Lambert Marie, O'Loughlin Jennifer, Delvin Edgard E, Levy Emile, Chiolero Arnaud, Paradis Gilles
Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, Canada.
J Hypertens. 2009 May;27(5):1025-32. doi: 10.1097/HJH.0b013e32832935b6.
To examine whether insulin, leptin and adiponectin are independent correlates of blood pressure (BP) in a large population-based sample of children and adolescents.
We studied 655 boys and 667 girls aged 9, 13 and 16 years who participated in the Quebec Child and Adolescent Health and Social Survey, a province-wide school-based survey conducted in 1999.
Strong, positive univariate associations between BMI, insulin and leptin Z-scores, and both systolic and diastolic BP were found in both sexes. Adiponectin Z-scores were negatively associated with systolic BP in girls only. In multivariate analyses only BMI and insulin Z-scores were significantly associated with systolic BP. In boys, each 1 SD increase in BMI was associated with a 4 mmHg increase in mean systolic BP; each 1 SD increase in insulin was associated with a 1 mmHg increase in mean systolic BP. Only insulin Z-scores were independently associated with diastolic BP in both sexes. For each 1 SD increase in insulin, there was a 1 mmHg increase in mean diastolic BP in boys. Similar to systolic BP, the magnitude of the effect of insulin Z-scores on diastolic BP increased as a function of BMI Z-scores in girls.
Independently of BMI, insulin is a strong correlate of systolic and diastolic BP in youth. Although animal studies support a role for leptin and adiponectin in controlling BP, they are not independently associated with BP in youth.
在一个基于大样本人群的儿童和青少年样本中,研究胰岛素、瘦素和脂联素是否为血压(BP)的独立相关因素。
我们研究了655名男孩和667名女孩,他们年龄分别为9岁、13岁和16岁,均参与了1999年在魁北克省开展的一项全省范围内基于学校的魁北克儿童与青少年健康及社会调查。
在两性中,BMI、胰岛素和瘦素Z评分与收缩压和舒张压之间均发现了强的正单变量关联。脂联素Z评分仅与女孩的收缩压呈负相关。在多变量分析中,只有BMI和胰岛素Z评分与收缩压显著相关。在男孩中,BMI每增加1个标准差,平均收缩压升高4 mmHg;胰岛素每增加1个标准差,平均收缩压升高1 mmHg。在两性中,只有胰岛素Z评分与舒张压独立相关。在男孩中,胰岛素每增加1个标准差,平均舒张压升高1 mmHg。与收缩压类似,在女孩中,胰岛素Z评分对舒张压的影响程度随BMI Z评分的增加而增加。
独立于BMI之外,胰岛素是青少年收缩压和舒张压的强相关因素。尽管动物研究支持瘦素和脂联素在控制血压方面的作用,但它们在青少年中与血压并无独立关联。