Association Between Obesity and Blood Pressure Among Iranian Children and Adolescents: A Sub-analysis from the SHED LIGHT Study.
Adolescent
Children
Hypertension
Obesity
Waist circumference
Waist-to-height ratio
Journal
Pediatric cardiology
ISSN: 1432-1971
Titre abrégé: Pediatr Cardiol
Pays: United States
ID NLM: 8003849
Informations de publication
Date de publication:
18 Oct 2022
18 Oct 2022
Historique:
received:
01
08
2022
accepted:
28
09
2022
entrez:
18
10
2022
pubmed:
19
10
2022
medline:
19
10
2022
Statut:
aheadofprint
Résumé
Childhood obesity has become a major non-communicable disease worldwide. It is associated with an increased risk of cardiometabolic factors, including diabetes and hypertension (HTN). The purpose of this study was to evaluate the association between obesity and HTN among Iranian children and adolescents. Cross-sectional data from the SHED LIGHT study performed in Tehran urban area were used in this report. The anthropometric values and blood pressure were analyzed. The obesity status was identified based on body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). The blood pressure status was defined using percentiles for height, age, and sex. A total of 14,641 children with a mean age of 12.28 ± 3.1 years (6-18) were assessed, and 52.8% of them were boys. The prevalence of HTN was higher among obese compared to healthy weight subjects (p < 0.001). HTN had the strongest association with the central obesity by WC (odds ratio [OR] 4.098, 95% confidence interval [CI] 3.549-4.732), generalized obesity by BMI (OR 3.000, 95% CI 2.749-3.274), and central obesity by WHtR (OR 2.683, 95% CI 2.451-2.936). Moreover, parental university education, having studied in private schools, and the smaller number of household children increased the risk of obesity. The rate of HTN was high among children and adolescents with generalized and central obesities. HTN, elevated blood pressure, boy gender, and socioeconomic status were associated with obesity, emphasizing on the importance of screening and implementing lifestyle changes to decrease future risk of cardiovascular diseases.
Identifiants
pubmed: 36255467
doi: 10.1007/s00246-022-03022-8
pii: 10.1007/s00246-022-03022-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : National Institute for Medical Research Development
ID : 962126
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Collaboration NCDRF (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet (London, England) 390:2627–2642
doi: 10.1016/S0140-6736(17)32129-3
Collaborators GBDO, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, Salama JS, Vos T, Abate KH, Abbafati C, Ahmed MB, Al-Aly Z, Aa A, Al-Raddadi R, Amare AT, Amberbir A, Amegah AK, Amini E, Amrock SM, Anjana RM, Ärnlöv J, Asayesh H, Banerjee A, Barac A, Baye E, Bennett DA, Beyene AS, Biadgilign S, Biryukov S, Bjertness E, Boneya DJ, Campos-Nonato I, Carrero JJ, Cecilio P, Cercy K, Ciobanu LG, Cornaby L, Damtew SA, Dandona L, Dandona R, Dharmaratne SD, Duncan BB, Eshrati B, Esteghamati A, Feigin VL, Fernandes JC, Fürst T, Gebrehiwot TT, Gold A, Gona PN, Goto A, Habtewold TD, Hadush KT, Hafezi-Nejad N, Hay SI, Horino M, Islami F, Kamal R, Kasaeian A, Katikireddi SV, Kengne AP, Kesavachandran CN, Khader YS, Khang Y-H, Khubchandani J, Kim D, Kim YJ, Kinfu Y, Kosen S, Ku T, Defo BK, Kumar GA, Larson HJ, Leinsalu M, Liang X, Lim SS, Liu P, Lopez AD, Lozano R, Majeed A, Malekzadeh R, Malta DC, Mazidi M, McAlinden C, McGarvey ST, Mengistu DT, Mensah GA, Mensink GBM, Mezgebe HB, Mirrakhimov EM, Mueller UO, Noubiap JJ, Obermeyer CM, Ogbo FA, Owolabi MO, Patton GC, Pourmalek F, Qorbani M, Rafay A, Rai RK, Ranabhat CL, Reinig N, Safiri S, Salomon JA, Sanabria JR, Santos IS, Sartorius B, Sawhney M, Schmidhuber J, Schutte AE, Schmidt MI, Sepanlou SG, Shamsizadeh M, Sheikhbahaei S, Shin M-J, Shiri R, Shiue I, Roba HS, Silva DAS, Silverberg JI, Singh JA, Stranges S, Swaminathan S, Tabarés-Seisdedos R, Tadese F, Tedla BA, Tegegne BS, Terkawi AS, Thakur JS, Tonelli M, Topor-Madry R, Tyrovolas S, Ukwaja KN, Uthman OA, Vaezghasemi M, Vasankari T, Vlassov VV, Vollset SE, Weiderpass E, Werdecker A, Wesana J, Westerman R, Yano Y, Yonemoto N, Yonga G, Zaidi Z, Zenebe ZM, Zipkin B, Murray CJL (2017) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377:13–27
