Porto Patricia Inés, García Silvia Inés, Dieuzeide Guillermo, González Claudio, Landa María Silvina, Pirola Carlos José
Cardiología Molecular, Instituto de Investigaciones Médicas A. Lanari, Buenos Aires-1427, Argentina.
Pediatr Res. 2004 May;55(5):836-41. doi: 10.1203/01.PDR.0000119367.21770.D7. Epub 2004 Jan 22.
Obesity and hypertension are increasing medical problems in adolescents. We evaluated the association between being overweight-particularly abdominal fat-and having hypertension and assessed the contribution of the Trp64Arg beta3-adrenergic receptor gene variant. In a population-based study, we determined family history, anthropometric variables, and arterial blood pressure of 934 high school students, out of whom we selected 121 normotensive and 54 hypertensive students. Biochemical measurements included circulating renin and angiotensin-converting enzyme activities, leptin, glucose, insulin and lipid levels, and beta3-adrenergic receptor genotypes. We used Mann-Whitney U test, chi2-test, and Spearman rank-order correlation. In the total population, hypertension prevalence increased across the entire range of body mass index (BMI) percentiles. In the sample, hypertensive students showed higher BMI, waist-to-hip ratio, triglycerides, and insulin resistance and lower HDL-cholesterol than normotensive students did. Age- and sex-adjusted systolic arterial blood pressure was correlated with BMI, waist-to-hip ratio, insulin resistance, and leptin. Leptin was correlated with BMI and homeostasis model assessment method. We found no association among hypertension, BMI, and leptin levels with beta3-adrenergic receptor genotypes. Especially in girls, the waist-to-hip ratio was, however, suggestively higher in Arg64 variant carriers than in noncarriers, independent of hypertension. In fact, there was a significantly (p < 0.01) higher frequency of carriers of the Arg64 variant across the waist-to-hip ratio quartiles. In adolescents of European origin, hypertension is associated with an increased degree of obesity among other characteristics of the metabolic syndrome; the Trp64Arg variant of the beta3-adrenergic receptor gene may favor the central adiposity gain.
肥胖和高血压在青少年中日益成为医学问题。我们评估了超重（尤其是腹部脂肪）与高血压之间的关联，并评估了β3-肾上腺素能受体基因Trp64Arg变体的作用。在一项基于人群的研究中，我们测定了934名高中生的家族史、人体测量学变量和动脉血压，从中选取了121名血压正常和54名高血压学生。生化检测包括循环肾素和血管紧张素转换酶活性、瘦素、葡萄糖、胰岛素和血脂水平以及β3-肾上腺素能受体基因型。我们使用了曼-惠特尼U检验、卡方检验和斯皮尔曼等级相关分析。在总体人群中，高血压患病率在整个体重指数（BMI）百分位数范围内均有所上升。在样本中,高血压学生的BMI、腰臀比、甘油三酯和胰岛素抵抗高于血压正常学生，而高密度脂蛋白胆固醇低于血压正常学生。经年龄和性别调整后的收缩期动脉血压与BMI、腰臀比、胰岛素抵抗和瘦素相关。瘦素与BMI和稳态模型评估方法相关。我们发现高血压、BMI和瘦素水平与β3-肾上腺素能受体基因型之间无关联。然而,尤其是在女孩中，Arg64变体携带者的腰臀比在不考虑高血压的情况下提示性地高于非携带者。事实上,在腰臀比四分位数中，Arg64变体携带者的频率显著更高（p<0.01）。在欧洲裔青少年中,高血压与代谢综合征的其他特征中肥胖程度增加有关；β3-肾上腺素能受体基因的Trp64Arg变体可能有利于中心性肥胖的增加。
