Metabolic Abnormalities, Insulin Resistance, and Metabolic Syndrome in Children with Primary Hypertension.
From: Department of Nephrology, Kidney Transplantation, and Arterial Hypertension, Children’s Memorial Health Institute, Warsaw, Poland. mieczyk@zigzag.pl
American journal of hypertension : journal of the American Society of Hypertension
- Publish Date: Aug 2007
- ISSN: 0895-7061
- Volume: 20
- Issue: 8
- Pages: 875-82
- Medium: Print
- Language: English
- Citation (JAMA): Litwin Mieczysław, Sladowska Joanna, Antoniewicz Jolanta, et al. Metabolic Abnormalities, Insulin Resistance, and Metabolic Syndrome in Children with Primary Hypertension.. Am. J. Hypertens. Aug 2007;20:875-82
Abstract
BACKGROUND: We sought to describe the prevalence of metabolic abnormalities and of metabolic syndrome (MS) and its relationship to target-organ damage in children with primary hypertension (PH). METHODS: Patients included 113 children with untreated PH at a mean age of 14.6 years (range, 5 to 18 years). The control group consisted of 134 healthy children at a mean age of 13.5 years (range, 5 to 20 years). We performed a cross-sectional assessment of anthropometric and biochemical cardiovascular risk factors, homeostatic metabolic assessment (HOMA-IR), the insulin sensitivity index (ISI[0,120]), and adiponectin. RESULTS: Metabolic syndrome, as defined by classic criteria, was present in 4 of 134 (3%) of controls versus 23 of 113 (20.4%) patients (P=.0001), but when PH was not taken as a criterion of MS, MS was diagnosed in 6.2% of patients (no significance). Left-ventricular hypertrophy (LVH) was found in 46 of 113 patients (40.7%), and severe LVH was found in 14 of 113 patients (12.5%). Patients with LVH had a greater body mass index, greater waist-to-hip-ratio, and greater number of parameters of metabolic syndrome (overall P<.05). Carotid (cIMT) and femoral superficial artery intima-media thicknesses correlated positively with HOMA-IR and negatively with ISI[0.120] and serum adiponectin (P<.05). The main predictor for cIMT was adiponectin (R2=0.178, beta=-0.466, P=.002). Left-ventricular hypertrophy was predicted (R2=0.332) by body mass index-standard deviation score (beta=0.551, P=.005) and HOMA-IR (beta=0.380, P=.04). CONCLUSIONS: Metabolic syndrome, as defined by classic criteria, was diagnosed in 20% of children with PH, but when PH was not a criterion, MS was present in 6.2% of patients. Irrespective of the definition of MS, the applied markers of MS and insulin resistance were the main predictors of target-organ damage.
Mesh Headings (Keywords): Adiponectin, Adolescent, Adult, Blood Pressure, Child, Child, Preschool, Cross-Sectional Studies, Echocardiography, Female, Follow-Up Studies, Humans, Hypertension, Hypertrophy, Left Ventricular, Insulin Resistance, Male, Metabolic Syndrome X, Poland, Prevalence, Prognosis, Retrospective Studies, Risk Factors, Severity of Illness Index
Check for Full Text / PubMed Unique Identifier (PMID): 17679036
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