Endothelial dysfunction in obese non-hypertensive children without evidence of sleep disordered breathing
Endothelial dysfunction in obese non-hypertensive children without evidence of sleep disordered breathing
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DOI：
10.1186/1471-2431-10-8
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发表时间：
2010-02-15
期刊：
影响因子：
2.4
通讯作者：
Gozal, David
中科院分区：
文献类型：
--
作者：
Bhattacharjee, Rakesh;Alotaibi, Wadha H.;Gozal, David
工作背景：内皮功能障碍是肥胖和阻塞性睡眠呼吸暂停综合征（OSAS）的并发症，后者在肥胖儿童中非常普遍。在没有OSAS的儿童中，肥胖是否会导致内皮功能障碍尚不清楚。本研究检查了未患有OSAS的肥胖和非肥胖儿童的内皮功能。方法：招募了青春期前非高血压儿童。在早晨空腹状态下，使用改良的充血试验（包括袖带诱导的桡动脉和尺动脉闭塞）评估内皮功能。通过整夜多导睡眠图证实没有OSAS。结果：55名肥胖儿童（平均年龄8.6 +/- 1.4岁，平均BMI z评分：2.3 +/- 0.3）与50名非肥胖儿童（平均年龄8.0 +/- 1.6岁，平均BMI z评分0.3 +/- 0.9）进行了比较。与非肥胖儿童相比，肥胖儿童在闭塞解除后毛细血管再灌注峰值显著延迟（45.3 +/- 21.9秒对31.5 +/- 14.1秒，p < 0.01），但充血程度无差异。再灌注峰值时间与体脂百分比呈正相关（r = 0.365，p < 0.01）。结论：我们的研究结果证实，即使没有OSAS，肥胖儿童在生命早期也会发生内皮功能障碍。因此，在儿童肥胖症中内皮功能障碍的潜在机制在没有睡眠呼吸障碍的情况下是可操作的。
Background: Endothelial dysfunction is a complication of both obesity and obstructive sleep apnea syndrome (OSAS), the latter being highly prevalent among obese children. It is unknown whether obesity causes endothelial dysfunction in children in the absence of OSAS. This study examines endothelial function in obese and non-obese children without OSAS.Methods: Pre-pubertal non-hypertensive children were recruited. Endothelial function was assessed in a morning fasted state, using a modified hyperemic test involving cuff-induced occlusion of the radial and ulnar arteries. The absence of OSAS was confirmed by overnight polysomnography. Anthropometry was also performed.Results: 55 obese children (mean age 8.6 +/- 1.4 years, mean BMI z-score: 2.3 +/- 0.3) were compared to 50 non-obese children (mean age 8.0 +/- 1.6 years, mean BMI z-score 0.3 +/- 0.9). Significant delays to peak capillary reperfusion after occlusion release occurred in obese compared to non-obese children (45.3 +/- 21.9 sec vs. 31.5 +/- 14.1 sec, p < 0.01), but no differences in the magnitude of hyperemia emerged. Time to peak reperfusion and percentage of body fat were positively correlated (r = 0.365, p < 0.01).Conclusions: Our findings confirm that endothelial dysfunction occurs early in life in obese children, even in the absence of OSAS. Thus, mechanisms underlying endothelial dysfunction in pediatric obesity are operational in the absence of sleep-disordered breathing.