Body mass index, blood pressure and electrocardiogram for screening in healthy children at Pilar City, Buenos Aires, Argentina, 2012 / Índice de masa corporal, presión arterial y electrocardiograma en el cribado de salud de niños sanos en La Ciudad del Pilar, Buenos Aires, Argentina, 2012

ABSTRACT Introduction: obesity is frequent in argentinian children and arterial hypertension affects 2.4% of scholars. Objective: the objectives of the present study are to evaluate the prevalence of obesity and hypertension and their association, and to analyze the ability of electrocardiograms to detect conditions in healthy children and adolescents who attended to request a medical certificate of fitness. Methods: 1030 children (47.9% females and 52.1% males) ranging from 1 to 18 years old who concurred for a check up between Janury and March 2012, were consecutively included. Their body mass index, blood pressure, weight, height, and electrocardiogram findings were calculated and evaluated by a pediatrician and a cardiologist. Results: obesity was detected in 12.1% of males and 9.9% of females, and malnutrition was found in 1.9% and 1.4, respectively. Overweight was more frequent in males, consistent across all age groups. Systolic hypertension (adjusted to the 95th height percentile) was observed in 8.8% males and 8.6% females, more prevalent in children ranging from 4 to 11 years old. A significant association between hypertension and high body mass index was observed. The ECG assessments resulted in six patients with pauses, one patient with asymptomatic Wenchebach AV block, three patients with asymptomatic sinus arrest, and one patient with ventricular bigeminy. Five cases of Wolf-Parkinson-White syndrome were diagnosed, and 2.7% children had long QTc segments. Conclusions: a high prevalence of hypertension was found, which was more frequent in obese children. The electrocardiogram analysis resulted in patients with potentially high risk conditions. MÉD.UIS. 2016;29(3):49-53.

RESUMEN Introducción: la obesidad es frecuente en niños argentinos y la hipertensión arterial afecta a 2,4% de los escolares. Objetivo: evaluar la prevalencia de obesidad e hipertensión y su asociación, y analizar la detección de anormalidades en el electrocardiograma en una población de niños sanos que concurrieron para certificado de estado físico. Materiales y método: se incluyeron 1030 niños (47,9% de sexo femenino y 52,1% masculinos), de 1 a 18 años, que concurrieron a control durante Enero y Marzo de 2012. Se les realizó un electrocardiograma y medición de presión arterial, peso y talla. Resultados: el 12,1% de los varones y 9,9% de las niñas tenían obesidad y el 1,9% y 1,4%, respectivamente, tenían desnutrición. Fue más frecuente el sobrepeso y la obesidad entre los varones que en las mujeres, con distribución homogénea entre las edades. El 8,8 % de los niños y el 8,6% de las niñas tuvieron valores de presión arterial sistólica por encima del percentil 95 según talla, especialmente entre los 4 y los 11 años, con una asociación estadísticamente significativa entre la hipertensión arterial y el índice de masa corporal elevado. En el electrocardiograma hubo seis pacientes con pausas, un bloqueo aurículoventricular tipo Wenchebach asintomático, tres pacientes con paro sinusal y un paciente con bigeminismo ventricular. Se diagnosticaron cinco Wolf Parkinson White y 2,7% de los niños presentaron QTc prolongado. Conclusiones: hubo alta prevalencia de hipertensión arterial, más frecuente en niños con obesidad. Se detectaron pacientes con trastornos potencialmente graves en el electrocardiograma. MÉD.UIS. 2016;29(3):49-53.Palabras clave: Riesgo. Sistema Cardiovascular. Hipertensión. Obesidad. Índice de Masa Corporal. Electrocardiografía.

[Vitamin D deficiency is associated with cardiovascular risk factors in a healthy population]. / El déficit de vitamina D se asocia a factores de riesgo en personas sin antecedentes cardiovasculares.

Vitamin D (VitD) deficiency is associated with increased morbidity and mortality. We evaluated the association of VitD deficiency (<50 mmol/l) and cardiovascular risk factors in a healthy population, from July-November 2012, in a private center at Buenos Aires province. 333 people were included, aged 41.6±12.4 years (58.6% men), 49.2% practiced no physical activity, 56.8% were overweight (70.3% man vs 37.7% women, p<0.001), 12.5% with systolic blood pressure (SBP) >140 mmHg and 6% diastolic blood pressure (DBP) >90 mmHg. VitD deficiency was observed in 29.1% (31.3% man vs 26.1% women, p=0.3), more frequent with obesity (OR 1.85, IC95:1.05-3.25, p=0.02), HDL-cholesterol (HDL-C)<50 mg/dl (OR 1.71, IC95:1.06-2.76, p=0.02) and triglycerides>150 mg/dl (OR 1.77, IC95:1.02-3.06, p=0.03). A trend towards VitD deficiency and SBP>140 mmHg (OR 1.88, IC95:0.93-3.77, p=0.07) or DBP>90 mmHg (OR 1.39, IC95:0.5-3.65, p=0.5) was observed. Lineal correlation between VitD and HDL-C (p<0.001) or triglycerides (p<0.001) was observed. Multiple logistic regression showed that VitD deficiency association with low HDL-C was independent of age, female sex, obesity and physical activity. Association of VitD deficiency with hypetriglyceridemia was independent of age, female sex and obesity. This study shows an association between VitD deficiency and cardiovascular risk factors like obesity, low HDL <50 mg/dl and hypertriglyceridemia. A trend toward higher SBP was also observed. Experimental studies are granted in order to establish a cause-effect relationship.

