Serum uric acid and ambulatory blood pressure in children with primary hypertension.
Serum uric acid and ambulatory blood pressure in children with primary hypertension.
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DOI：
10.1203/pdr.0b013e318183fd7c
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发表时间：
2008-11
影响因子：
3.6
通讯作者：
Li R
中科院分区：
文献类型：
--
作者：
Jones DP;Richey PA;Alpert BS;Li R
高尿酸血症与成人和儿童原发性高血压（HTN）有关。此外，儿童时期的尿酸水平与成年期的血压（BP）水平有关。我们测量了104例可能患有高血压的儿童24小时动态血压和血清尿酸（SUA）。平均年龄13.7±2.6岁（7 ~ 18岁），男性67人，女性37人；74名非裔美国人，29名白种人和1名亚洲人。SUA与年龄（r=0.38， P=0.0001）和BMI Z-score （r=0.23， P=0.021）相关。SUA与平均动态收缩压(S)和舒张压(D)显著相关。使用血压指数将平均动态血压归一化为性别和身高特定的参考标准。在调整年龄、性别、种族、BMI Z-score和尿钠排泄量后，SUA与24小时舒张指数和夜间舒张指数显著相关。SUA还与24小时舒张压负荷和夜间舒张压负荷显著相关。在校正其他协变量后，尿酸与舒张期HTN的可能性增加显著相关（OR 2.1, CI 1.2, 3.7； P=0.0063）。在有HTN风险的儿童中，舒张期HTN（由动态血压监测定义）的可能性随着SUA的增加而显著增加。在青少年时期，SUA可能与HTN的严重程度增加有关。
Hyperuricemia is associated with primary hypertension (HTN) in adults and children. Furthermore, uric acid levels during childhood are associated with blood pressure (BP) levels in adulthood. We measured 24-h ambulatory BP and serum uric acid (SUA) in 104 children referred for possible hypertension. Mean age was 13.7 ± 2.6 y (range 7-18y) with 67 males and 37 females; 74 were African-American, 29 Caucasian and one Asian. SUA was associated with age (r=0.38, P=0.0001) and BMI Z-score (r=0.23, P=0.021). SUA was significantly associated with mean ambulatory systolic (S) and diastolic (D) BP. Mean ambulatory BP was normalized to gender- and height-specific reference standards using BP index. SUA was significantly associated with 24-h DBP index and nocturnal DBP index after adjusting for age, gender, race, BMI Z-score and urinary sodium excretion. SUA was also significantly associated with 24-h DBP load and nocturnal DBP load. Uric acid was significantly associated with increased likelihood for diastolic HTN (OR 2.1, CI 1.2, 3.7; P=0.0063) after adjusting for other co-variables. Among children at risk for HTN, the likelihood for diastolic HTN (as defined by ambulatory blood pressure monitoring) increases significantly as SUA increases. SUA may be associated with increased severity of HTN during youth.