Stelcar Andreja, Homsak Evgenija, Marcun Varda Natasa
Pediatrics, Univerzitetni Klinicni Center Maribor, Maribor, Slovenia.
Department of Laboratory Diagnostics, Univerzitetni Klinicni Center Maribor, Maribor, Slovenia.
Klin Padiatr. 2017 Sep;229(5):286-292. doi: 10.1055/s-0043-104220. Epub 2017 Apr 24.
The aim of our study was to investigate some early markers of hypertensive target organ damage in hypertensive children and adolescents, and to detect those showing most prominent clinical significance. We included 100 children with essential hypertension (EH) and 50 age-matched healthy control children, and evaluated left ventricular mass (LVM), intima-media thickness in the carotid arteries (IMT), pulse wave velocity (PWV), microalbuminuria, biochemical parameters and some adipokines. Statistically significant differences between the 2 groups were observed for HDL-cholesterol, LDL-cholesterol, triglycerides, insulin, uric acid, glucose, apolipoprotein A1, and total adiponectin. The mean values of IMT, PWV and LVM were greater in hypertensive children, but only the differences in IMT and LVM were statistically significant. In addition, hypertensive children showed significantly higher values of AoSP (aortic systolic pressure), AoPP (aortic pulse pressure) and AIx@75 (augmentation index corrected for heart rate of 75 b.p.m.). Metabolic syndrome was diagnosed in 31% of hypertensive children. A significant number of children with EH have early target organ changes as well as other risk factors, including metabolic syndrome, especially obese ones. However, IMT, LVM and some parameters of arterial stiffness have been found to be early markers in both obese and non-obese hypertensives. In addition, adipokines and coagulation factors seem to be important in obese hypertensives.
我们研究的目的是调查高血压儿童和青少年高血压靶器官损害的一些早期标志物，并检测那些具有最显著临床意义的标志物。我们纳入了100例原发性高血压（EH）儿童和50例年龄匹配的健康对照儿童，评估了左心室质量（LVM）、颈动脉内膜中层厚度（IMT）、脉搏波速度（PWV）、微量白蛋白尿、生化参数和一些脂肪因子。两组之间在高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、胰岛素、尿酸、葡萄糖、载脂蛋白A1和总脂联素方面观察到统计学显著差异。高血压儿童的IMT、PWV和LVM平均值更高，但只有IMT和LVM的差异具有统计学意义。此外，高血压儿童的主动脉收缩压（AoSP）、主动脉脉压（AoPP）和心率校正为75次/分钟时的增强指数（AIx@75）值显著更高。31%的高血压儿童被诊断为代谢综合征。相当数量的EH儿童有早期靶器官改变以及其他危险因素，包括代谢综合征，尤其是肥胖儿童。然而，IMT、LVM和一些动脉僵硬度参数已被发现是肥胖和非肥胖高血压患者的早期标志物。此外，脂肪因子和凝血因子在肥胖高血压患者中似乎很重要。
