Whole blood viscosity and cerebral blood flow velocities in obese hypertensive or obese normotensive adolescents
-
Meltem Akcaboy
,
Bijen Nazliel
Abstract
Background:
Obesity affects all major organ systems and leads to increased morbidity and mortality. Whole blood viscosity is an important independent regulator of cerebral blood flow. The aim of the present study was to evaluate the effect of whole blood viscosity on cerebral artery blood flow velocities using transcranial Doppler ultrasound in pediatric patients with obesity compared to healthy controls and analyze the effect of whole blood viscosity and blood pressure status to the cerebral artery blood flow velocities.
Methods:
Sixty patients with obesity diagnosed according to their body mass index (BMI) percentiles aged 13–18 years old were prospectively enrolled. They were grouped as hypertensive or normotensive according to their ambulatory blood pressure monitoring. Whole blood viscosity and middle cerebral artery velocities by transcranial Doppler ultrasound were studied and compared to 20 healthy same aged controls.
Results:
Whole blood viscosity values in hypertensive (0.0619±0.0077 poise) and normotensive (0.0607±0.0071 poise) groups were higher than controls (0.0616±0.0064 poise), with no significance. Middle cerebral artery blood flow velocities were higher in the obese hypertensive (73.9±15.0 cm/s) and obese normotensive groups (75.2±13.5 cm/s) than controls (66.4±11.5 cm/s), but with no statistical significance.
Conclusions:
Physiological changes in blood viscosity and changes in blood pressure did not seem to have any direct effect on cerebral blood flow velocities, the reason might be that the cerebral circulation is capable of adaptively modulating itself to changes to maintain a uniform cerebral blood flow.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This study was partially financed by the Scientific Research Project Foundation of Gazi University School of Medicine (Grant number: 01/2011-97).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Kotchen TA. Obesity-related hypertension: epidemiology, path physiology, and clinical management. Am J Hypertens 2010;23:1170–8.10.1038/ajh.2010.172Search in Google Scholar PubMed
2. Raj M, Krishnakumar R. Hypertension in children and adolescents: epidemiology and pathogenesis. Indian J Pediatr 2013;80:S71–6.10.1007/s12098-012-0851-4Search in Google Scholar PubMed
3. Assunção SN, Boa Sorte NC, Alves CA, Mendes PS, Alves CR, et al. Glucose alteration and insulin resistance in asymptomatic obese children and adolescents. J Pediatr (Rio J). 2017 Aug 26. pii: S0021-7557(16)30322-9.10.1016/j.jped.2017.06.008Search in Google Scholar PubMed
4. Dibeklioglu SE, Çevik BŞ, Acar B, Özçakar ZB, Uncu N, et al. The association between obesity, hypertension and leftventricular mass inadolescents. J Pediatr Endocrinol Metab 2017;30:167–74.10.1515/jpem-2016-0170Search in Google Scholar PubMed
5. Tomiyama Y, Brian JE Jr, Todd MM. Plasma viscosity and cerebral blood flow. Am J Physiol Heart Circ Physiol 2000; 279:H1949–54.10.1152/ajpheart.2000.279.4.H1949Search in Google Scholar PubMed
6. Sohn YH, Kim GW, Kim JS. Do hematocrit and serum fibrinogen influence transcranial Doppler measurements? J Korean Med Sci 1997;12:405–8.10.3346/jkms.1997.12.5.405Search in Google Scholar PubMed PubMed Central
7. Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982;57:769–74.10.3171/jns.1982.57.6.0769Search in Google Scholar PubMed
8. Fodale V, Schifilliti D, Conti A, Lucanto T, Pino G, et al. Transcranial Doppler and anesthetics. Acta Anaesthesiol Scand 2007;51:839–47.10.1111/j.1399-6576.2007.01355.xSearch in Google Scholar PubMed
9. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, et al. Body mass index references for Turkish children. Acta Paediatr 2006;95:194–8.10.1080/08035250500334738Search in Google Scholar PubMed
