Skrzypczyk Piotr, Zacharzewska Anna, Szyszka Michał, Ofiara Anna, Pańczyk-Tomaszewska Malgorzata
Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland.
Student Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland.
Cent Eur J Immunol. 2021;46(3):336-343. doi: 10.5114/ceji.2021.109156. Epub 2021 Oct 6.
The immune system can trigger an inflammatory process leading to blood pressure elevation and arterial damage. The aim of the study was to assess the relation between subclinical inflammation and arterial damage in pediatric patients with primary hypertension (PH) and to establish the usefulness of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios, and mean platelet volume (MPV) as markers of arterial damage in these subjects.
In 119 children with PH (14.94 ±2.76 years) and 45 healthy children (14.91 ±2.69 years) we analyzed markers of subclinical inflammation (NLR, PLR, MPV), clinical and biochemical parameters, office blood pressure, ambulatory blood pressure monitoring (ABPM), central blood pressure, aortic pulse wave velocity (aPWV), augmentation index corrected for heart rates 75 (AIx75HR), carotid intima media thickness (cIMT), and common carotid artery stiffness (E-tracking).
Children with PH were characterized by significantly higher neutrophil (3.9 ±1.7 vs. 3.0 ±1.0 [1000/µl], p < 0.001) and platelet counts (271.9 ±62.3 vs. 250.3 ±60.3 [1000/µl], p = 0.047), NLR (1.9 ±1.5 vs. 1.3 ±0.4, p = 0.010), PLR (131.4 ±41.9 vs. 114.7 ±37.6, p = 0.020), aPWV (5.36 ±0.88 vs. 4.88 ±0.92 m/s, p = 0.004), and cIMT (0.46 ±0.07 vs. 0.43 ±0.07 mm, p = 0.002) compared to healthy children. In PH children NLR correlated positively (p < 0.05) with: systolic, diastolic and mean blood pressure in ABPM (r = 0.243, r = 0.216, r = 0.251), aPWV [m/s] (r = 0.241), aPWV Z-score (r = 0.204), and common carotid artery PWVbeta [m/s] (r = 0.202).
There is a link between arterial stiffness and subclinical inflammation in pediatric patients with primary hypertension. Neutrophil-to-lymphocyte ratio may serve as a promising marker of arterial stiffness in pediatric patients affected by primary hypertension.
免疫系统可引发炎症过程，导致血压升高和动脉损伤。本研究的目的是评估原发性高血压（PH）患儿亚临床炎症与动脉损伤之间的关系，并确定中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及平均血小板体积（MPV）作为这些患儿动脉损伤标志物的实用性。
我们分析了119例PH患儿（14.94±2.76岁）和45例健康儿童（14.91±2.69岁）的亚临床炎症标志物（NLR、PLR、MPV）、临床和生化参数、诊室血压、动态血压监测（ABPM）、中心血压、主动脉脉搏波速度（aPWV）、心率校正为75时的增强指数（AIx75HR）、颈动脉内膜中层厚度（cIMT）以及颈总动脉硬度（E-跟踪）。
与健康儿童相比，PH患儿的中性粒细胞计数（3.9±1.7对3.0±1.0[1000/μl]，p<0.001）和血小板计数（271.9±62.3对250.3±60.3[1000/μl]，p = 0.047）、NLR（1.9±1.5对1.3±0.4，p = 0.010）、PLR（131.4±41.9对114.7±37.6，p = 0.020）、aPWV（5.36±0.88对4.88±0.92 m/s，p = 0.004）和cIMT（0.46±0.07对0.43±0.07 mm，p = 0.002）显著更高。在PH患儿中，NLR与ABPM中的收缩压、舒张压和平均血压呈正相关（p<0.05）（r = 0.243，r = 0.216，r = 0.251）、aPWV [m/s]（r = 0.241）、aPWV Z评分（r = 0.204）以及颈总动脉PWVbeta [m/s]（r = 0.202）。
原发性高血压患儿的动脉僵硬度与亚临床炎症之间存在联系。中性粒细胞与淋巴细胞比值可能是原发性高血压患儿动脉僵硬度的一个有前景的标志物。