doi: 10.1056/NEJMoa1614362
Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311:806–814
pubmed: 24570244
pmcid: 4770258
doi: 10.1001/jama.2014.732
Fernández JR, Bohan Brown M, López-Alarcón M, Dawson JA, Guo F, Redden DT, Allison DB (2017) Changes in pediatric waist circumference percentiles despite reported pediatric weight stabilization in the United States. Pediatr Obes 12:347–355
pubmed: 27273320
doi: 10.1111/ijpo.12150
Javed A, Jumean M, Murad MH, Okorodudu D, Kumar S, Somers VK, Sochor O, Lopez-Jimenez F (2015) Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis. Pediatr Obes 10:234–244
pubmed: 24961794
doi: 10.1111/ijpo.242
Esmaili H, Bahreynian M, Qorbani M, Motlagh ME, Ardalan G, Heshmat R, Kelishadi R (2015) Prevalence of general and abdominal obesity in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV Study. Iran J Pediatr 25
Ashwell M, Hsieh SD (2005) Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr 56:303–307
pubmed: 16236591
doi: 10.1080/09637480500195066
Kumar S, Kelly AS (2017) Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc 92:251–265
pubmed: 28065514
doi: 10.1016/j.mayocp.2016.09.017
Skinner AC, Perrin EM, Moss LA, Skelton JA (2015) Cardiometabolic risks and severity of obesity in children and young adults. N Engl J Med 373:1307–1317
pubmed: 26422721
doi: 10.1056/NEJMoa1502821
Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, Srinivasan SR, Daniels SR, Davis PH, Chen W, Sun C, Cheung M, Viikari JSA, Dwyer T, Raitakari OT (2011) Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 365:1876–1885
pubmed: 22087679
doi: 10.1056/NEJMoa1010112
Freedman DS, Dietz WH, Srinivasan SR, Berenson GS (1999) The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 103:1175–1182
pubmed: 10353925
doi: 10.1542/peds.103.6.1175
Rosner B, Cook NR, Daniels S, Falkner B (2013) Childhood blood pressure trends and risk factors for high blood pressure: the NHANES experience 1988–2008. Hypertension (Dallas, Tex: 1979) 62:247–254
Sorof JM, Poffenbarger T, Franco K, Bernard L, Portman RJ (2002) Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children. J Pediatr 140:660–666
pubmed: 12072867
doi: 10.1067/mpd.2002.125228
Wang M, Kelishadi R, Khadilkar A, Mi Hong Y, Nawarycz T, Krzywińska-Wiewiorowska M, Aounallah-Skhiri H, Esmaeil Motlagh M, Soon Kim H, Khadilkar V, Krzyżaniak A, Ben Romdhane H, Heshmat R, Chiplonkar S, Stawińska-Witoszyńska B, El Ati J, Qorbani M, Kajale N, Traissac P, Ostrowska-Nawarycz L, Ardalan G, Ekbote V, Yang L, Zhao M, Liu X, Liang Y, Xi B (2020) Body mass index percentiles and elevated blood pressure among children and adolescents. J Hum Hypertens 34:319–325
pubmed: 31253844
doi: 10.1038/s41371-019-0215-x
Hosseini S, Samiei N, Tabib A, Bakhshandeh H, Rezaei Y, Parsaee M, Ghader FR, Moradian M, Shojaeifard M, Khajali Z, Taghavi S, Naderi N, Hejri GM, Ghaderian H, Houshmand G, Kaviani R, Farrashi M, Pakbaz M, Mombeini H, Saedi S, Ghavidel AA, Omrani G, Mohebbi A, Peighambari MM, Khorgami MR, Nikpajouh A, Amin A, Maleki M, Mestres CA, Badano LP, Noohi F, Investigators OBotSL (2022) Prevalence of structural heart diseases detected by handheld echocardiographic device in school-age children in Iran: the SHED LIGHT study. Global Heart 17
Taylor RW, Williams SM, Grant AM, Taylor BJ, Goulding A (2011) Predictive ability of waist-to-height in relation to adiposity in children is not improved with age and sex-specific values. Obesity (Silver Spring) 19:1062–1068
doi: 10.1038/oby.2010.217
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL (2000) CDC growth charts: United States. Adv Data 1–27
Li C, Ford ES, Mokdad AH, Cook S (2006) Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics 118:e1390-1398
pubmed: 17079540
doi: 10.1542/peds.2006-1062
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, de Ferranti SD, Dionne JM, Falkner B, Flinn SK, Gidding SS, Goodwin C, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV, Urbina EM (2017) Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 140
