Serum markers of inflammation and endothelial activation in children with obesity-related hypertension

OBJECTIVES: It has been suggested that a rise in blood pressure (BP) causes low-grade inflammation of the endothelium which, in turn, may be responsible for further damage of endothelium and worsening of BP control. The aim of the study was to evaluate serum levels of inflammation and endothelial activation markers in children with obesity-related hypertension and normotensive controls in relation to other traditional risk factors of arterial hypertension. METHODS: Plasma insulin, glucose, C-reactive protein (CRP), fibrinogen (FB) interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and lipids levels were determined in 50 children with obesity-related hypertension and 143 obese children with normal BP. Insulin resistance was assessed by the homeostasis model. RESULTS: Children with hypertension had significantly higher levels of all inflammatory markers as well as endothelial activation indices compared with normotensive subjects. In the stepwise regression model significant independent correlates for systolic BP were CRP, FB, VCAM-1, HOMA IR, LDL cholesterol and fat mass, whereas CRP, IL-6, ICAM-1, FB, LDL and HDL cholesterol were the determinants of diastolic BP in children with obesity-related hypertension. CONCLUSION: These results indicate that low-grade inflammation and endothelial dysfunction are closely involved in the pathogenesis of obesity-related hypertension relatively early in life.