a Dialysis Division for Children, Department of Pediatric Nephrology , Public Clinical Hospital , Zabrze , Poland.
b Chair and Clinical Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia in Katowice , Zabrze , Poland.
Clin Exp Hypertens. 2017;39(8):718-725. doi: 10.1080/10641963.2017.1324474. Epub 2017 Jun 21.
High blood pressure (BP) in children and adolescents is associated with increased risk of persistent hypertension (HT) in adulthood and, consequently, cardiovascular disease and target organ damage.
The values of selected anthropometric parameters and laboratory test results including leptin and apelin concentration were evaluated with regard to averaged values of office BP measurements and 24-hour ABPM.
The study included 55 children: 23-with primary HT and coexisting overweight or obese (HT-OB), 16-with primary HT and normal weight (HT-NW), and 16 healthy children (C).
The concentration of leptin and apelin in HT-OB children was significantly higher than in the C and HT-NW group. A similar finding for leptin level was demonstrated in comparison of HT-NW with C group. In children with HT-OB, the lack of decline in nocturnal DBP was associated with significantly higher BMI and the Cole's Index value. Children with HT-OB and lack of decline in nocturnal SBP showed lower leptin and insulin concentrations, and lower values of HOMA-IR as compared with dipping children. Positive correlation in the whole study group was found between adipokines levels and BP measurements. In conclusion, children with primary HT show higher concentration of adipokines compared with their healthy peers. The data on relationship of serum adipokines levels with anthropometric and BP parameters in children may be helpful to clarify the sequence of disturbances in the cardiovascular system in adults, which requires further examination.
儿童和青少年的高血压(BP)与成年后持续性高血压(HT)的风险增加有关,因此会导致心血管疾病和靶器官损伤。
评估了选定的人体测量参数和实验室检查结果(包括瘦素和apelin 浓度)的值与办公室血压测量和 24 小时 ABPM 的平均值有关。
该研究包括 55 名儿童:23 名患有原发性 HT 并伴有超重或肥胖(HT-OB),16 名患有原发性 HT 且体重正常(HT-NW),16 名健康儿童(C)。
HT-OB 儿童的瘦素和 apelin 浓度明显高于 C 和 HT-NW 组。与 HT-NW 与 C 组相比,瘦素水平也存在类似的发现。在 HT-OB 儿童中,夜间 DBP 下降不足与 BMI 和 Cole 指数值明显升高有关。与非夜间血压下降的儿童相比,HT-OB 且夜间 SBP 下降不足的儿童显示出较低的瘦素和胰岛素浓度,以及较低的 HOMA-IR 值。在整个研究组中,发现了脂联素水平与 BP 测量值之间的正相关。总之,原发性 HT 儿童的脂联素浓度高于其健康同龄人。关于血清脂联素水平与儿童人体测量和 BP 参数之间关系的数据可能有助于阐明成年人心血管系统紊乱的顺序,这需要进一步研究。