Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto.
Unidade de Saúde Familiar (USF) Nuno Grande, Agrupamento de Centros de Saúde (ACeS) Douro I - Marão e Douro Norte, Vila Real.
J Hypertens. 2023 Apr 1;41(4):545-553. doi: 10.1097/HJH.0000000000003345. Epub 2023 Jan 24.
Angiotensin-converting enzymes' (ACEs) relationship with blood pressure (BP) during childhood has not been clearly established. We aimed to compare ACE and ACE2 activities between BMI groups in a sample of prepubertal children, and to characterize the association between these enzymes' activities and BP.
Cross-sectional study of 313 children aged 8-9 years old, included in the birth cohort Generation XXI (Portugal). Anthropometric measurements and 24-h ambulatory BP monitoring were performed. ACE and ACE2 activities were quantified by fluorometric methods.
Overweight/obese children demonstrated significantly higher ACE and ACE2 activities, when compared to their normal weight counterparts [median (P25-P75), ACE: 39.48 (30.52-48.97) vs. 42.90 (35.62-47.18) vs. 43.38 (33.49-49.89) mU/ml, P for trend = 0.009; ACE2: 10.41 (7.58-15.47) vs. 21.56 (13.34-29.09) vs. 29.00 (22.91-34.32) pM/min per ml, P for trend < 0.001, in normal weight, overweight and obese children, respectively]. In girls, night-time systolic BP (SBP) and diastolic BP (DBP) increased across tertiles of ACE activity ( P < 0.001 and P = 0.002, respectively). ACE2 activity was associated with higher night-time SBP and DBP in overweight/obese girls ( P = 0.037 and P = 0.048, respectively) and night-time DBP in the BMI z-score girl adjusted model ( P = 0.018). Median ACE2 levels were significantly higher among nondipper girls (16.7 vs. 11.6 pM/min per ml, P = 0.009).
Our work shows that obesity is associated with activation of the renin-angiotensin-aldosterone system, with significant increase of ACE and ACE2 activities already in childhood. Also, we report sex differences in the association of ACE and ACE2 activities with BP.
血管紧张素转换酶（ACE）与儿童时期血压（BP）的关系尚未明确。我们旨在比较肥胖儿童和正常体重儿童的 ACE 和 ACE2 活性，并描述这些酶活性与 BP 的相关性。
本横断面研究纳入了 313 名 8-9 岁的儿童，他们是Generation XXI（葡萄牙）出生队列的一部分。进行了体格测量和 24 小时动态血压监测。采用荧光法测定 ACE 和 ACE2 活性。
与正常体重儿童相比，超重/肥胖儿童的 ACE 和 ACE2 活性显著升高[中位数（P25-P75），ACE：39.48（30.52-48.97）比 42.90（35.62-47.18）比 43.38（33.49-49.89）mU/ml，趋势 P = 0.009；ACE2：10.41（7.58-15.47）比 21.56（13.34-29.09）比 29.00（22.91-34.32）pM/min/ml，趋势 P < 0.001，在正常体重、超重和肥胖儿童中分别]。在女孩中，ACE 活性三分位组夜间收缩压（SBP）和舒张压（DBP）随时间增加（P < 0.001 和 P = 0.002）。ACE2 活性与超重/肥胖女孩夜间 SBP 和 DBP升高相关（P = 0.037 和 P = 0.048），与 BMI z 分数女孩调整模型中的夜间 DBP 相关（P = 0.018）。非杓型女孩的 ACE2 水平中位数明显较高（16.7 比 11.6 pM/min/ml，P = 0.009）。
我们的工作表明，肥胖与肾素-血管紧张素-醛固酮系统的激活有关，在儿童时期就已经出现 ACE 和 ACE2 活性的显著增加。此外，我们还报告了 ACE 和 ACE2 活性与 BP 相关性的性别差异。
