Unit of Social Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey.
Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
BMC Nephrol. 2022 Apr 12;23(1):141. doi: 10.1186/s12882-022-02774-y.
Among the possible causes of hypertension in adolescence, electrolyte imbalances and environmental pollutants are drawing increasing attention. We aimed to examine the relationship between bisphenol A (BPA), phthalate metabolites, and serum electrolytes and blood pressure.
Eighty-six participants aged 12-15 years were included in the study. Body mass index (BMI), office blood pressure and 24-h ambulatory blood pressure measurements (ABPM), and carotid intima-media thickness were determined. Blood samples were taken for hemogram, renal function tests, and serum electrolytes. Free- and total-BPA and phthalate metabolites were analyzed from urine samples.
Of the participants, 34 were evaluated as normal blood pressure profile, 33 as white-coat hypertension (WCHT), and 19 as ABPM-hypertension. Adolescents in ABPM- hypertension groups had higher BMI-standard deviation score (SDS), leucocyte, platelet count; but lower serum chloride, compared to the normal blood pressure profile group. The percentage of adolescents with detectable urinary mono-benzyl phthalate (MBzP) was higher in ABPM-hypertension (42.1%) and WCHT groups (33.3%), compared to the normal blood pressure profile group (5.9%, p = 0.004). Associations between MBzP and ABPM- hypertension and WCHT were remained after confounding factor adjustment. Adolescents with detectable MBzP levels had also higher "albumin-corrected calcium" and lower serum phosphate and "albumin-corrected calcium x phosphate product" compared to others. Adolescents with detectable urinary MBzP levels had higher blood pressure profiles in some 24-h (mean arterial pressure-SDS, systolic blood pressure-SDS), daytime (systolic blood pressure-SDS), and night-time (mean arterial pressure-SDS, systolic blood pressure-SDS, and diastolic blood pressure-SDS) measurements, compared to others. WCHT was found to be associated negatively with monomethyl phthalate and the sum of dibutyl phthalate metabolites and ABPM-HT with MCPP. There was no significant association between blood pressure profiles and free- and total-BPA status.
MBzP was associated with adverse blood pressure profiles in adolescence. Additive follow-up studies are necessary for cause-effect relations.
在青少年高血压的诸多可能病因中，电解质失衡和环境污染物正受到越来越多的关注。我们旨在探讨双酚 A（BPA）、邻苯二甲酸酯代谢物与血清电解质和血压之间的关系。
本研究纳入了 86 名 12-15 岁的参与者。测定了体重指数（BMI）、诊室血压和 24 小时动态血压（ABPM）以及颈动脉内膜中层厚度。采集血样用于血常规、肾功能检查和血清电解质检测。从尿液样本中分析游离和总 BPA 以及邻苯二甲酸酯代谢物。
参与者中，34 人被评估为正常血压谱，33 人被评估为白大衣高血压（WCHT），19 人被评估为 ABPM 高血压。ABPM 高血压组的青少年 BMI 标准差评分（SDS）、白细胞和血小板计数较高，但血清氯较低，与正常血压谱组相比。ABPM 高血压（42.1%）和 WCHT 组（33.3%）青少年尿中单苄基邻苯二甲酸酯（MBzP）检出率高于正常血压谱组（5.9%，p=0.004）。在校正混杂因素后，MBzP 与 ABPM 高血压和 WCHT 之间仍存在相关性。MBzP 水平可检出的青少年的“白蛋白校正钙”水平也较高，而磷酸盐和“白蛋白校正钙 x 磷酸盐乘积”水平较低。与其他青少年相比，MBzP 尿中可检出的青少年的一些 24 小时（平均动脉压-SDS、收缩压-SDS）、日间（收缩压-SDS）和夜间（平均动脉压-SDS、收缩压-SDS、舒张压-SDS）血压谱更高。WCHT 与单甲基邻苯二甲酸酯和二丁基邻苯二甲酸酯代谢物总和呈负相关，ABPM-HT 与 MCPP 呈正相关。血压谱与游离和总 BPA 状态之间无显著相关性。
MBzP 与青少年的不良血压谱有关。需要进行附加的随访研究以确定因果关系。
