To study the relationship between metabolic syndrome and target organ damage of essential hypertension in adolescents.Design and Method:
From Jan. 2007 to Sup. 2015, 186 children were enrolled who were diagnosed as essential hypertension in Capital Institute of Pediatrics. All children received the following examinations: fundus oculi, electrocardiogram, echocardiography, serum triglyceride, glucose, insulin, C peptide, uric acid, renal function, urine microalbumin, and serum and urine β2-microglobulin. According the diagnostic criteria of metabolic syndrome defined by Chinese Pediatric Society of Chinese Medical Association in 2012, all children were divided into group with metabolic syndrome (Group A) and group without metabolic syndrome (Group B). All data were collected as standard procedure and analyzed using statistic methods.Results:
In all recruited adolescents, 41 patients had diagnosed as metabolic syndrome with the rate of 22.0%. The incidences of target organ damage in Group A was significantly higher than Group B (78% vs 61.4%, χ2 = 3.907, P = 0.048). Specially, the incidences of cardiovascular damage in Group A was much higher than Group B (36.6% vs 9.7%, χ2 = 17.641, P < 0.001). The average numbers of damaged target organ in Group A were significantly higher than that of Group B (1.2 ± 0.9 vs 0.8 ± 0.7, t = 2.576, P = 0.011). A ROC curve on the predictive value of fasting serum insulin concentration showed that the area under the curve was 0.638 (P < 0.05). Using a cutoff value for fasting serum insulin concentration of 15.05mIU/L produced sensitivity of 72.2% and specificity of 55.9% in predicting target organ damage, while the cutoff value of 14.81mIU/L produced sensitivity of 80.8% and specificity of 48.5% in predicting renal damage.Conclusions:
Adolescent essential hypertension complicated with metabolic syndrome had a much higher incidence of target organ damage than those without metabolic syndrome. Specially, cardiovascular damage was more common in those adolescents with metabolic syndrome. Fasting serum insulin concentration was very important for predicting target organ damage.