and adolescents

Background: Arterial hypertension (AH) is a growing problem globally, bringing various health consequences. Numerous surveys show that the risk of AH is higher in overweight and obese individuals than in eutrophic ones. However, the number of data that investigates blood pressure in obese pediatric populations is still small. Therefore, this study aims to assess the prevalence of hypertension in overweight and obese children and adolescents. Methods:Retrospective cross-sectional study with children and adolescents from two health services in different regions of Brazil and distinct socioeconomic profiles. All children and adolescents seen between 1998-2020, aged 5-17 years, with a body mass index greater than +1 standard deviation (Z-score), were enrolled in the study. Blood pressure was measured once with the patient lying down and at rest. American Academy of Pediatrics guidelines were used to classify the patient’s blood pressure levels. Results: 691 patients were evaluated (49% male). Of these, 47.6% had hypertension. The prevalences of hypertension among overweight and obese subjects were 38.8% and 51.5% (p = 0.002), respectively. In addition, obese people were 1.67 times more likely to have hypertension than overweight people. Males had a higher prevalence of hypertension (52.1% vs. 43.3%; p = 0.002) and were 1.3 times more likely to have high blood pressure values. Conclusion: The prevalence of hypertension was high in overweightand obese children and adolescents from two pediatric outpatient clinics. Males and subjects with obesity were at significantly higher risk of having hypertension.

Untargeted Metabolomics Analysis Using UHPLC-Q-TOF/MS Reveals Metabolic Changes Associated with Hypertension in Children.

The mechanism of hypertension in children remains elusive. The objective of this study was to analyze plasma metabolomics characteristics to explore the potential mechanism of hypertension in children. Serum samples from 29 control children, 38 children with normal body mass index and simple hypertension (NBp), 8 children overweight with simple hypertension (OBp), 37 children with normal body mass index and H-type hypertension (NH) and 19 children overweight with H-type hypertension (OH) were analyzed by non-targeted metabolomics. A total of 1235 differential metabolites were identified between children with hypertension and normal controls, of which 193 metabolites including various lipids were significantly expressed. Compared with the control group, 3-dehydroepiandrosterone sulfate, oleic acid and linoleic acid were up-regulated, and gamma-muricholic acid was down-regulated in the NBp group; 3-dehydroepiandrosterone sulfate, 4-acetamidobutanoate and 1-hexadecanoyl-2-octadecadienoyl-sn-glyero-3-phosphocholine were up-regulated in the OBp group, whereas adenosine and 1-myristoyl-sn-glyero-3-phosphocholine were down-regulated; in the NH group, 1-palmitoyl-2-linoleoyl-sn-glycero-3-phosphocholine, phenol and 3-methoxytyramine were up-regulated, while pentadecanoic acid was down-regulated; in the OH group, NG,NG-dimethyl-L-arginine, 1-palmitoyl-sn-glycero-3-phosphocholine and monoethyl phthalate were up-regulated, while phloretin and glycine were down-regulated. The results showed that the children with hypertension had obvious disorders of lipid metabolism (especially in the overweight hypertension group), which led to the occurrence of hypertension. Additionally, the concentration of NO production-related NG, NG-dimethyl-L-arginine, was significantly increased, which may play an important role in H-type hypertension in children.

Blood pressure alterations in recently COVID-19 vaccinated patients

Abstract Background A non-immediate hypertensive response short after COVID-19 vaccination has been reported. Mild to moderate elevated arterial blood pressure (BP) levels have been documented few days after a single or two-doses vaccine. This study sought to investigate this observation as a potential side effect in patients with known hypertension and healthy controls. Methods A total of 100 vaccinated patients between the age of 50 to 70 years old were studied. They were randomly assigned to one of the approved and available vaccines (Pfizer, Astra Zeneca, Moderna, Johnson &amp; Johnson). Half of them were hypertensives under medical treatment and half of them were not. All participants had systolic BP &amp;lt;140mmHg and diastolic BP &amp;lt;90mmHg before vaccination and volunteered for standard daily home BP measurements (HBPM) and ambulatory BP measurements (ABPM) between the 1st and the 21st day after considered fully COVID-19 vaccinated. Results All patients, hypertensives or not, had at some point a recorded hypertensive response for both systolic (SBP) and diastolic (DBP) BP after considered fully vaccinated. Hypertensives were older and with higher body mass index (BMI). Some of the hypertensive patients received additional medication whereas some of the non-hypertensive patients started life modification changes and systematic BP measurements for a possible diagnosis of hypertension. Conclusions Vaccination for COVID-19 seems to be related with a short period of hypertensive response. This phenomenon was partial and mostly observed in older overweight hypertensives. Funding Acknowledgement Type of funding sources: None.