10. Kurtoğlu S, Hatipoğlu N, Mazıcıoğlu M, Kendirici M, Keskin M, et al. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. J Clin Res Pediatr Endocrinol 2010;2:100–6.10.4274/jcrpe.v2i3.100Search in Google Scholar PubMed PubMed Central
11. Lurbe E, Torro I, Aguilar F, Alvarez J, Alcon J, et al. Added impact of obesity and insulin resistance in nocturnal blood pressure elevation in children and adolescents. Hypertension 2008;51:635–41.10.1161/HYPERTENSIONAHA.107.099234Search in Google Scholar
12. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–76.10.1542/peds.114.S2.555Search in Google Scholar
13. Urbina E, Alpert B, Flynn J, Hayman L, Harshfield GA, et al. Ambulatory blood pressure monitoring in children and adolescents: recommendations for standard assessment: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the council on cardiovascular disease in the young and the council for high blood pressure research. Hypertension 2008;52:433–51.10.1161/HYPERTENSIONAHA.108.190329Search in Google Scholar
14. Soergel M, Kirschstein M, Busch C, Danne T, Gellermann J, et al. Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 1997;130:178–84.10.1016/S0022-3476(97)70340-8Search in Google Scholar
15. Zhang P, Huang Y, Li Y, Shi P, Lu M, et al. Gender and risk factor dependence of cerebral blood flow velocity in Chinese adults. Brain Res Bull 2006;69:282–7.10.1016/j.brainresbull.2005.12.008Search in Google Scholar
16. Farhoudi M, Mehrvar K, Aslanabadi N, Ghabili K, Baqhmishe NR, et al. Doppler study of cerebral arteries in hypercholesterolemia. Vasc Health Risk Manag 2011;7:203–7.Search in Google Scholar
17. Thomas DJ, Marshall J, Russell RW, Wetherley-Mein G, du Boulay GH, et al. Effect of haematocrit on cerebral blood-flow in man. Lancet 1977;2:941–3.10.1016/S0140-6736(77)90885-6Search in Google Scholar
18. Grotta L, Ackerman R, Correia J, Fallick G, Chang J. Whole blood viscosity parameters and cerebral blood flow. Stroke 1982;13:296–301.10.1161/01.STR.13.3.296Search in Google Scholar
19. Kee DB, Wood JH. Influence of blood rheology on cerebral circulation. In: Wood JH, editor. Cerebral blood flow. Physiologic and clinical aspects. New-York: McGraw-Hill Co, 1988:173–85.Search in Google Scholar
20. Akcaboy M, Kula S, Göktas T, Nazliel B, Terlemez S, et al. Effect of plasma NOx values on cardiac function in obese hypertensive and normotensive pediatric patients. Pediatr Nephrol 2016;31:473–83.10.1007/s00467-015-3223-2Search in Google Scholar PubMed
21. Selim M, Jones R, Novak P, Zhao P, Novak V. The effects of body mass index on cerebral blood flow velocity. Clin Auton Res 2008;18:331–8.10.1007/s10286-008-0490-zSearch in Google Scholar PubMed PubMed Central
22. Acree L, Montgomery PS, Gardner AW. The influence of obesity on arterial compliance in adult men and women. Vasc Med 2007;12:183–8.10.1177/1358863X07079323Search in Google Scholar PubMed
23. Zebekakis PE, Nawrot T, Thijs L, Balkestein EJ, van der Heijden-Spek J, et al. Obesity is associated with increased arterial stiffness from adolescence until old age. J Hypertens 2005;23:1839–46.10.1097/01.hjh.0000179511.93889.e9Search in Google Scholar
24. Kusunoki M, Kimura K, Nakamura M, Isaka Y, Yoneda S, et al. Effects of hematocrit variations on cerebral blood flow and oxygen transport in ischemic cerebrovascular disease. J Cereb Blood Flow Metab 1981;1:413–7.10.1038/jcbfm.1981.45Search in Google Scholar
25. Brown MM, Marshall J. Regulation of cerebral blood flow in response to changes in blood viscosity. Lancet 1985;1:604–9.10.1016/S0140-6736(85)92145-2Search in Google Scholar
26. Borzage MT, Bush AM, Choi S, Nederveen AJ, Václavů L, et al. Predictors of cerebral blood flow in patients with and without anemia. J Appl Physiol (1985) 2016;120:976–81.10.1152/japplphysiol.00994.2015Search in Google Scholar
