Methods We have conducted clinical, functional and laboratory examination of 104 adolescents 11–18 years with a primary abdominal obesity. The body mass index (BMI) of all children exceeded 95 percentile. It was studied the reaction of the brachial artery in the process of conducting endothelial test with reactive hyperemia and calculated of percentage flow-mediated dilation (%FMD).
Results In 66% (n = 67) cases in adolescents identified endothelial dysfunction on the basis of positive endothelial samples (FMD <10%).
A further analysis was performed among children with dysfunction of endothelium of the brachial artery. The children were divided in to 2 groups: group A (n = 31) - children with stable essential hypertension;group B (n = 36) - children with labile hypertension or normal blood pressure.
In adolescents of the group A with a moderate increase in the percentage content of fat mass (M=31.4 ± 4.7%) disorders in the blood are recorded: hyperglycemia –16,6%, hypercholesterolemia in 4%, hyperinsulinemia in 27%, with the development of insulin resistance in 17%. Children of group B were characterised by significantly more pronounced disorders in the blood. They registered with a higher percentage of body fat in the body (M = 39.45 ± 4.4%). Hyperglycemia was reported in 33% (p = 0.04), hypercholesterolemia at 33% (p = 0.04), hyperinsulinemia at 45% (p = 0.041) with the development of insulin resistance in 30% (p = 0.042).
Conclusions The analysis of groups allows defining a primary factor that causes dysfunction of endothelium at obesity (high blood pressure or hyperinsulinemia), as well as to suggest which of the pathogenetic variants may further progress obesity: essential hypertension or diabetes type 2.
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