PREVALENCE OF HYPERTENSION AND ITS ASSOCIATION WITH DEMOGRAPHIC AND ANTHROPOMETRIC FACTORS IN OVERWEIGHT-OBESE WOMEN 20-45 YEARS OLD IN BAC GIANG PROVINCE, 2019

Data for the association between adiposity and hypertension in overweight and obese women in reproductive age in Vietnam are insufficient. A cross-sectional study was conducted on 194 overweight and obese women aged 20-45 years old in Bac Giang province in 2019 to determine the prevalence of hypertension and its associated factors with demographics and anthropometrics. Anthropometry (weight, height, waist circumference, and body fat percentage (BF)) and blood pressure (BP) were collected with waist circumference of &gt; 88 cm defined abdominal obesity, systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg defined hypertension, and systolic BP between 120 and &lt;140 mmHg or diastolic BP between 80 and &lt;90 mmHg defined prehypertension, BF ³39% or ³ 40 in people aged 20 - 39 and 40 - 59 defined high BF. Results: The prevalence of hypertension, prehypertension, abdominal obesity and high BF was 11.2%, 30.9%, 63.4% and 30.9%, respectively. Hypertension associated with age and abdominal obesity. There was an association between blood pressure and age in overweight and obese women. Conclusion: Screening for waist circumference and age should be included in the regular health examination procedure for overweight and obese people.

SHORT-TERM BLOOD PRESSURE ALTERATIONS AFTER COVID-19 VACCINATION

Objective: A non-immediate hypertensive response short after COVID-19 vaccination has been reported. Mild to moderate elevated arterial blood pressure (BP) levels have been documented few days after a single or two-doses vaccine. This study sought to investigate this observation as a potential side effect in patients with known hypertension and healthy controls. Design and method: A total of 100 vaccinated patients between the age of 50 to 70 years old were studied. They were randomly assigned to one of the approved and available vaccines (Pfizer, Astra Zeneca, Moderna, Johnson &amp; Johnson). Half of them were hypertensives under medical treatment and half of them were not. All participants had systolic BP &lt; 140mmHg and diastolic BP &lt; 90mmHg before vaccination and volunteered for standard daily home BP measurements (HBPM) and ambulatory BP measurements (ABPM) between the 1st and the 21st day after considered fully COVID-19 vaccinated. Results: All patients, hypertensives or not, had at some point a recorded hypertensive response for both systolic (SBP) and diastolic (DBP) BP after considered fully vaccinated. Hypertensives were older and with higher body mass index (BMI). Some of the hypertensive patients received additional medication whereas some of the non-hypertensive patients started life modification changes and systematic BP measurements for a possible diagnosis of hypertension. Conclusions: Vaccination for COVID-19 seems to be related with a short period of hypertensive response. This phenomenon was partial and mostly observed in older overweight hypertensives.

