Abstract
BackgroundCirculating 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).MethodsIn 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.ResultsChildren 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.ConclusionsThis study reveals that in children with primary hypertension, arterial damage is related to lower fetuin A concentrations.Graphical abstract
Highlights
Primary hypertension (PH) is a complex systemic disorder involving in its pathogenesis genetic factors, environmental factors, inappropriate body composition and fatty tissue distribution, Increased arterial stiffness and abnormal common carotid artery intima-media thickness have been recognized as independent risk factors for cardiovascular morbidity and mortality in adult populations [2, 3]
primary hypertension (PH) patients did not differ from healthy children in terms of sex, age, and kidney function, as well as total and low-density lipoprotein (LDL) cholesterol
When we analyzed subclinical inflammation markers, we found that PH children had significantly higher NLR (1.49 (1.18–2.06) vs. 1.20 (0.89– 1.53), P = 0.040) without differences in mean platelet volume (MPV) and PLR in comparison to the control group
Summary
Primary hypertension (PH) is a complex systemic disorder involving in its pathogenesis genetic factors, environmental factors (e.g., sedentary lifestyle, high-sodium diet), inappropriate body composition and fatty tissue distribution, Increased arterial stiffness and abnormal common carotid artery intima-media thickness (cIMT) have been recognized as independent risk factors for cardiovascular morbidity and mortality in adult populations [2, 3]. Fetuin-A (FA) (α2-Heremans-Schmid glycoprotein) is a soluble glycoprotein produced exclusively by hepatocytes and released into the circulation in high concentrations. It is involved in several functions, such as endocytosis, brain development, insulin resistance, and formation of bone tissue, and shows negative correlations with systemic and local inflammation. 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. 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
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