Relation of low-grade inflammation and endothelial activation to blood pressure in obese children and adolescents.

OBJECTIVE

To determine the role of low-grade, systemic inflammation and endothelial activation in the modulation of blood pressure (BP) independently of other traditional risk factors in obese children and adolescents.

DESIGN

We surveyed 281 obese subjects, aged 6-18 years to investigate the relationship of serum inflammation and endothelial activation markers and blood pressure.

MEASUREMENTS

Clinical variables, indices of obesity, ambulatory 24-h blood pressure and serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), glucose and insulin. HOMA IR was used as a marker of insulin resistance (IR).

RESULTS

CRP, IL-6, IL-1 beta, and ICAM-1 correlated significantly with mean 24-h systolic BP, whereas CRP and IL-6 was positively correlated with mean 24-h diastolic BP. Multiple regression analysis showed that serum IL-6 (P < .001) concentration, HOMA IR (P < .01), and waist to hip ratio (P < .05) were the significant determinants of systolic BP, whereas CRP (P < .05) level was the only predictor of diastolic BP. There were no significant associations of cell adhesion molecules with BP.

CONCLUSIONS

These results indicate that low-grade inflammation may play a role in the modulation of arterial BP relatively early in life.