27. Chen RY, Carlin RD, Simchon S, Jan KM, Chien S. Effects of dextran – induced hyperviscosity on regional cerebral blood flow and hemodynamics in dogs. Am J Physiol 1989;256:H898–905.10.1152/ajpheart.1989.256.3.H898Search in Google Scholar
28. Sharma M, Kupferman JC, Brosgol Y, Paterno K, Goodman S, et al. The effects of hypertension on the paediatric brain: ajustifiable concern. Lancet Neurol 2010;9:933–40.10.1016/S1474-4422(10)70167-8Search in Google Scholar
29. Hill CM, Hogan AM, Onugha N, Harrison D, Cooper S, et al. Increased cerebral blood flow velocity in children with mild sleep-disordered breathing: a possible association with abnormal neuropsychological function. Pediatrics 2006;118:e1100–8.10.1542/peds.2006-0092Search in Google Scholar PubMed PubMed Central
30. Bos MJ, Koudstaal PJ, Hofman A, Witteman JC, Breteler MM. Transcranial Doppler hemodynamic parameters and risk of stroke: the Rotterdam study. Stroke 2007;38:2453–8.10.1161/STROKEAHA.107.483073Search in Google Scholar PubMed
31. Wong LJ, Kupferman JC, Prohovnik I, Kirkham FJ, Goodman S, et al. Hypertensionimpairsvascularreactivity in thepediatricbrain. Stroke 2011;42:1834–8.10.1161/STROKEAHA.110.607606Search in Google Scholar PubMed
32. Lassen NA. Cerebral blood flow and oxygen consumption in man. Physiol Rev 1959;39:183–238.10.1152/physrev.1959.39.2.183Search in Google Scholar PubMed
33. Finnerty FA Jr, Witkin L, Fazekas JF. Cerebral hemodynamics during cerebral ischemia induced by acute hypotension. J Clin Invest 1954;33:1227–32.10.1172/JCI102997Search in Google Scholar PubMed PubMed Central
©2018 Walter de Gruyter GmbH, Berlin/Boston
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- Brain gray matter volume differences in obese youth with type 2 diabetes: a pilot study
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- Whole blood viscosity and cerebral blood flow velocities in obese hypertensive or obese normotensive adolescents
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Articles in the same Issue
- Frontmatter
- Review
- Vitamin D deficiency in childhood: old lessons and current challenges
- Original Articles
- Brain gray matter volume differences in obese youth with type 2 diabetes: a pilot study
- Prevalence and clinical presentation at the onset of type 1 diabetes mellitus among children and adolescents in AL-Baha region, Saudi Arabia
- Whole blood viscosity and cerebral blood flow velocities in obese hypertensive or obese normotensive adolescents
- The utility of body mass index as an indicator for lipid abnormalities in non-fasting children
- Association of insulin-like growth factor-1 and IGF binding protein-3 with 25-hydroxy vitamin D in pre-pubertal and adolescent Indian girls
- The safety of Lipistart, a medium-chain triglyceride based formula, in the dietary treatment of long-chain fatty acid disorders: a phase I study
- Clinical follow-up data and the rate of development of precocious and rapidly progressive puberty in patients with premature thelarche
- Age of pubertal events among school girls in Lagos, Nigeria
- Evaluation of basal sex hormone levels for activation of the hypothalamic–pituitary–gonadal axis
- PHKG2 mutation spectrum in glycogen storage disease type IXc: a case report and review of the literature
- Twenty-seven mutations with three novel pathologenic variants causing biotinidase deficiency: a report of 203 patients from the southeastern part of Turkey
- Case Reports
- Emergence of insulin resistance following empirical glibenclamide therapy: a case report of neonatal diabetes with a recessive INS gene mutation
- A rare unbalanced Y:autosome translocation in a Turner syndrome patient
- A Japanese patient with congenital central hypothyroidism caused by a novel IGSF1 mutation
- Growth, sexual and bone development in a boy with bilateral anorchia under testosterone treatment guided by the development of his monozygotic twin
