A group of investigators led by Dr Maria Marcovecchio of the University of Chieti, Italy, assessed the relationship between ambulatory blood pressure monitoring (ABPM) parameters and insulin resistance in obese children. A total of 56 obese children underwent ABPM, an oral glucose tolerance test (OGTT), and complete physical examination, including body-mass index, skinfolds, waist-to-hip ratio (WHR), and fat mass. Insulin resistance was estimated with the homeostasis model assessment for insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI).

The investigators found that HOMA-IR and QUICKI correlated significantly with 24-hour diastolic blood pressure (DBP) (p=0.01 and p=0.03, respectively), daytime DBP (p=0.009 and p=0.01, respectively), and daytime systolic blood pressure (SBP) (p=0.02 and p=0.04, respectively). After adjusting for obesity, only 24-hour and daytime DBP remained significant. Body-mass index and fat mass correlated with several ABPM parameters, but WHR did not.

The investigators concluded that insulin resistance and adiposity are correlated with ambulatory blood pressure in obese children. This is of importance because high blood pressure early in life, or tracking from childhood into adulthood, is associated with an increased cardiovascular risk.

Journal of Hypertension 2006;24:2431-6