肥胖儿童高血压发病因素和机理的研究

Pathogenic Factors and Mechanism of Hypertension in Obese Children

目的:探讨儿童肥胖引起高血压的机制。方法:测定104例12～16岁中学儿童的血脂、胰岛素水平,Na^+K^+ATP酶和Ca^(2+)-ATP酶活性。结果:在正常血压肥胖组(ONT)和高血压肥胖组(OHT),空腹胰岛素(Ins)显著升高,而Na^+-K^+-ATP酶和Ca^(2+)-ATP酶活性显著下降,三者在ONT和OHT组之间也有显著性差异;在OHT组Ins升高,两酶活性下降。Pearson相关和多元回归分析显示,在OHT组,Ins和Ca^(2+)-ATP酶与收缩压(SBP)显著相关,Na^+-K^+-ATP酶与舒张压(DBP)显著相关。结论:高胰岛素血症、Na^+-K^+-ATP酶和Ca^(2+)-ATP酶活性降低可能在肥胖儿童高血压的发病机制中起重要作用。

Objective:To explore the mechanism of obesity-induced hypertension in children. Methods:The levels of serum lipid, serum insulin (Ins) and cell membrane ATPase activities were measured in 104 middle school children aged 12~16 years. Results:The level of serum Ins was significantly higher,and the activities of Na+ -K+ -ATPase and Ca2+ -ATPase were significantly lower in obese normotensive (ONT) and obese hypertensive (OHT) children than those in normal children. There were also significant differences in them between ONT and OHT children, the level of serum Ins was increased and the activities of the two ATPases were lowered in OHT children. Pearson correlation and multiple regression analysis shown that the level of Ins and the activity of Ca2+ -ATPase were correlated with systolic pressure and the activity of Na+ -K+ -ATPase was correlated with diastolic pressure in OHT children. Conclusion: Hyperinsulinemia and decreased activities of Na+ -K+-ATPse and Ca2+ -ATPase may play important roles in pathogenesis of hypertension in obese children.