Taner Sevgin, Gezici Esra, Unal Asena, Tolunay Orkun
Adana City Training and Research Hospital, Pediatric Nephrology, Adana, Turkey.
Adana City Training and Research Hospital, Pediatrics, Adana, Turkey.
Pediatr Nephrol. 2025 Mar;40(3):787-796. doi: 10.1007/s00467-024-06540-0. Epub 2024 Oct 5.
Primary hypertension (HTN) in children is on the rise and linked to the childhood obesity epidemic. Recent studies support the role of hyperuricemia in the pathogenesis of HTN. With this study we intend to evaluate the effect of body mass index (BMI) and uric acid levels on daily blood pressure (BP) parameters/phenotypes and target organ damage (TOD).
A mean ambulatory systolic and/or diastolic BP ≥ 95th percentile or above the adolescent cut points was defined as 'HTN'. Patients were grouped as group 1 normal weight, and group 2 overweight/obese.
Of the 140 children (89 male/51 female) with a mean age of 13.9 ± 2.6 years, 21 were overweight and 86 were obese. Mean 24-h systolic BP (SBP) and daytime SBP were higher in group 2 (p = 0.015, p = 0.011). BMI was positively correlated with 24-h SBP (r = 0.272, p = 0.001) and daytime SBP (r = 0.280, p = 0.001). Uric acid level showed a moderate correlation with daytime SBP (r = 0.311, p < 0.01). Logistical regression analysis showed that daytime SBP is independently associated with obesity (OR 7.44, 95%CI 2.7-20.6, p < 0.001) and male sex (OR 4.60, 95%CI 2.0-10.2, p < 0.001), but not uric acid. Left ventricular hypertrophy was more common in non-dippers (p = 0.044).
Male sex and BMI are independently associated risk factors for systolic BP. The association between non-dipping pattern and TOD suggests the widespread use of ambulatory blood pressure monitoring (ABPM) in childhood HT. In this paper, we could not demonstrate an independent association between uric acid and SBP. The effect of uric acid on SBP seems to be regulated by other metabolic factors in addition to uric acid.
儿童原发性高血压（HTN）呈上升趋势，且与儿童肥胖流行有关。最近的研究支持高尿酸血症在高血压发病机制中的作用。通过本研究，我们旨在评估体重指数（BMI）和尿酸水平对日常血压（BP）参数/表型及靶器官损害（TOD）的影响。
平均动态收缩压和/或舒张压≥第95百分位数或高于青少年切点定义为“高血压”。患者分为1组正常体重和2组超重/肥胖。
140名儿童（89名男性/51名女性），平均年龄13.9±2.6岁，其中21名超重，86名肥胖。2组的平均24小时收缩压（SBP）和日间SBP较高（p = 0.015，p = 0.011）。BMI与24小时SBP（r = 0.272，p = 0.001）和日间SBP（r = 0.280，p = 0.001）呈正相关。尿酸水平与日间SBP呈中度相关（r = 0.311，p <0.01）。逻辑回归分析显示，日间SBP与肥胖（比值比7.44，95%置信区间2.7 - 20.6，p <0.001）和男性（比值比4.60，95%置信区间2.0 - 10.2，p <0.001）独立相关，但与尿酸无关。非勺型血压者左心室肥厚更常见（p = 0.044）。
男性和BMI是收缩压的独立相关危险因素。非勺型血压模式与靶器官损害之间的关联表明，动态血压监测（ABPM）在儿童高血压中应广泛应用。在本文中，我们未能证明尿酸与SBP之间存在独立关联。尿酸对SBP的影响似乎除尿酸外还受其他代谢因素调节。
