ESPE Abstracts (2015) 84 P-1-8

Cortisol:Cortisone Ratio and Metalloproteinase 9 Emerging as Risk Factors Associated with Paediatrics Hypertension

Alejandro Martinez-Aguayoa, Carmen Campinob,e,f, Rene Baudrandb, Cristian Carvajalb,e, Constanza Pinocheta, Hernan Garciaa, Rodrigo Bancalaria, Alejandra Tapiaa, Lorena Garciac, Carolina Loureiroa, Carolina Mendozaa, Andrea Vecchiolab, Carolina Valdiviab,e, Cristobal Fuenteb, Carlos Lagosb, Francisca Groba, Sandra Solarid, Fidel Allended, Alexis Kalergisb,e,f & Carlos Fardellab,e,f


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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