Prevalence of Occasional Hypertension and Its Association With Overweight and Obesity in Children Aged 5–6 Years in Tianjin

Abstract Background To investigate occasional hypertension in preschool children aged 5–6 years, and to analyze its association with overweight or obesity to provide the basis for early prevention. Methods Cluster random sampling was used to select 63 out of 1,802 kindergartens in 16 districts of Tianjin from 2016 to 2018. Blood pressure, height, and weight were measured among 21,393 children aged 5–6 years. A retrospective questionnaire survey was conducted to collect environmental factors. A multivariate logistic regression model was used to analyze the association between overweight or obesity and occasional hypertension, after adjustment for environmental factors. Results The prevalence of high blood pressure in preschool children of Tianjin was 11.9%, and the rate of occasional hypertension was 17.5%. The detection rate of abnormal blood pressure in overweight and obese children was significantly higher than that in normal weight children (P &amp;lt; 0.01). After adjusted for environmental factors, overweight and obesity were positively associated with high blood pressure and occasional hypertension. The odds ratio (95% confidence interval) of overweight for high blood pressure and occasional hypertension was 1.61 (1.41–1.83) and 1.79 (1.61–1.99), respectively; and odds ratio (95% confidence interval) of obesity for high blood pressure and occasional hypertension was 2.15 (1.85–2.50) and 3.16 (2.82–3.53), respectively. Conclusions Overweight and obesity increase the risk of occasional hypertension in preschoolers.

Prevalence and Associated Risk Factors of Hypertension for the Middle-Aged Population (30-59Years) in Iran: A National Cross-Sectional Study.

The prevalence of hypertension (HTN) is increasing in the middle-aged population, but few studies have examined the prevalence and risk factors associated with hypertension in this age group. Toestimate the prevalence of HTN and its associated demographic risk factors in the middle-aged population (30-59years) of Iran. In this cross-sectional study, 4112 middle-aged people from five provinces of the country were selected by multi-stage sampling and entered into the study. HTN or high blood pressure (HBP) was defined as systolic blood pressure ≥140mmHg and diastolic blood pressure ≥90mmHg. The relationship between demographic risk factors and the prevalence of HTN was assessed by multivariate logistic regression in Stata software version 14. The prevalence of HTN was 17.8% (95% CI 16.5-19.0) and was higher in women than men (19.1% vs. 16.5%). The prevalence of HTN in three studied age groups including 30-39, 40-49 and 50-59years were 7.2, 18.7 and 38.0%, respectively. The frequency of HTN in urban residents was higher than rural residents (18.4% vs. 15.6%). The chance of developing hypertension in urban residents (OR 1.25), overweight (OR 3.94) and obese persons (OR 7.54) was higher. Hypertension has a relatively high prevalence in the middle-aged Iranian population. According to our results, age, living in urban regions, being illiterate, overweight and obesity are independent risk factors for HBP. It seems that the administration of prevention programs in general population especially in younger ages based on existing risk factors is a necessity.

Abstract P266: Hypertensive Response In Recently Covid-19 Vaccinated Patients

Background: A non-immediate hypertensive response after COVID-19 vaccination has been reported. Mild to moderate elevated arterial blood pressure (BP) levels have been documented a few days after a single or two-doses vaccine. This study sought to investigate this observation as a potential side effect in patients with known hypertension and healthy controls. Methods: Overall 60 vaccinated patients between the age of 50 to 70 years old were studied. They were randomly assigned to one of the approved and available vaccines (Pfizer, Astra Zeneca or Moderna) twice within a month. Half of them were hypertensives under medical treatment and half of them were not.All participants volunteered for standard daily home blood pressure measurements (HBPM) and had also ambulatory blood pressure measurements (ABPM) between the 1 st and the 30 th day after the second dose of COVID-19 vaccine. Results: All patients, hypertensives or not, had at some point a recorded and substantial hypertensive response for both systolic (SBP) and diastolic (DBP) blood pressure after the second dose of the vaccine. Hypertensives were older and with higher body mass index (BMI). Some of the hypertensive patients received additional medication whereas some of the non-hypertensive patients started life modification changes and systematic BP measurements for a possible diagnosis of hypertension. Conclusions: Vaccination for COVID 19 seems to be related with a short period of hypertensive response. This phenomenon was partial and mostly observed in older overweight hypertensives.

