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Insulin sensitivity and blood pressure in black and white children
Martha L Cruz1, Terry T-K Huang, Maria S Johnson
1Institute for Health Promotion and Disease Prevention Research and Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles 90089-9008, USA.
Insights
Insulin sensitivity is linked to higher systolic blood pressure in children, independent of body composition. Black children exhibit higher blood pressure than white children, a difference not explained by body composition or insulin sensitivity.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Insulin sensitivity is associated with hypertension in adults, but its role in pediatric hypertension across ethnic groups is not well understood.
- Understanding these relationships in children is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To investigate the relationship between body composition, insulin sensitivity, and blood pressure in children.
- To determine if body composition and/or insulin sensitivity explain blood pressure differences between white and black children.
Main Methods:
- Utilized the minimal model to assess insulin sensitivity and acute insulin response.
- Employed dual-energy X-ray absorptiometry for body composition analysis.
- Measured blood pressure in children while in a supine position.
Main Results:
- Positive correlations were found between body composition, fasting insulin, acute insulin response, and systolic blood pressure.
- Insulin sensitivity showed a negative association with systolic blood pressure, even after adjusting for body composition.
- Black children had significantly higher systolic and diastolic blood pressure compared to white children, irrespective of body composition or insulin sensitivity.
Conclusions:
- The inverse relationship between insulin sensitivity and systolic blood pressure is present in childhood.
- Black ethnicity and diminished insulin sensitivity are independent risk factors for elevated blood pressure in children.
Abstract:
Although insulin sensitivity is correlated with high blood pressure in adults, it is unclear whether such a relationship exists in children across ethnic groups. Therefore, the aims of the study were to establish (1) if body composition and insulin sensitivity were related to blood pressure in children, and (2) if any differences in blood pressure between white and black children were explained by body composition and/or insulin sensitivity. Insulin sensitivity and the acute insulin response were established by the minimal model and body composition by dual-energy X-ray absorptiometry. Blood pressure was recorded in the supine position. Body composition, fasting insulin (P<0.01), and the acute insulin response (P<0.05) were positively related to systolic blood pressure but not to diastolic blood pressure, and insulin sensitivity (P<0.001) was negatively related to systolic blood pressure but not to diastolic blood pressure. Insulin sensitivity was negatively associated with systolic and diastolic blood pressure after adjustment for body composition (P<0.01). Black children had higher systolic (110+/-9.2 versus 105+/-8.5 mm Hg, P=0.01) and diastolic (59+/-7.0 versus 54+/-8.0 mm Hg, P<0.01) blood pressure than did white children. The ethnic difference in blood pressure was not explained by body composition, fasting insulin, acute insulin response, or insulin sensitivity. In conclusion, the relationship between insulin sensitivity and systolic blood pressure is evident early in life. Black ethnicity and low insulin sensitivity contribute independently to higher blood pressure in children.