ESPE Abstracts (2015) 84 P-1-8

aDivision of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile; bDepartment of Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile; cDepartment of Biochemistry and Molecular Biology, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile; dDepartment of Clinical Laboratories, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; eDepartment of Molecular Genetics and Microbiology, Millennium Institute on Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago, Chile; fDepartment of Celular and Molecular Biology, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile


Background: Paediatric hypertension is increasing and has been associated with obesity and insulin resistance. Recently, cortisol:cortisone ratio and the metalloproteinase 9 (MMP9), which is a marker of vascular remodelling, have been syndicated as new risk factors associated with hypertension.

Objective and hypotheses: To analyse the association between paediatric hypertension with clinical, biochemical, inflammation, and vascular remodelling biomarkers

Method: A cross-sectional study was designed. We selected 320 subjects (4–16 years old, female 49.4%), anthropometric parameters, serum aldosterone (SA), plasma renin activity (PRA), cortisol, cortisone, HOMA-IR, hsCRP, adiponectin, IL6, TNFα, PAI1, MMP2, and MMP9 activities were measured. We calculated SA:PRA ratio (ARR >10, as screening of hyperaldosteronism) and serum cortisol:cortisone ratio as 11β-HSD2 activity estimation. The systolic and diastolic blood pressure indexes were calculated (SBPi and DBPi=observed/50th percentile blood pressure).

Results: According the Fourth Report of Task Force and JNC7, 59 children were hypertensive. Cortisol and cortisol:cortisone ratio were higher in hypertensive (P<0.001). No hyperaldosteronism was found. A positive linear correlation was observed between SBPi and DBPi with: BMI–SDS, HOMA-IR, cortisol:cortisone ratio, MMP2, and MMP9 activities. However, correlations with SA, PRA, and ARR were not significant. The variables associated with hypertension in the multivariate logistic model were: serum cortisol:cortisone ratio (OR: 4.73; CI=2.32–9.65), BMI–SDS (OR: 3.74; CI=1.91–7.32), MMP9 (OR: 3.48; CI=1.79–6.78), and HOMA-IR (OR: 2.20; CI=1.10–4.38). The other variables we did not correlate with blood pressure.

Conclusion: Novel biomarkers such serum cortisol:cortisone ratio and MMP9 activity emerged associated with paediatric hypertension. Further studies are needed to know the role of these markers in hypertensive patients.

Funding: This work was supported by Fondecyt 1130427 and 1150437, CORFO 13CTI-21526-P1 and IMII P09/016-F (ICM) Chilean Grants.

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