Williams K, Thomson D, Seto I, Contopoulos-Ioannidis DG, Ioannidis JPA, Curtis S, Constantin E, Batmanabane G, Hartling L, Klassen T, Sta RCHG (2012) Standard 6: age groups for pediatric trials. Pediatrics 129(Suppl 3):S153-160
pubmed: 22661762
doi: 10.1542/peds.2012-0055I
Reilly JJ, Kelly J (2011) Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obesity 35:891–898
doi: 10.1038/ijo.2010.222
Chorin E, Hassidim A, Hartal M, Havakuk O, Flint N, Ziv-Baran T, Arbel Y (2015) Trends in adolescents obesity and the association between BMI and blood pressure: a cross-sectional study in 714,922 healthy teenagers. Am J Hypertens 28:1157–1163
pubmed: 25736450
doi: 10.1093/ajh/hpv007
Kelishadi R, Haghdoost A-A, Sadeghirad B, Khajehkazemi R (2014) Trend in the prevalence of obesity and overweight among Iranian children and adolescents: a systematic review and meta-analysis. Nutrition (Burbank, Los Angeles County, Calif) 30:393–400
doi: 10.1016/j.nut.2013.08.011
Ejtahed H-S, Kelishadi R, Qorbani M, Motlagh ME, Hasani-Ranjbar S, Angoorani P, Beshtar S, Ziaodini H, Taheri M, Heshmat R (2019) Utility of waist circumference-to-height ratio as a screening tool for generalized and central obesity among Iranian children and adolescents: the CASPIAN-V study. Pediatr Diabetes 20:530–537
pubmed: 30968521
Sukhonthachit P, Aekplakorn W, Hudthagosol C, Sirikulchayanonta C (2014) The association between obesity and blood pressure in Thai public school children. BMC Public Health, p 729
Lu X, Shi P, Luo C-Y, Zhou Y-F, Yu H-T, Guo C-Y, Wu F (2013) Prevalence of hypertension in overweight and obese children from a large school-based population in Shanghai. BMC Public Health, China, p 24
Flores-Huerta S, Klünder-Klünder M, Reyes de la Cruz L, Santos JI (2009) Increase in body mass index and waist circumference is associated with high blood pressure in children and adolescents in Mexico city. Arch Med Res 40:208–215
pubmed: 19427973
doi: 10.1016/j.arcmed.2009.02.009
Khoury M, Manlhiot C, Dobbin S, Gibson D, Chahal N, Wong H, Davies J, Stearne K, Fisher A, McCrindle BW (2012) Role of waist measures in characterizing the lipid and blood pressure assessment of adolescents classified by body mass index. Arch Pediatr Adolesc Med 166:719–724
pubmed: 22473884
doi: 10.1001/archpediatrics.2012.126
Larkins NG, Teixeira-Pinto A, Kim S, Burgner DP, Craig JC (2019) The population-based prevalence of hypertension and correlates of blood pressure among Australian children. Pediatr Nephrol (Berlin, Germany) 34:1107–1115
doi: 10.1007/s00467-019-04206-w
Önsüz FM, Demir F (2015) Prevalence of hypertension and its association with obesity among school children aged 6–15 living in Sakarya Province in Turkey. Turk J Med Sci 45:907–912
pubmed: 26422866
doi: 10.3906/sag-1407-120
Bauer KW, MarcusEl ghormli L, Ogden CL, Foster GD MD (2015) Cardio-metabolic risk screening among adolescents: understanding the utility of body mass index, waist circumference and waist to height ratio. Pediatr Obes 10:329–337
pubmed: 25515620
doi: 10.1111/ijpo.267
Madruga JG, Moraes Silva F, Scherer Adami F (2016) Positive association between waist-to-height ratio and hypertension in adolescents. Rev Port Cardiol 35:479–484
pubmed: 27503587
doi: 10.1016/j.repc.2016.03.004
Rerksuppaphol S, Rerksuppaphol L (2015) Association of obesity with the prevalence of hypertension in school children from central Thailand. J Res Health Sci 15:17–21
pubmed: 25821020
Mushtaq MU, Gull S, Abdullah HM, Shahid U, Shad MA, Akram J (2011) Waist circumference, waist-hip ratio and waist-height ratio percentiles and central obesity among Pakistani children aged five to twelve years. BMC Pediatr 11:105
pubmed: 22104025
pmcid: 3239239
doi: 10.1186/1471-2431-11-105
Chiolero A, Paradis G, Maximova K, Burnier M, Bovet P (2013) No use for waist-for-height ratio in addition to body mass index to identify children with elevated blood pressure. Blood Press 22:17–20
pubmed: 22817261
doi: 10.3109/08037051.2012.701376
Daniels SR (2009) Complications of obesity in children and adolescents. Int J Obes 33(Suppl 1):S60-65
