Güneş Hatice, Alkan Baylan Filiz, Güneş Hakan, Temiz Fatih
Sütçü İmam University Faculty of Medicine, Department of Pediatrics, Kahramanmaraş, Turkey
Sütçü İmam University Faculty of Medicine, Department of Biochemistry, Kahramanmaraş, Turkey
J Clin Res Pediatr Endocrinol. 2020 Mar 19;12(1):29-36. doi: 10.4274/jcrpe.galenos.2019.2019.0072. Epub 2019 Jul 24.
The prevalence of childhood obesity is increasing and leads to co-morbidities such as hypertension. However, it is still not clear why some obese individuals are hypertensive and others not. Nesfatin-1 is a recently discovered anorexigenic peptide which also has effects on blood pressure (BP). Our aim was to evaluate the relationship between obesity-related hypertension and Nesfatin-1.
This cross-sectional study comprised 87 obese children. The patients were divided into two groups; hypertensive (n=30) and normotensive (n=57) obese. The American Academy of Pediatrics guidelines were used to diagnose hypertension. Blood samples were collected after 12 hours of fasting to investigate Nesfatin-1 concentrations. We also evaluated serum trace elements in addition to the routine blood tests.
Body mass index (BMI), weight and serum Nesfatin-1 concentrations were higher in the hypertensive group (p=0.002, p=0.001, and p=0.007, respectively). There was no difference between serum zinc levels, but Copper (Cu) levels were significantly lower in the hypertensive group (p=0.248, p=0.007, respectively). There were positive correlations between BP and BMI and weight Z-scores and a negative correlation with Cu. The optimal cut-off value of Nesfatin-1 to predict hypertension was found to be >1.8 ng/mL, with a specificity of 71.9% and a sensitivity of 96.7% [area under the curve=0.703, 95% confidence interval (CI): 0.577-0.809; p=0.002]. In multiple logistic regression analysis Nesfatin-1 [Odds ratio (OR)=1.103, 95% CI: 1.039-1.171; p=0.001], Cu (OR=0.947, 95% CI: 0.915-0.979; p=0.001) and BMI for age Z-score (OR=56.277, 95% CI: 5.791-546.907; p=0.001) still remained significant predictors of hypertension.
Nesfatin-1 levels are higher and are an independent predictor of hypertension in obese subjects.
儿童肥胖症的患病率正在上升，并导致如高血压等合并症。然而，仍不清楚为何一些肥胖个体患有高血压而另一些则没有。Nesfatin-1是一种最近发现的食欲抑制肽，它也对血压（BP）有影响。我们的目的是评估肥胖相关高血压与Nesfatin-1之间的关系。
这项横断面研究纳入了87名肥胖儿童。患者被分为两组；高血压组（n = 30）和血压正常组（n = 57）的肥胖儿童。采用美国儿科学会指南诊断高血压。禁食12小时后采集血样以检测Nesfatin-1浓度。除常规血液检查外，我们还评估了血清微量元素。
高血压组的体重指数（BMI）、体重和血清Nesfatin-1浓度更高（分别为p = 0.002、p = 0.001和p = 0.007）。血清锌水平无差异，但高血压组的铜（Cu）水平显著更低（分别为p = 0.248、p = 0.007）。血压与BMI、体重Z评分呈正相关，与铜呈负相关。发现预测高血压的Nesfatin-1最佳截断值>1.8 ng/mL，特异性为71.9%，敏感性为96.7%[曲线下面积=0.703，95%置信区间（CI）：0.577 - 0.809；p = 0.002]。在多因素逻辑回归分析中，Nesfatin-1[比值比（OR）=1.103，95%CI：1.039 - 1.171；p = 0.001]、铜（OR = 0.947，95%CI：0.915 - 0.979；p = 0.001）和年龄BMI Z评分（OR = 56.277，95%CI：5.791 - 546.907；p = 0.001）仍然是高血压的显著预测因素。
Nesfatin-1水平更高，是肥胖受试者高血压的独立预测因素。
