Szyszka Michał, Skrzypczyk Piotr, Pańczyk-Tomaszewska Małgorzata
Medical University of Warsaw, Poland: Doctoral School, Department of Pediatrics and Nephrology.
Medical University of Warsaw, Poland: Department of Pediatrics and Nephrology.
Pol Merkur Lekarski. 2021 Apr 18;49(290):119-124.
Increased concentration of uric acid may play a role in the pathogenesis of primary hypertension (PH).
The aim of the study was to assess concentration of uric acid and to assess its correlation with selected clinical and biochemical parameters in children with PH.
In a group of 57 untreated pharmacologically children with PH (44 boys, 13 girls, mean age 14.99±2.84 years) following parameters were assessed: serum uric acid concentration, blood pressure in office measurement and in 24-hour ambulatory blood pressure monitoring (ABPM), and selected clinical and biochemical parameters. Control group consisted of 20 healthy children (mean 14.11±2.99 years).
Serum uric acid concentration was significantly higher in children with PH compared to healthy children (5.72±1.38 vs. 4.55±1.07 mg/dL; p=0.001). In patients with PH, its concentration was significantly higher in boys compared to girls ((6.12±1.20 mg/dL vs. 4.35±1.13 mg/dL, p<0.001), no such difference was found in healthy children. In the PH group, uric acid concentration correlated positively with age (r=0.426, p=0.001), height (r=0.557, p<0.001), weight (r=0.518, p<0.001), weight Z- score (r=0.296, p=0.025), BMI (r=0.316, p=0.017), neutrophil count (r=0.280, p=0.035), systolic blood pressure (r=0.375, p=0.004) and pulse pressure (r=0.444, p=0.001) in ABPM and negatively with HDL cholesterol, heart rate (r=-0.310, p=0.02 (1=-0.309, p=0.020) and nighttime diastolic blood pressure dip (r=-0.268, p=0.044) in ABPM. In multivariate analysis, the determinants of uric acid concentration in children with PH were sex (Β = 0,367, 95%CI(0.122-0.611), p=0.004) and weight Z-score (Β= 0.254, 95%CI(0.005-0.504), p=0.046).
Children with PH have increased serum uric acid concentration compared to healthy children. The risk factors for hyperuricemia in pediatric patients with PH are male sex and high body weight.
尿酸浓度升高可能在原发性高血压（PH）的发病机制中起作用。
本研究旨在评估PH患儿的尿酸浓度，并评估其与选定的临床和生化参数的相关性。
对57例未经药物治疗的PH患儿（44例男孩，13例女孩，平均年龄14.99±2.84岁）评估以下参数：血清尿酸浓度、诊室血压测量及24小时动态血压监测（ABPM），以及选定的临床和生化参数。对照组由20名健康儿童组成（平均年龄14.11±2.99岁）。
与健康儿童相比，PH患儿的血清尿酸浓度显著更高（5.72±1.38 vs. 4.55±1.07mg/dL；p = 0.001）。在PH患儿中，男孩的尿酸浓度显著高于女孩（（6.12±1.20mg/dL vs. 4.35±1.13mg/dL，p<0.001），而在健康儿童中未发现此类差异。在PH组中，尿酸浓度与年龄呈正相关（r = 0.426，p = 0.001）、身高（r = 0.557，p<0.001）、体重（r = 0.518，p<0.001）、体重Z评分（r = 0.296，p = 0.025）、BMI（r = 0.316，p = 0.017）、中性粒细胞计数（r = 0.280，p = 0.035）、ABPM中的收缩压（r = 0.375，p = 0.004）和脉压（r = 0.444，p = 0.001）呈正相关，与HDL胆固醇、心率（r = -0.310，p = 0.02（1 = -0.309，p = 0.020）和ABPM中的夜间舒张压下降幅度（r = -0.268，p = 0.044）呈负相关。在多变量分析中，PH患儿尿酸浓度的决定因素是性别（Β = 0.367，95%CI（0.122 - 0.611），p = 0.004）和体重Z评分（Β = 0.254，95%CI（0.005 - 0.504），p = 0.046）。
与健康儿童相比，PH患儿的血清尿酸浓度升高。PH患儿高尿酸血症的危险因素是男性和高体重。
