Csábi G, Molnár D, Hartmann G
Department of Paediatrics, University Medical School of Pécs, Hungary.
Eur J Pediatr. 1996 Oct;155(10):895-7. doi: 10.1007/BF02282841.
The aim of the present study was to evaluate the association between 24 h urinary excretion of sodium and blood pressure, fasting plasma insulin, renin, aldosterone and serum norepinephrine concentrations in 45 obese and 15 control children. Urinary sodium excretion was significantly lower in obese subjects (1.3 +/- 0.6 mmol/kg/24 h, P < 0.01) than in controls (2.8 +/- 1.3 mmol/kg/24 h). Hyperinsulinaemia did not affect sodium excretion of obese children. Plasma renin and aldosterone levels did not correlate with sodium excretion and were significantly higher in overweight children. Serum norepinephrine levels were also significantly higher in the obese group (0.66 +/- 0.89 microgram/100 ml) as compared to the controls (0.11 +/- 0.03 microgram/100 ml, P < 0.01) and showed significant negative correlation with urinary sodium excretion (r = 0.43, P < 0.05).
Hyperinsulinaemia and the consequently increased sympathetic nervous system activity might be involved in the development of high blood pressure in obese children by decreasing urinary sodium excretion.
本研究旨在评估45名肥胖儿童和15名对照儿童的24小时尿钠排泄与血压、空腹血浆胰岛素、肾素、醛固酮及血清去甲肾上腺素浓度之间的关联。肥胖受试者的尿钠排泄(1.3±0.6 mmol/kg/24小时,P<0.01)显著低于对照组(2.8±1.3 mmol/kg/24小时)。高胰岛素血症不影响肥胖儿童的钠排泄。血浆肾素和醛固酮水平与钠排泄无相关性,且在超重儿童中显著升高。肥胖组的血清去甲肾上腺素水平(0.66±0.89微克/100毫升)也显著高于对照组(0.11±0.03微克/100毫升,P<0.01),且与尿钠排泄呈显著负相关(r = 0.43,P<0.05)。
高胰岛素血症及随之增加的交感神经系统活动可能通过减少尿钠排泄参与肥胖儿童高血压的发生发展。