Markers of chronic inflammation in essential hypertension and obesity in children

Introduction: Essential hypertension (EH) is a multifactorial pathology that can begin in childhood. Several risk factors have been associated with pediatric hypertension in several studies in different regions, but the role of overweight and obesity is best documented. Proinflammatory biomarkers could be considered as tools to stratify patients’ risk at an individual level and serve as targets of cardiovascular events.

Objective: To evaluate inflammatory markers (PCR hs, – TNF) in the development of Essential hypertension and obesity in children.

Methods: A case-control study included 115 children with essential hypertension, aged between 10 and 18 years. Depending on the BMI, three research groups were created: group I – 35 normal-weight hypertensive children, group II – 36 overweight hypertensive chil-dren and group III – 44 obese hypertensive children. The diagnosis of hypertension has been established in accordance with the latest recommendations of the Eu-ropean guide on hypertension in children. For the bio-chemical indicators, which do not have definite norms in children, a control group was selected consisting of 35 normal-weight normotensive children, of similar age. Proinflammatory markers: TNF-α was assessed by the ELISA method, and hs-PCR was determined by the latex-immunoturbidimetry method.

Results: Comparing the research groups, we found that children, who associated with increased BP valu-es and obesity, had a longer duration of hypertension, compared to children who associated overweight (7.4 50 vs. 6.9 ± 1.32 months; p 2.3> 0.05) or normo-ponderability (7.4 ± 1.50 vs. 7.2 ± 1.44 months; p 1.3> 0.05). TNF α values were high, compared to the control group, both in overweight hypertensive children (7.2 ± 0.97 vs. 2.8 ± 0.05 mg/pl; p< 0.001), obese hypertensi-ves (6, 6 ± 0.89 vs. 2.8 ± 0.05 mg/pl; p< 0.001), as well as in the normal-weight hypertensive ones (6.7 ± 0.83 vs. 2.8 ± 0.05 mg/pl; p< 0.001), and hs PCR was> 3 pg/ ml in all study groups, which places these children in the high-risk group for cardiovascular complications. TNF ά correlated positively with PCR hs (r= +0.23; p< 0.01) and negatively with HDL-C (r = -0.17; p< 0.05), serum adiponectin, 16; p < 0.05) and 25 – OH vitamin D (r= -0.20; p< 0.05). PCR – hs was positively correla-ted with TNF ά (r= +0.23; p< 0.01), urinary adrenaline (r= +0.20; p< 0.05), urinary norepinephrine (r= +0.19) p< 0.05), serum leptin (r= +0.20; p< 0.05) and negative with serum adiponectin (r= -0.23; p< 0.01) and 25 – OH vit D (r= -0.38; p< 0.01).

Conclusions: T he evolution of hypertension in chil-dren is associated with increased chronic inflamma-tion, which is justified by the significant and notable increase compared to the control group of circulating TNF-α in both normal-weight children (6.7 ± 0.83 vs. 2.8 ± 0.05 mg/pl; p< 0.001), as well as overweight (7.2 97 vs. 2.8 ± 0.05 mg/pl; p< 0.001) and obese (6.6 89 vs. 2.8 ± 0.05 mg/μl; p < 0.001). In all research groups, the serum content of PCR hs exceeded 3 pg / ml, which places these children in the high cardiovascular risk group.


ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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