Cebeci Ayse N, Guven Ayla, Kuru Lütfi I
Clinic of Pediatric Endocrinology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey -
Minerva Endocrinol. 2016 Jun;41(2):166-74. Epub 2014 May 27.
Visceral adiposity plays an important role in the pathogenesis of obesity related hypertension. Measurement of perinephric adipose tissue (PNAT) thickness has not been studied yet. We aimed to define the relation of PNAT with hypertension, and to investigate its correlations with apelin and C-reactive protein.
Sixty obese adolescents (33 females, 27 males) with a mean age of 14.0±0.8 years and 29 age-matched lean controls were recruited. Obese subjects were divided as hypertensive (Group 1) and normotensive (Group 2) using 24-hour ambulatory blood pressure monitoring. PNAT was measured using ultrasonography bilaterally.
PNAT thickness was found increased by 0.5 mm for each point of increase in body mass index (BMI). Plasma apelin levels were significantly higher in Groups 1 and 2 than those in control group (P<0.001 and P=0.001, respectively). In Group 1 BMI, plasma insulin and cortisol levels were significantly higher. Apelin was positively correlated with BMI and PNAT (P<0.001 for both), and negatively correlated with pubertal stage (ρ=-0.313, P=0.003) and age (ρ=-0.250; P=0.018).
This is the first study showing direct correlation between PNAT and BMI and also between apelin and BMI in obese adolescents. Hypertension in adolescence is related to degree of obesity. While plasma apelin increases in obesity, it decreases with increasing age and pubertal stage.
内脏脂肪在肥胖相关高血压的发病机制中起重要作用。肾周脂肪组织（PNAT）厚度的测量尚未得到研究。我们旨在确定PNAT与高血压的关系，并研究其与apelin和C反应蛋白的相关性。
招募了60名平均年龄为14.0±0.8岁的肥胖青少年（33名女性，27名男性）和29名年龄匹配的瘦对照者。使用24小时动态血压监测将肥胖受试者分为高血压组（第1组）和正常血压组（第2组）。双侧使用超声测量PNAT。
发现体重指数（BMI）每增加1个点，PNAT厚度增加0.5毫米。第1组和第2组的血浆apelin水平显著高于对照组（分别为P<0.001和P=0.001）。在第1组中，BMI、血浆胰岛素和皮质醇水平显著更高。Apelin与BMI和PNAT呈正相关（两者均P<0.001），与青春期阶段呈负相关（ρ=-0.313，P=0.003），与年龄呈负相关（ρ=-0.250；P=0.018）。
这是第一项显示肥胖青少年中PNAT与BMI以及apelin与BMI之间存在直接相关性的研究。青少年高血压与肥胖程度有关。肥胖时血浆apelin升高，但随年龄和青春期阶段增加而降低。
