The association between metabolic complications and arterial hypertension in obese adolescents.

OBJECTIVE: There is increasing evidence for the contribution of obesity and its metabolic sequels in the development of arterial hypertension (AH).

METHODS: The casual blood pressure (CBP), 24hABPM, ambulatory arterial stiffness index (AASI) and symmetric (sAASI) ambulatory arterial stiffness index (both derived from a 24 h ABPM) and selected laboratory tests were performed in 130 obese (mean BMI SDS 4.2) adolescents at the mean age of 13.7 years.

RESULTS: AH was diagnosed in 36.2%, and in 33.8% patients on the basis of CBP and 24hABPM respectively. There were significant correlations between: CBPSBP insulin level (fasting r=0.19, p=0.03 and post glucose load r=0.18, p=0.04), HOMA-IR (r=0.18, p=0.04), and uric acid (UA) level (r=0.35, p<0.001); CBPDBP and UA level (r=0.23, p=0.01). There were significant correlations between 24hABPM parameters and cortisol secretion: dSBP and urinary free cortisol (r=0.3, p=0.03), nDBP and nMAP and cortisol rhythm (r=0.21, p=0.03). There a correlation between sAASI and creatinine level (r=0.29, p=0.002) and negative correlation between AASI and eGFR (r=-0.23, p=0.009).

CONCLUSIONS: The increase of the CBP parameters is associated with insulin resistance and hyperuricemia, while the increase of ABPM results is proportional to the cortisol secretion in obese adolescents.