Endocrine Abstracts

Objective: To investigate the state of blood pressure in children with obesity and insulin resistance.

Materials and Methods: 127 obese children, age from 6 to 15 years, average age 11.5 years. Anthropometry, calculation of body mass index (BMI), waist/hip volume ratio, measurement of blood pressure (SBP, DBP), study of the level of immunoreactive insulin, glucose were carried out. Insulin resistance was determined with hyperinsulinemia above 22.0 microns/ml, a high NOMА index.

Results: obesity in the observed children was of varying degrees, the average BMI was 26.9±2.2, while the predominantly abdominal type of distribution of the subcutaneous fat layer was revealed. Impaired glucose tolerance and fasting glycemia were detected in 14 (11.0%) obese children, type 2 diabetes mellitus in 1 (0.8%) child, hyperinsulinemia was detected in 45 (35.4%) children, while the average insulin level was 56.5±8.6 μm/ml. An increase in the HOMA index was detected in 64 (50.4%) patients, the average indicator was 12.0±1.9, which made it possible to verify their insulin resistance syndrome. An increase in blood pressure was detected in 46.5 ± 4.4% of obese children, in 55.2±8.1 children with obesity and insulin resistance. The frequency of elevated SBP values in obese children was registered in 39.1%, DBP - in 24.6%. In children with obesity and the presence of insulin resistance, high rates of SBP were recorded in 53.4%, DBP - 39.7%. Also, among children with insulin resistance, there were high values of SBP and pulse pressure, which indicates the indirect influence of insulin resistance syndrome in the formation of increased peripheral vascular resistance and the development of arterial hypertension.

Conclusions: arterial hypertension is a fairly common concomitant pathology in obese children. When burdened with insulin resistance syndrome in obese children, the frequency of arterial hypertension increases and is recorded in every second sick child, which indicates a direct and/or indirect effect of insulin resistance on an increase in blood pressure.