Document Detail


Metabolic abnormalities, insulin resistance, and metabolic syndrome in children with primary hypertension.
MedLine Citation:
PMID:  17679036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mieczysław Litwin; Joanna Sladowska; Jolanta Antoniewicz; Anna Niemirska; Aldona Wierzbicka; Jadwiga Daszkowska; Zbigniew T Wawer; Roman Janas; Ryszard Grenda
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  20     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-06     Completed Date:  2007-10-25     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  875-82     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Kidney Transplantation, and Arterial Hypertension, Children's Memorial Health Institute, Warsaw, Poland. mieczyk@zigzag.pl
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MeSH Terms
Descriptor/Qualifier:
Adiponectin / blood*
Adolescent
Adult
Blood Pressure / physiology
Child
Child, Preschool
Cross-Sectional Studies
Echocardiography
Female
Follow-Up Studies
Humans
Hypertension / blood*,  complications,  physiopathology
Hypertrophy, Left Ventricular / etiology,  physiopathology,  ultrasonography
Insulin Resistance / physiology*
Male
Metabolic Syndrome X / blood*,  complications,  epidemiology
Poland / epidemiology
Prevalence
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Adiponectin
Comments/Corrections
Comment In:
Am J Hypertens. 2007 Aug;20(8):883   [PMID:  17679037 ]

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