3/2019
vol. 44
abstract:
Clinical immunology
Markers of endothelial injury and subclinical inflammation in children and adolescents with primary hypertension
Piotr Skrzypczyk , Anna Ozimek , Anna Ofiara , Michał Szyszka , Jarosław Sołtyski , Anna Stelmaszczyk-Emmel , Elżbieta Górska , Małgorzata Pańczyk-Tomaszewska
(Centr Eur J Immunol 2019; 44 (3): 253-261)
Online publish date: 2019/09/30
Introduction Adhesion molecules: E-selectin and intercellular adhesion molecule 1 (ICAM-1) are well-established markers of endothelial injury. The aim of the study was to assess the relation between E-selectin and ICAM-1 and clinical and biochemical parameters in children and adolescents with primary hypertension (PH).
Material and methods In 77 patients with PH (15.04 ±2.62 years, 50 boys, 27 girls) we evaluated serum E-selectin, ICAM-1, and selected clinical and biochemical parameters including inflammatory indicators and ambulatory blood pressure monitoring (ABPM).
Results The E-selectin concentration was 55.63 ±26.49 ng/ml and the ICAM-1 concentration was 302.17 ±67.14 ng/ml. E-selectin and ICAM-1 correlated (p < 0.05) with BMI Z-score (r = 0.24, r = 0.29), ICAM-1 also with uric acid (r = 0.35), HDL-cholesterol (r = –0.28), platelet-to-lymphocyte ratio (r = 0.26), and systolic and mean blood pressure variability (r = 0.24, r = 0.24); in boys ICAM-1 correlated with mean platelet volume (r = 0.29). In multivariate analysis the only significant predictor of E-selectin was mean arterial pressure during 24 hours (β = 0.329, 95% CI: 0.012-0.646) and of ICAM-1
– uric acid (β = 0.430, 95% CI: 0.040-0.819). In 27 children with newly diagnosed PH E-selectin correlated negatively with diastolic blood pressure dipping (r = –0.54, p = 0.004) and positively with ambulatory arterial stiffness index (r = 0.51, p = 0.012).
Conclusions Elevated mean arterial pressure and hyperuricemia are risk factors of endothelial damage in paediatric patients with primary hypertension. In children with untreated primary hypertension there may be a relation between endothelial damage and disturbed circadian blood pressure profile.
keywords:
children, ICAM-1, adolescents, E-selectin, endothelial injury, primary hypertension, subclinical inflammation
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