A cross-sectional study of prevalence of overweight and hypertension among veterans in Eastern Uttar Pradesh

Background: Health problems of veterans have not been studied extensively. Obesity though not a major problem while in service, could be a major factor leading to morbidity and mortality due to lifestyle diseases seen among overweight/obese people.Methods: Status of overweight and hypertension was studied among ex-servicemen population of a military station in the age group of primarily 50-70 years.Results: More than 35% veterans were found to be overweight/obese. Underweight was a more serious problem than overweight among those above 70 years of age. Prevalence of hypertension was also high (25%). There was weak association of overweight with hypertension among ex-servicemen because the problem seems to appear late in life. This association was stronger upto 60 years of age after which it starts decreasing.Conclusions: The problems of overweight and obesity and hypertension constitute considerable health burden among the veterans. However, a significant causal association could not be established between overweight and hypertension.

Temporal pattern of cardiovascular risk factors depending on outpatient care status

Aim. To study the temporal pattern of cardiovascular risk factors and cardiovascular disease (CVD) in the adult cohort depending on outpatient care status.Materials and Methods. We analyzed the incidence of CVD in the adult cohort (n = 1170) admitted to Research Institute – Ochapovsky Regional Clinical Hospital # 1 in 2015 (baseline) and after 3 years of follow-up. Groups were stratified according to the outpatient care status.Results. After 3 years of follow-up, the proportion of patients adhered to unhealthy diet decreased by 32.2%, 28.8% and 28.0% in groups without regular outpatient care, with regular outpatient care, and with regular outpatient care and CVD, respectively, as compared to baseline. Similar trend was observed regarding low physical activity (reduction by 50.3%, 24.7% and 21.8%, respectively) and tobacco smoking (45.6%, 63.0% and 61.8%, respectively). However, patients without regular outpatient care demonstrated an increase in overweight and obesity by 19.2%. Notably, the frequency of arterial hypertension increased by 48.33% in patients without regular outpatient care but decreased by 24% in those with regular outpatient care and CVD.Conclusion. During 3-year outpatient observation, we found a trend to a reduction in prevalence of cardiovascular risk factors, also in patients with CVD. Nevertheless, patients without regular outpatient care showed a statistically significant increase in prevalence of overweight, obesity and arterial hypertension.

P0165HYPERTENSION IN OVERWEIGHT AND OBESE CHILDREN: IMPACT ASSESMENT OF ABPM PARAMETERS

Abstract Background and Aims We describe the relationship between overweight and obesity and Hypertension on ABPM. Method We conducted a cross-sectional study using a database of patients aged 6-16 years, who had undergone 24h ABPM from December 2002 through December 2016. ABPM were performed using the validated device Spacelab 90217. Were evaluated the 24h MAP, daytime MAP, nocturnal MAP, systolic and diastolic load, MAP Systolic and Diastolic. Subjects were grouped by BMI Z-score into overweight (&amp;gt;1&amp;lt;2), obese (BMI Z-score &amp;gt;2&amp;lt;3) and severe obese (BMI Z-score &amp;gt;3). A total of 1016 patients were enrolled and recorded n.1210 ABPMs. Obese pts were 202 (19.8%); 126 M;76F;median age 10,2 y. Overweight childrens were 97 (11.9%);52 M;45F;median age 8,4y. Results Among overweight childrens (BMI Z-Score &amp;gt;1&amp;lt;2): 12 (12.3%) had hypertension, 22 (22.6%) pre-hypertension, 15 (15.4%) MH; non dipping pattern was recorded in 26 (52%). 48 were normotensive. Among obese childrens, 122 had hypertension (60.3%): 24 pts had Masked Hypertension (19.6%); 72 (59.0%) had severe ambulatory hypertension with BMI z-score &amp;gt;3 (mean 3.8) ,and in this category all pts were both systolic and diastolic non dipping. 32 (64%) obese with BMI z-score &amp;gt;2, &amp;lt;3 were non-dipping. Diastolic load was significantly higher (p&amp;gt;0,0001) in severe obese. 28 pts had ambulatory prehypertension (13.8%), 11 pts had White Coat Hypertension (4.9%).41 pts had normotension (20.2%). Conclusion The severity of ambulatory hypertension increased with increased BMI Z-score. The non-dipping status is associated, not only with higher BMI Z-score, but was present in overweight and obese with BMI z-score &amp;gt;2&amp;lt;3 also. ABPM is an effective tool that should become routine in all obese patient, but also in overweight childrens, which may lead to better treatments and prevention methods.

