Artículo de revista
Cortisol/cortisone ratio and matrix metalloproteinase-9 activity are associated with pediatric primary hypertension
Fecha
2016Registro en:
Journal of Hypertension Volumen: 34 Número: 9 Páginas: 1808-1814
10.1097/HJH.0000000000001017
Autor
Martínez Aguayo, Alejandro
Campino, Carmen
Baudrand, René
Carvajal, Cristian
Garcia, Hernán
Aglony, Marlene
Bancalari, Rodrigo
García Nannig, Lorena
Loureiro, Carolina
Vecchiola, Andrea
Tapia Castillo, Alejandra
Valdivia, Carolina
Sanhueza, Sebastián
Fuentes, Cristóbal
Lagos, Carlos F.
Solari, Sandra
Allende, Fidel
Kalergis, Alexis
Fardella, Carlos E.
Institución
Resumen
Objective: To identify novel biomarkers associated with pediatric primary hypertension.
Methods: We recruited 350 participants (4-16 years). Anthropometric parameters and aldosterone, plasma renin activity, cortisol, cortisone, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), high-sensitivity C-reactive protein, adiponectin, IL-6, plasminogen activator inhibitor type 1 levels and matrix metalloproteinase-9 and matrix metalloproteinase-2 (MMP-9 and MMP-2) activities were measured. Genomic DNA was isolated. Patients with altered glucose metabolism, severe obesity [BMI-SD score (BMI-SDS)> 2.51, renovascular disease, primary aldosteronism and apparent mineralocorticoid excess syndrome were excluded.
Results: In selected participants (n = 320), SBP was positively correlated with BMI-SDS (r = 0.382, P < 0.001), HOMA-IR (r = 0.211, P<0.001), MMP-9 activity (r = 0.215, P< 0.001) and the cortisol/cortisone ratio (r = 0.231, P< 0.001). DBP showed similar correlations with these variables. No correlation was observed with aldosterone or plasma renin activity. Participants were categorized as hypertensive (n = 59) or nonhypertensive (n = 261). In the univariate analysis, hypertensive patients had higher BMISDS (P<0.001), HOMA-IR (P<0.001), high-sensitivity C reactive protein (P < 0.001), MMP-9 activity (P< 0.001), plasminogen activator inhibitor type 1 (P<0.001) and cortisol/cortisone ratio (P < 0.001) than nonhypertensive patients. Multiple regression analysis showed that the variables that remained associated with hypertension were higher BMI-SDS [odds ratio (OR)=3.74; 95% confidence interval (CI)=1.84-7.581, a higher cortisol/cortisone ratio (OR=3.92; 95% Cl= 1.98-7.71) and increased MMP-9 activity (OR=4.23; 95% C1=2.15-8,32).
Conclusion: We report that MMP-9 activity and the cortisol/cortisone ratio were higher in pediatric primary hypertensive patients, and these associations were independent of the effect of obesity. The potential role of these novel biomarkers in predicting hypertension risk and blood pressure regulation warrants further investigation