循环钙化抑制剂:胎球蛋白A(FA)和骨保护素(OPG)以及核因子κB受体激活剂(sRANKL)的可溶性配体与血管钙化和动脉损伤有关。本研究旨在评估FA,OPG,sRANKL,原发性高血压(PH)儿童的动脉损害。
在这项横断面单中心研究中,钙化抑制剂(FA,OPG,在60名PH儿童(中位年龄15.8,IQR:[14.5-16.8]岁)和20名年龄匹配的健康志愿者的血液样本中测量sRANKL)水平。在每个参与者中,对患者进行外周和中心血压评估(BP)和动态血压监测(ABPM).使用颈总动脉内膜中膜厚度(cIMT)测量动脉损伤,脉搏波速度(PWV),增强指数(AIx75HR),和局部动脉僵硬度(ECHO-tracking-ET)分析。
PH患儿的外周和中枢血压明显升高,BP在ABPM中,较厚的cIMT,更高的PWV,和AIx75HR。与健康同龄人相比,PH患者的FA显着降低,而OPG无差异,sRANKL,和OPG/sRANKL和OPG/FA比率。在患有PH的儿童中,FA水平与cIMTZ评分和ETAIx呈负相关;sRANKL水平与ABPM收缩压(SBP)呈负相关,SBP荷载,舒张压血压负荷,和AIx75HR;OPG/sRANKL比值与SBP负荷呈正相关,OPG/FA比值与ETAIx呈正相关。在多变量分析中,FA是cIMT(mm)和cIMTZ评分的重要决定因素。
这项研究表明,在患有原发性高血压的儿童中,动脉损伤与胎球蛋白A浓度降低有关。
Circulating calcification inhibitors: fetuin A (FA) and osteoprotegerin (OPG) together with soluble ligand of receptor activator of nuclear factor kappa-B (sRANKL) have been linked to vascular calcifications and arterial damage. This study aimed to evaluate relationships between FA, OPG, sRANKL, and arterial damage in children with primary hypertension (PH).
In this cross-sectional single-center study, calcification inhibitors (FA, OPG, sRANKL) levels were measured in blood samples of 60 children with PH (median age 15.8, IQR: [14.5-16.8] years) and 20 age-matched healthy volunteers. In each participant, peripheral and central blood pressure evaluation (BP) and ambulatory BP monitoring (ABPM) were performed. Arterial damage was measured using common carotid artery intima media thickness (cIMT), pulse wave velocity (PWV), augmentation index (AIx75HR), and local arterial stiffness (ECHO-tracking-ET) analysis.
Children with PH had significantly higher peripheral and central BP, BP in ABPM, thicker cIMT, higher PWV, and AIx75HR. FA was significantly lower in patients with PH compared to healthy peers without differences in OPG, sRANKL, and OPG/sRANKL and OPG/FA ratios. In children with PH, FA level correlated negatively with cIMT Z-score and ET AIx; sRANKL level correlated negatively with ABPM systolic blood pressure (SBP), SBP load, diastolic BP load, and AIx75HR; OPG/sRANKL ratio correlated positively with SBP load, while OPG/FA ratio correlated positively with ET AIx. In multivariate analysis, FA was a significant determinant of cIMT (mm) and cIMT Z-score.
This study reveals that in children with primary hypertension, arterial damage is related to lower fetuin A concentrations.