Large thigh circumference is associated with lower blood pressure in overweight and obese individuals: a community-based study.

ObjectiveA small thigh circumference is associated with an increased risk of diabetes, cardiovascular diseases, and total mortality. The purpose of this study was to evaluate the association between thigh circumference and hypertension in the middle-aged and elderly population.MethodsA total of 9520 individuals aged 40 years and older with measurement of thigh circumference were available for analysis. The measurement of thigh circumference was performed directly below the gluteal fold of the thigh. The association of thigh circumference with hypertension was tested in logistic regression analyses and reported as odds ratio (OR) with 95% CI.ResultsThigh circumference was negatively correlated with systolic blood pressure, diastolic blood pressure, fasting glucose, and total cholesterol. Compared with the lowest thigh circumference tertile group, the risk of hypertension was significantly lower in the highest tertile group, both in overweight individuals (OR 0.68; 95% CI 0.59–0.79, P < 0.001) and obese individuals (OR 0.51; 95% CI 0.38–0.70, P < 0.001).ConclusionIn the present study, large thigh circumference is associated with lower risk of hypertension in overweight and obese Chinese individuals.

Prevalence and distribution of hypertension in overweight and obese subjects in an urban community in Enugu, South East Nigeria. A post hoc analysis.

Most recent studies in Nigeria have documented high prevalence of hypertension, diabetes, and obesity. Several mechanisms may link hypertension and obesity hence the high prevalences of both disorders in Nigeria. There are however no studies on the prevalence of hypertension among the obese in urban settings. The aim of this study was to describe the prevalence and pattern of hypertension in overweight/obese individuals in a community. We conducted a post-hoc analysis on obese subjects 20 years and above from two urban settlements within Enugu metropolis. For database management and statistical analyses, we used the SPSS version 22. Data from a total of 301 individuals with obesity who met the selection criteria were re-analyzed. A total of 198 (65.8%) individuals were found to have hypertension most of whom were newly diagnosed 110 (55.6%). The prevalence of hypertension was 65.8% and increased with age and BMI. Individuals with overweight/obesity have very high rates of hypertension. The prevalence of hypertension also increased with and BMI. Thus, there is need for targeted health education in adults to address the burden of obesity and hypertension to reduce the burden of cardiovascular disease in the community.

Lack of Associations between Elevated Serum Uric Acid and Components of Metabolic Syndrome Such as Hypertension, Dyslipidemia, and T2DM in Overweight and Obese Chinese Adults.

The overweight and obese population experiences a higher occurrence of both hyperuricemia and metabolic syndrome. The present study was to explore the relationship between serum uric acid and metabolic syndrome-related risk factors among 409 obese Chinese adults (254 women and 155 men) with >24 kg/m2 BMI. Based on sex-specific reference ranges, 233 (57%) patients showed elevated serum uric acid. A total of 15 attributes were selected to assess the associations between elevated serum uric acid and components of metabolic syndrome, including serum uric acid, total cholesterol, HDL-C, LDL-C, triglyceride, systolic blood pressure, fasting blood glucose, glycosylated hemoglobin, HOMA-IR, alanine aminotransferase, creatinine, urine microalbumin, muscle mass amount, BMI, and age. Among the participants stratified into three groups of grade I, grade II, and grade III obesity, as well as among the participants stratified into male and female groups, univariate correlation analysis identified a negative association (P < 0.01) for age, positive associations (P < 0.01) for BMI, muscle mass, alanine aminotransferase, and creatinine. The stepwise multivariate logistic regression proved similar associations for age, BMI, creatinine, and alanine aminotransferase. No significant associations were testified between serum uric acid levels and cholesterol, HDL-C, LDL-C, triglyceride, fasting blood glucose, glycosylated hemoglobin, HOMA-IR, and urine microalbumin. Factor analysis illustrated that 15 attributes could be grouped into two common factors and five individual factors. A common underlying factor was identified among uric acid, muscle mass, creatinine, alanine aminotransferase, and BMI. The results indicate that serum uric acid has no apparent association with metabolic syndromes that are commonly characterized by hypertension, dyslipidemia, and T2DM.

