Wrist circumference is associated with systolic blood pressure in a population of overweight/obese children and adolescents.

Wrist circumference is associated with systolic blood pressure in a population of overweight/obese children and adolescents G. Campagna1, S. Zampetti1, F. Lucantoni1, M. Capizzi1, L. Marandola1, C. Chiesa2, L. Pacifico3, A. Vania4, R. Buzzetti1; 1Experimental Medicine, Sapienza, University of Rome, 2National Research Counci, Institute of Translational Pharmacology, 3Policlinico Umberto I Hospital, Sapienza, University of Rome, 4Pediatric, Sapienza, University of Rome, Rome, Italy. Background and aims: Insulin resistance, according to many pathophysiological models is one of the most important cardiovascular (CV) risk factors. In a previous study, we demonstrated that the wrist circumference is a clinical marker for insulin-resistance in overweight/obese children and adolescents. Hypertension is another relevant cardiovascular risk factor and obesity is one of its major determinants in children. Various indexes of obesity, such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio and neck circumference, are associated with a high risk of hypertension. The aim of the present study was to investigate a possible association between the wrist circumference and systolic (S) and diastolic (D) blood pressure (BP) in a population of overweight/obese children and adolescents. Materials and methods: N=1133 overweight/obese children and adolescents (580 boys and 553 girls) were consecutively enrolled. In all children and adolescents, body weight, height, SBP, DBP,wrist circumference, SDS-BMI, fasting glucose, fasting insulin levels, and lipid profiles were evaluated at entry. Insulin resistance was estimated according to the homeostasis model assessment of insulin resistance (HOMA-IR). Subjects were evaluated by a doctor for the pubertal stages. Shapiro-Wilk test was used to verify the normality of distribution of continuous variables. The dependent variables for this study were SBP and diastolic DBP; independent variables were SDS-BMI and wrist circumference adjusted for Tanner stage. Multivariate linear regression analyses were used to investigate the influence of independent variables on the variance of blood pressure. All analyses were performed using Statistical Analysis Software (SAS v.9.3). Results: The frequency of hypertension was 22.6% in males and 28.2% in females (p=0.048). Results of the multivariate regression analysis performed in the 1133 children and adolescents stratified according to gender, using wrist circumference and SDS-BMI as independent variable and blood pressure as the dependent variables showed that SBP was significantly associated with wrist circumference and SDS-BMI both in males and females (p≤0.04 for both comparison). We found no association between DBP and wrist circumference in both gender. Wrist circumference and SDS-BMI together explained 21% of the variance of SBP in males and 18% in females. To evaluate the contribution of wrist circumference and SDS-BMI, respectively, to explained variance (R2) of SBP index, we used the backward method. The total variance of SBP was explained by wrist circumference for 17% and by SDS-BMI for 2.7% in males; and by wrist circumference for 14% and SDS-BMI 1% in females. Conclusion: The wrist circumference in overweight/obese children and adolescents is correlated with SBP, confirming that this bone anthropometric marker could be useful for the prediction of cardiovascular risk being correlated with insulin resistance and its deleterious effects. Disclosure: G. Campagna: None.