El déficit de vitamina D (VitD) se asocia con mayor morbimortalidad. Se evaluó la relación entre el déficit de VitD (<20 mg/dl) y los factores de riesgo cardiovascular (FRCV) en pacientes sin antecedentes, de Julio a Noviembre 2012, en un centro privado de la Provincia de Buenos Aires. Se incluyeron 333 pacientes de 41.6±12.4 años (58.6% hombres), el 49.2% no realizaba actividad física, 56.8% con sobrepeso (hombres 70.3% vs 37.7% mujeres, p<0.001), 12.5% con PAS>140 mmHg y 6% PAD>90 mmHg. El déficit de VitD se observó en el 29.1% (31.3% hombres y 26.1% mujeres, p=0.3), más frecuente en obesos (OR 1.85, IC95:1.05-3.25, p=0.02), en HDL <50 mg/dl (OR 1.71, IC95:1.06-2.76, p=0.02) y triglicéridos(TG)>150 mg/dl (OR 1.77, IC95:1.02-3.06, p=0.03). Se observó tendencia a mayor déficit de VitD en TAS>140 mmHg (OR 1.88, IC95:0.93-3.77, p=0.07) y TAD>90 mmHg (OR 1.39, IC95:0.5-3.65, p=0.5). Se observó correlación lineal entre VitD con HDL (p<0.001) y triglicéridos (p<0.001). Por regresión logística múltiple, el déficit de VitD se asoció con HDL bajo independientemente de edad, sexo femenino, obesidad y actividad física, mientras que la asociación con hipertrigliceridemia fue independiente de edad, obesidad y sexo femenino, que fueron las otras variables asociadas con diferencia estadísticamente significativa en el univariable. Este estudio muestra una asociación entre el déficit de VitD y FRCV como la obesidad, el HDL<50 mg/dl y la hipertrigliceridemia. Se observó también una tendencia a mayor PA en pacientes con déficit de VitD. Se necesitan estudios experimentales para evaluar si la asociación es causal.

El déficit de vitamina D se asocia a factores de riesgo en personas sin antecedentes cardiovasculares / [Vitamin D deficiency is associated with cardiovascular risk factors in a healthy population].

Vitamin D (VitD) deficiency is associated with increased morbidity and mortality. We evaluated the association of VitD deficiency (<50 mmol/l) and cardiovascular risk factors in a healthy population, from July-November 2012, in a private center at Buenos Aires province. 333 people were included, aged 41.6±12.4 years (58.6

with systolic blood pressure (SBP) >140 mmHg and 6

diastolic blood pressure (DBP) >90 mmHg. VitD deficiency was observed in 29.1

women, p=0.3), more frequent with obesity (OR 1.85, IC95:1.05-3.25, p=0.02), HDL-cholesterol (HDL-C)150 mg/dl (OR 1.77, IC95:1.02-3.06, p=0.03). A trend towards VitD deficiency and SBP>140 mmHg (OR 1.88, IC95:0.93-3.77, p=0.07) or DBP>90 mmHg (OR 1.39, IC95:0.5-3.65, p=0.5) was observed. Lineal correlation between VitD and HDL-C (p<0.001) or triglycerides (p<0.001) was observed. Multiple logistic regression showed that VitD deficiency association with low HDL-C was independent of age, female sex, obesity and physical activity. Association of VitD deficiency with hypetriglyceridemia was independent of age, female sex and obesity. This study shows an association between VitD deficiency and cardiovascular risk factors like obesity, low HDL <50 mg/dl and hypertriglyceridemia. A trend toward higher SBP was also observed. Experimental studies are granted in order to establish a cause-effect relationship.

El déficit de vitamina D se asocia a factores de riesgo en personas sin antecedentes cardiovasculares. / [Vitamin D deficiency is associated with cardiovascular risk factors in a healthy population].

Vitamin D (VitD) deficiency is associated with increased morbidity and mortality. We evaluated the association of VitD deficiency (<50 mmol/l) and cardiovascular risk factors in a healthy population, from July-November 2012, in a private center at Buenos Aires province. 333 people were included, aged 41.6±12.4 years (58.6

men), 49.2

practiced no physical activity, 56.8

were overweight (70.3

man vs 37.7

women, p<0.001), 12.5

with systolic blood pressure (SBP) >140 mmHg and 6

diastolic blood pressure (DBP) >90 mmHg. VitD deficiency was observed in 29.1

(31.3

man vs 26.1

women, p=0.3), more frequent with obesity (OR 1.85, IC95:1.05-3.25, p=0.02), HDL-cholesterol (HDL-C)<50 mg/dl (OR 1.71, IC95:1.06-2.76, p=0.02) and triglycerides>150 mg/dl (OR 1.77, IC95:1.02-3.06, p=0.03). A trend towards VitD deficiency and SBP>140 mmHg (OR 1.88, IC95:0.93-3.77, p=0.07) or DBP>90 mmHg (OR 1.39, IC95:0.5-3.65, p=0.5) was observed. Lineal correlation between VitD and HDL-C (p<0.001) or triglycerides (p<0.001) was observed. Multiple logistic regression showed that VitD deficiency association with low HDL-C was independent of age, female sex, obesity and physical activity. Association of VitD deficiency with hypetriglyceridemia was independent of age, female sex and obesity. This study shows an association between VitD deficiency and cardiovascular risk factors like obesity, low HDL <50 mg/dl and hypertriglyceridemia. A trend toward higher SBP was also observed. Experimental studies are granted in order to establish a cause-effect relationship.