Evaluation of left ventricular function in overweight children and teenagers with arterial hypertension and white coat hypertension.

Obesity in childhood is strongly associated with elevated arterial blood pressure and risk of hypertension. The aim of the study was the evaluation of left ventricular (LV) function in hypertensive and white coat hypertensive overweight children and teenagers. The study group consisted of 74 overweight patients aged 10.3 ± 3.1 years (range: 6-16 years) diagnosed as hypertensive in standard blood pressure measurement. The control group consisted of 31 normotensive and normoweight children. Ambulatory blood pressure monitoring (ABPM) and echocardiographic assessment of the LV mass and function were performed in all participants. Using ABPM hypertension was confirmed in 20 (27%) children. In the 54 (73%) remaining children white coat hypertension was diagnosed. The analysis of echocardiographic parameters revealed higher LV mass index (LVMI) in hypertensive overweight than in normotensive normoweight children (47.5 ± 9.2 g/m2.7 vs. 39.8 ± 12.1 g/m2.7; p < 0.05) and no difference between overweight hypertensive and white coat hypertension-hypertensive groups. The deceleration time of mitral early filling (DCT) was longer in hypertensive normoweight children than in normotensive overweight patients (219.5 ± 110.3 ms vs. 197.8 ± 65.8 ms; p < 0.05). A significant correlation between systolic blood pressure load (SBPL) and DCT (r = 0.57) and moderate correlation between SBPL and LVMI (r: 0.48) as well as between LVMI and isovolumetric relaxation time (r = 0.37) were found. In overweight children the diagnosis of hypertension should be confirmed in ABPM because of the high prevalence of white coat hypertension. Periodic echocardiographic examinations should be recommended in overweight children with increased SBPL and decreased systolic nocturnal deep because of the possibility of LV function impairment.

The Impact of Obesity in Patients Undergoing Robotic Partial Nephrectomy.

Introduction: As the prevalence of obesity increases worldwide, an increasing proportion of surgical candidates have an elevated body mass index (BMI), with associated metabolic syndrome. Yet there exists limited evidence regarding the effect of elevated BMI on surgical outcomes in robotic surgeries. We examined whether obese patients had worse perioperative outcomes and postoperative renal function after robotic partial nephrectomies (RPNs). Materials and Methods: We performed a multi-institutional analysis of 1770 patients who underwent RPNs between 2008 and 2015, allowing time for the data set to mature. Associations between BMI, as a continuous and categorical variable, and perioperative outcomes, acute kidney injury (AKI, >25% reduction in estimated glomerular filtration rate [eGFR]) at discharge, and change in eGFR per month were analyzed. AKI and eGFR were evaluated using multivariable logistic and linear regression models adjusted for confounders, including age, Charlson comorbidity index, tumor size, and the identity of the surgeon. Results: In total 45.2% (n = 529) of patients were found to be obese, with a greater prevalence of hypertension and diabetes in overweight and obese patients. Obese patients were more likely to have malignant tumors (>77% vs 68%, p < 0.001) and trended toward having larger tumors (3.0 cm vs 2.8 cm; p = 0.061). Heavier patients required longer operative times (166-196 minutes vs 155 minutes; p < 0.001), although equivalent warm ischemia times (p = 0.873). Obesity did not correlate with an increased complication rate (p > 0.05). On multivariable analysis, obesity (odds ratio [OR] = 1.81; p = 0.031), male sex (OR = 1.54; p = 0.028), and larger tumor size (OR = 1.23; p < 0.001) were associated with a significant increase in the likelihood of AKI at discharge. BMI above normal weight was not associated with greater eGFR decline per month post-RPN. Conclusions: Obesity was associated with equivalent perioperative outcomes and long-term renal function. Further research is warranted into how obesity and metabolic syndrome may foster a more aggressive tumor environment. RPN appears to be an equally safe operative option for patients regardless of obesity status.