title: Cardiovascular risk in nonobese hypertensive adolescents: a study based on plasma biomarkers and ultrasonographic assessment of early atherosclerosis.
abstract: The objective of this study was to investigate the vascular status, left-ventricular mass and biomarkers of endothelial activation in hypertensive (HT) adolescents, with particular attention to comparing nonobese with obese patients. Seventy-nine newly diagnosed HT adolescents aged 15.1±2.1 years (divided into 34 nonobese and 45 obese) were compared with 35 healthy volunteers. Intima-media thickness (IMT), flow-mediated dilation (FMD) and left-ventricular mass index (LVMi) were determined using ultrasound. Adhesion molecules and inflammatory interleukins (ILs), together with lipids and insulin resistance (HOMA), were also studied. HT obese adolescents had higher triglycerides, HOMA, and elevated levels of interleukin-6, tumor necrosis factor-α, soluble intercellular adhesion molecule-1 and soluble E-selectin compared with controls and nonobese HT patients. FMD was lower in HT groups (8.5±4.5% in nonobese, P=0.004; 8.1±4.9%, P=0.01 in obese vs 12.5±4.9%; in control), and IMT was higher (0.52±0.06 mm, P<0.001 in nonobese; 0.54±0.05 mm, P<0.001 in obese vs 0.42±0.05 mm in control). Higher LVMi was found in both HT groups, with the highest value in the nonobese group being 37.8±5.3 g m(-2.7) vs 28.4±5.3 g m(-2.7) in controls (P=0.003). In conclusion, nonobese HT adolescents had the same early cardiovascular deteriorations assessed ultrasonographically as their obese HT peers, although metabolic alterations and endothelial activation measured as plasma biomarkers were more pronounced in obese individuals. The potential mechanisms of early atherosclerosis in nonobese HT adolescents need further evaluation in prospective studies because these factors may differ considerably from those found in young obese individuals with HT.
authors.affiliation: Department of Paediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Białystok, Białystok University Children's Hospital, Białystok, Poland. bglowinska@poczta.onet.pl
authors.forename: B
authors.initials: B
authors.lastname: Głowińska-Olszewska
authors.forename: J
authors.initials: J
authors.lastname: Tołwińska
authors.forename: W
authors.initials: W
authors.lastname: Łuczyński
authors.forename: J
authors.initials: J
authors.lastname: Konstantynowicz
authors.forename: A
authors.initials: A
authors.lastname: Bossowski
mesh_terms: D000293:Adolescent; D000367:Age Factors; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001916:Brachial Artery / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000097:blood; D007328:Insulin / Q000097:blood; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D015815:Cell Adhesion Molecules; D018836:Inflammation Mediators; D007328:Insulin; D008055:Lipids