The Level of Serum Uric Acid as Evidence of Endothelial Dysfunction in Normal Weight and Obese Children with Primary Hypertension
Year 2022,
Volume: 23 Issue: 4, 495 - 501, 30.12.2022
Hatice Sınav Ütkü
,
Dilek Yılmaz
Mustafa Yılmaz
Ahmet Anık
,
Tolga Ünüvar
,
İmran Kurt Omurlu
Abstract
Objective: Primary hypertension (HT) and obesity with a global increase in prevalence in children has become a critical health problem. HT and obesity are among the well-established cardiovascular risk factors. In this study, we investigated the relationship between arterial stiffness (AS) and serum uric acid (UA) levels in normal-weight and obese children with primary HT.
Materials and Methods: This prospective study was conducted at the university hospital between September 2016 and September 2017. The children aged 6-18 years and recently diagnosed with HT (n=77) were categorized into two groups based on body mass index values as group 1 (HT + obese) (n=46) and group 2 (HT + normal weight) (n=31). The control group (n=35) consisted of age and gendermatched healthy children. The AS of all children included in the study was measured by ossilometric methods using mobil-O-Graph.
Results: A total of 112 children with a mean age of 13.2±3.1 years and most males (61.6%) were included in this study. The values of pulse wave velocity (PWV), central systolic blood pressure (SBP)- diastolic blood pressure (DBP), peripheral SBP-DBP, mean BP, and cardiac output in both HT groups (HT + normal weight and HT + obese) were significantly higher than those in the control group (p<0.05). The pulse wave reflection (%) was the lowest in the HT + obese group. When the serum UA levels were compared among the groups, the highest value was found in the HT + obese group.
Conclusions: A higher AS-PWV was detected in the normal weight and the obese children with a recent diagnosis of primary HT compared with the control group.
References
- 1. Panchangam C, Merrill ED, Raghuveer G. Utility of arterial stiffness assessment in children. Cardiol Young 2018; 28: 362-76.
- 2. Wójtowicz J, Łempicka A, Łuczyński W, Szczepański W, Zomerfeld A, Semeran K, et al. Central aortic pressure, arterial stiffness and echocardiographic parameters of children with overweight/obesity and arterial hypertension. Adv Clin Exp Med 2017; 26: 1399-404.
- 3. Tokgöz ST, Yılmaz D, Tokgöz Y, Çelik B, Bulut Y. The evaluation of arterial stiffness of essential hypertension and white coat hypertension in children: a case-control study. Cardiol Young 2018; 28: 403-8.
- 4. Yilmaz D, Inan G, Karakas S, Buyukozturk-Karul A, Sonmez F. Obesity and its diagnostic methods in Turkish children. Eurasian J Med 2012; 44: 94-8.
- 5. Awazu M. Hypertension. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa N. (eds). Pediatric Nephrology (6th ed). Berlin Heidelberg: Springer Verlag, 2009: 1457-541.
- 6. Flynn JT. What’s new in pediatric hypertension? Curr Hypertens Rep 2001; 3: 503-10.
- 7. Lowenthal A, Evans JM, Punn R, Nourse SE, Vu CN, Popat RA, et al. Arterial applanation tonometry: Feasibility and reproducibility in children and adolescents. Am J Hypertens 2014; 27: 1218-24.
- 8. Lurbe E, Simonetti G. Childhood hypertension. In: Geary DF, Schaefer F, (eds). Pediatric kidney disease (2nd ed). Berlin: Springer, 2016: 1313-39.
- 9. Available from: [http://www.cdc.gov/growthcharts](http://www.cdc.gov/growthcharts)
- 10. McNiece KL, Portman RJ. Ambulatory blood pressure monitoring: what a pediatrician should know. Curr Opin Pediatr 2007; 19: 178-82.
- 11. Macumber IR, Weiss NS, Halbach SM, Hanevold CD, Flynn JT. The association of pediatric obesity with nocturnal non-dipping on 24-hour ambulatory blood pressure monitoring. Am J Hypertens 2016; 29: 647-52.
- 12. Yanik M, Feig DI. Serum urate: a biomarker or treatment target in pediatric hypertension? Curr Opin Cardiol 2013; 28: 433-8.
- 13. Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol 2005; 25: 932-43.
- 14. Mansia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 ESH-ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood Press 2007; 16: 135-232.