Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Lira 85, Piso 5, Santiago 8330074, Chile.
Hypertension. 2010 Sep;56(3):391-6. doi: 10.1161/HYPERTENSIONAHA.110.155135. Epub 2010 Aug 9.
Primary aldosteronism is an important cause of secondary hypertension and is suspected in adults with an aldosterone/renin ratio > or =25. The normal aldosterone/renin ratio is unknown in children. The aim was to establish serum aldosterone, plasma renin activity, and aldosterone/renin ratio values in a healthy pediatric population. A cross-sectional study was performed in 211 healthy normotensive children (4 to 16 years old). Two subgroups of normotensive children were obtained: with hypertensive parents (NH) (n=113) and normotensive parents (n=98). Blood samples for measuring serum aldosterone, plasma renin activity, aldosterone/renin ratio, and DNA were collected. In subjects with aldosterone/renin ratio > or =25, the chimeric CYP11B1/CYP11B2 gene was investigated by long-extension PCR. Results are expressed as median [Q(1)-Q(3)]. NH and normotensive parents groups were similar in serum aldosterone (6.5 [3.6 to 9.0] ng/dL versus 6.5 [2.9 to 9.7] ng/dL; P=0.968) and plasma renin activity (2.3 [1.6 to 3.1] versus 2.4 [1.7 to 3.7] ng/mL per hour; P=0.129). The aldosterone/renin ratio was higher in the NH group, but this difference did not reach statistical significance (2.8 [1.9 to 4.1] versus 2.5 [1.4 to 4.0], P=0.104). In one subject of the NH group, the chimeric CYP11B1/CYP11B2 gene was detected. We demonstrated that normal aldosterone/renin ratio values in a healthy pediatric population without NH were lower than those reported for an adult normotensive population.
原醛症是继发性高血压的一个重要病因，在醛固酮/肾素比值≥25 的成年患者中应怀疑该病。儿童的正常醛固酮/肾素比值尚不清楚。本研究旨在建立健康儿科人群的血清醛固酮、血浆肾素活性和醛固酮/肾素比值。对 211 例健康血压正常的儿童（4 至 16 岁）进行了横断面研究。从这些血压正常的儿童中获得了两组亚组：高血压父母（NH）的正常血压儿童（n=113）和血压正常父母的正常血压儿童（n=98）。采集血样以测量血清醛固酮、血浆肾素活性、醛固酮/肾素比值和 DNA。在醛固酮/肾素比值≥25 的患者中，通过长延伸 PCR 检查嵌合 CYP11B1/CYP11B2 基因。结果表示为中位数[Q(1)-Q(3)]。NH 和血压正常父母组的血清醛固酮（6.5[3.6 至 9.0]ng/dL 与 6.5[2.9 至 9.7]ng/dL；P=0.968）和血浆肾素活性（2.3[1.6 至 3.1]ng/mL per hour 与 2.4[1.7 至 3.7]ng/mL per hour；P=0.129）相似。NH 组的醛固酮/肾素比值较高，但差异无统计学意义（2.8[1.9 至 4.1]与 2.5[1.4 至 4.0]，P=0.104）。在 NH 组的 1 名患者中，检测到嵌合 CYP11B1/CYP11B2 基因。我们证实，NH 儿童的正常醛固酮/肾素比值低于已报道的成人正常血压人群。