doi: 10.1038/ijo.2009.20
Sommer A, Twig G (2018) The impact of childhood and adolescent obesity on cardiovascular risk in adulthood: a systematic review. Curr Diab Rep 91
Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS (2001) Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics 108:712–718
pubmed: 11533341
doi: 10.1542/peds.108.3.712
Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM (2012) Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ e4759
Genovesi S, Antolini L, Giussani M, Pieruzzi F, Galbiati S, Valsecchi MG, Brambilla P, Stella A (2008) Usefulness of waist circumference for the identification of childhood hypertension. J Hypertens 26:1563–1570
pubmed: 18622233
doi: 10.1097/HJH.0b013e328302842b
Benmohammed K, Nguyen MT, Khensal S, Valensi P, Lezzar A (2011) Arterial hypertension in overweight and obese Algerian adolescents: role of abdominal adiposity. Diabetes Metab 37:291–297
pubmed: 21277245
doi: 10.1016/j.diabet.2010.10.010
Wang L, Song L, Liu B, Zhang L, Wu M, Cao Z, Wang Y (2019) Trends and status of the prevalence of elevated blood pressure in children and adolescents in china: a systematic review and meta-analysis. Curr Hypertens Rep 21:88
pubmed: 31599364
doi: 10.1007/s11906-019-0992-1
Basiratnia M, Derakhshan D, Ajdari S, Saki F (2013) Prevalence of childhood obesity and hypertension in south of Iran. Iran J Kidney Dis 7:282–289
pubmed: 23880805
Lamerz A, Kuepper-Nybelen J, Wehle C, Bruning N, Trost-Brinkhues G, Brenner H, Hebebrand J, Herpertz-Dahlmann B (2005) Social class, parental education, and obesity prevalence in a study of six-year-old children in Germany. Int J Obes 29:373–380
doi: 10.1038/sj.ijo.0802914
Orden AB, Lamarque MS, Apezteguía MC (2019) Trend in childhood obesity reflects socioeconomic status in Argentina. Ann Hum Biol 46:531–536
pubmed: 31793341
doi: 10.1080/03014460.2019.1694070
Zhu Y, Zheng H, Zou Z, Jing J, Ma Y, Wang H, Luo J, Zhang X, Luo C, Wang H, Zhao H, Pan D, Sangild P, Karmacharya BM, Ma J, Chen Y (2019) Metabolic syndrome and related factors in chinese children and adolescents: analysis from a Chinese national study. J Atheroscler Thromb
Soltani S, Kazemi Z, Karyani AK, Matin BK, Ebrahimi M, Rezaei S (2019) Socioeconomic disparities in unhealthy weight: a need for health promotion among school-aged children. J Educ Health Promot 240
Anderson PM, Butcher KF, Levine PB (2003) Maternal employment and overweight children. J Health Econ 22:477–504
pubmed: 12683963
doi: 10.1016/S0167-6296(03)00022-5
Rezai-Rashti GM, Moghadam VM (2011) Women and higher education in Iran: what are the implications for employment and the “marriage market”? Int Rev Educ 57:419–441
doi: 10.1007/s11159-011-9217-9
Moinifar HS (2012) Higher education of women in Iran: progress or problem? Int J Women’s Res 1:43–60
Paduano S, Borsari L, Salvia C, Arletti S, Tripodi A, Pinca J, Borella P (2020) Risk factors for overweight and obesity in children attending the first year of primary schools in Modena, Italy. J Community Health 45:301–309
pubmed: 31522302
doi: 10.1007/s10900-019-00741-7
Koebnick C, Black MH, Wu J, Martinez MP, Smith N, Kuizon B, Cuan D, Young DR, Lawrence JM, Jacobsen SJ (2013) High blood pressure in overweight and obese youth: implications for screening. J Clin Hypertens (Greenwich) 15:793–805
doi: 10.1111/jch.12199
Heo S, Kwon S, Lee Y-M, Shin J-Y, Lee D-H (2020) Comparison of trends in blood pressure and the prevalence of obesity among Korean and American adolescents: a 12-years cross-sectional study. J Prev Med Public Health 53:45–55
pubmed: 32023674
doi: 10.3961/jpmph.19.198
Duzova A, Yalçinkaya F, Baskin E, Bakkaloglu A, Soylemezoglu O (2013) Prevalence of hypertension and decreased glomerular filtration rate in obese children: results of a population-based field study. Nephrol Dial Transpl 28(Suppl 4): iv166–171
Siklar Z, Berberoglu M, Savas Erdeve S, Hacihamdioglu B, Ocal G, Egin Y, Akar N (2011) Contribution of clinical, metabolic, and genetic factors on hypertension in obese children and adolescents. J Pediatr Endocrinol Metab 24:21–24
pubmed: 21528810
doi: 10.1515/jpem.2011.105