Abstract
Background: Activation of the renin-angiotensin-aldosterone
system, hyperinsulinemia, and hyperleptinemia have been
implicated in the pathogenesis of obesity-related arterial hypertension
(AH). We therefore studied serum renin, aldosterone,
leptin, and insulin levels in overweight and obese children with
and without AH.
Methods: 129 (77 male) overweight/obese (BMI z-score > 1.3
/ > 2), children and adolescents, seeking obesity management were
studied. Fasting insulin, leptin, renin, and aldosterone were measured
by automated methods, and office blood pressure readings
were done by oscillometric method. AH was defined by the ESH
2016 guidelines. P25 and P75 limits for sex and age were used to
define decreased/ increased renin or aldosterone levels.
Results: Median (range) age was 12.1 (6.6 – 17.3) years, while
median BMI z-score was 2.29 (1.30-3.29). An elevated systolic (S)
and diastolic (D) blood pressure (BP) was registered in 52 (40 %)
and 16 (12 %) subjects, respectively. AH (increased SBP and/or
DBP) was more prevalent in male vs. female (51 % vs 33 %; p=0.024)
and obese vs. overweight subjects (41 % vs 25 %; p=0.026).
Increased renin and aldosterone levels were measured in 4 (3 %)
and 82 (63 %) subjects, while 84 (65%) subjects had decreased
renin levels. 48 of the 84 (57%) subjects with low renin levels had
elevated aldosterone levels. Renin levels correlated positively with
aldosterone levels ( Rho = 0.42; p < 0.000). However, plasma renin
nor aldosterone correlated significantly with serum leptin, serum
insulin, age, or z-scores of BMI, waist circumference, SBP, or DBP.
Increased renin and aldosterone levels were seen in 3 (1 %) and 44
(59 %) of the 74 normotensive and 1 ( 1 %) and 38 (69 %) of the 55
hypertensive subjects, while 51/74 (69 %) normotensive and 33/55
(60 %) hypertensive subjects had decreased renin levels.
Hypertensive subjects had similar median renin, aldosterone, and
leptin levels but significantly (p< 0.001) higher median insulin levels
(133(39-467) vs 194(38-93) pmol/L).
Conclusion: AH was observed in 43 % of overweight/obese
children. Low renin hypertension was diagnosed in 25.5 % and
high renin hypertension in less than 1%. Our results confirm that
male sex, higher adiposity (BMI z-score), and hyperinsulinemia
are risk factors for obesity-related arterial hypertension.
system, hyperinsulinemia, and hyperleptinemia have been
implicated in the pathogenesis of obesity-related arterial hypertension
(AH). We therefore studied serum renin, aldosterone,
leptin, and insulin levels in overweight and obese children with
and without AH.
Methods: 129 (77 male) overweight/obese (BMI z-score > 1.3
/ > 2), children and adolescents, seeking obesity management were
studied. Fasting insulin, leptin, renin, and aldosterone were measured
by automated methods, and office blood pressure readings
were done by oscillometric method. AH was defined by the ESH
2016 guidelines. P25 and P75 limits for sex and age were used to
define decreased/ increased renin or aldosterone levels.
Results: Median (range) age was 12.1 (6.6 – 17.3) years, while
median BMI z-score was 2.29 (1.30-3.29). An elevated systolic (S)
and diastolic (D) blood pressure (BP) was registered in 52 (40 %)
and 16 (12 %) subjects, respectively. AH (increased SBP and/or
DBP) was more prevalent in male vs. female (51 % vs 33 %; p=0.024)
and obese vs. overweight subjects (41 % vs 25 %; p=0.026).
Increased renin and aldosterone levels were measured in 4 (3 %)
and 82 (63 %) subjects, while 84 (65%) subjects had decreased
renin levels. 48 of the 84 (57%) subjects with low renin levels had
elevated aldosterone levels. Renin levels correlated positively with
aldosterone levels ( Rho = 0.42; p < 0.000). However, plasma renin
nor aldosterone correlated significantly with serum leptin, serum
insulin, age, or z-scores of BMI, waist circumference, SBP, or DBP.
Increased renin and aldosterone levels were seen in 3 (1 %) and 44
(59 %) of the 74 normotensive and 1 ( 1 %) and 38 (69 %) of the 55
hypertensive subjects, while 51/74 (69 %) normotensive and 33/55
(60 %) hypertensive subjects had decreased renin levels.
Hypertensive subjects had similar median renin, aldosterone, and
leptin levels but significantly (p< 0.001) higher median insulin levels
(133(39-467) vs 194(38-93) pmol/L).
Conclusion: AH was observed in 43 % of overweight/obese
children. Low renin hypertension was diagnosed in 25.5 % and
high renin hypertension in less than 1%. Our results confirm that
male sex, higher adiposity (BMI z-score), and hyperinsulinemia
are risk factors for obesity-related arterial hypertension.
| Original language | English |
|---|---|
| Pages | 577 |
| Number of pages <span style="color:red"p> <font size="1.5"> ✽ </span> </font> | 578 |
| Publication status | Published - 16 Nov 2024 |
| Event | 62nd Annual Meeting of the European Society for Pediatric Endocrinology (ESPE) - Liverpool , Liverpool, United Kingdom Duration: 16 Nov 2024 → 18 Nov 2024 https://www.eurospe.org/event/62nd-espe-meeting/ |
Conference
| Conference | 62nd Annual Meeting of the European Society for Pediatric Endocrinology (ESPE) |
|---|---|
| Country/Territory | United Kingdom |
| City | Liverpool |
| Period | 16/11/24 → 18/11/24 |
| Internet address |