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 (416 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: BMISDS, 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=2.329.65), BMISDS (OR: 3.74; CI=1.917.32), MMP9 (OR: 3.48; CI=1.796.78), and HOMA-IR (OR: 2.20; CI=1.104.38). 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.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology