Serum Renalase Levels in Children with Essential Hypertension

H. Yakut, Ali Ata Çerkezoğlu, U. Bayrakçı, I. Cetin
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Abstract

Objective: Left ventricular hypertrophy is the most commonly studied index for hypertension related target organ damage due to the wide usage of echocardiography. Renalase is a monoamine oxidase, mainly produced by the kidneys, regulating blood pressure by reducing catecholamines and acting on cardiovascular functions. In this study, the relationship between serum renalase level and hypertensive cardiac changes in children with essential hypertension was compared with the healthy control group. Materials and Methods: A total of 60 hypertensive children (female/male 20/40) aged between 4-18 years (mean 15.1 ± 1.9 years) were included in the study. Twenty healthy children with normal body mass index (4-18, mean14.2 ± 1.3 years) and similar gender (female/male 10/10) formed the control group. In 30 of hypertensive children (female/male: 9/21), echocardiography showed left ventricular hypertrophy. Echocardiographic findings of 30 remaining hypertensive patients (female/male: 11/19) were normal. A venous blood sample was collected from the hypertensive groups for biochemical examinations and renalase level. Urine samples and 24-hour urine samples were collected. 24-hour ambulatory blood pressure monitoring (ABPM) was used to measure blood pressure of hypertensive groups. The cardiac evaluation of hypertensive groups was performed using M-mode echocardiography. Results: The body mass index was significantly higher in hypertensive groups than the group with normal blood pressure (p <0.05). In comparison of hypertensive groups, no significant difference was found in terms of body mass index. All day systolic, diastolic; night systolic, diastolic, and daytime systolic blood pressure loads were significantly higher in hypertensive left-ventricular hypertrophic group than hypertensive non-hypertrophic group (p <0.05). Left ventricular mass index in M-mode echocardiography, revealed 39.7 g/m2 in the left ventricular hypertrophic group and 27.9 g/m2 in the hypertensive non-hypertrophic group (p <0.05). When the relationship between blood pressure loads and left ventricular mass index was compared between the groups, a significant correlation was found between daytime systolic blood pressure load and increased left ventricular mass index (p <0.05). Renalase level was significantly lower in hypertensive groups compared to normotensive group (p <0.05). There is a relationship between renalase deficiency and increased left ventricular mass index. Conclusion: There is a correlation between renalase deficiency and increased left ventricular mass index. We believe that utilization of low renalase levels as an early marker may be a useful and valuable parameter for determining the patients at risk for left ventricular hypertrophy and long-term complications of hypertension
原发性高血压患儿血清Renalase水平
目的:由于超声心动图的广泛应用,左心室肥厚是高血压相关靶器官损害最常用的指标。Renalase是一种单胺氧化酶,主要由肾脏产生,通过降低儿茶酚胺来调节血压,并作用于心血管功能。本研究比较了原发性高血压患儿血清renalase水平与高血压心脏变化的关系。材料与方法:选取年龄4 ~ 18岁(平均15.1±1.9岁)的高血压儿童60例(女/男20/40)。对照组为体重指数正常(4 ~ 18岁,平均14.2±1.3岁)、性别相近(女/男10/10)的健康儿童20例。30例高血压儿童(女/男:9/21)超声心动图显示左心室肥厚。其余30例高血压患者超声心动图显示正常(女/男:11/19)。采集高血压组静脉血进行生化检查和再酶水平测定。采集尿样和24小时尿样。采用24小时动态血压监测(ABPM)测量高血压组血压。采用m型超声心动图对高血压组进行心脏评价。结果:高血压组体重指数明显高于血压正常组(p <0.05)。与高血压组比较,体重指数无明显差异。全天收缩期,舒张期;高血压左室肥厚组夜间收缩压、舒张压和日间收缩压负荷均显著高于非肥厚组(p <0.05)。m型超声心动图左室质量指数:肥厚组39.7 g/m2,非肥厚组27.9 g/m2 (p <0.05)。比较各组血压负荷与左室质量指数的关系,发现白天收缩压负荷与左室质量指数升高有显著相关(p <0.05)。高血压组Renalase水平明显低于正常组(p <0.05)。renalase缺乏与左心室质量指数升高之间存在相关性。结论:肾再酶缺乏与左室质量指数升高有相关性。我们认为,利用低renalase水平作为早期标记可能是确定患者左心室肥厚和高血压长期并发症风险的有用和有价值的参数
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