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Insulin resistance, prehypertension, hypertension and blood pressure values in paediatric age

Simonetta Genovesi1, Paolo Brambilla, Marco Giussani

  • 1Department of Clinical Medicine and Prevention, University of Milano-Bicocca and Nephrology Unit, San Gerardo Hospital, Monza, Italy. simonetta.genovesi@unimib.it

Journal of Hypertension
|December 20, 2011
PubMed

Insights

Insulin resistance, measured by the Homeostasis Model Assessment (HOMA) index, independently increases hypertension risk in children. This finding holds true even after accounting for body mass index (BMI) and waist-to-height ratio across all weight classes.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Cardiovascular Health

Background:

  • Childhood obesity and cardiovascular risk factors are rising concerns.
  • Insulin resistance is increasingly recognized as a key metabolic abnormality.
  • The independent contribution of insulin resistance to hypertension in children requires further elucidation.

Purpose of the Study:

  • To investigate the association between insulin resistance and the risk of prehypertension and hypertension in children.
  • To determine if insulin resistance impacts hypertension risk independently of obesity indicators like BMI and waist-to-height ratio.
  • To analyze these relationships across diverse weight classes in a pediatric cohort.

Main Methods:

  • A cohort of 377 children aged 10.5 ± 2.3 years with a hypertension diagnosis or family history was studied.
  • Insulin resistance was assessed using the Homeostasis Model Assessment (HOMA) index.
  • HOMA index was standardized using linear regression, incorporating BMI, waist-to-height ratio, and pubertal status.

Main Results:

  • Both BMI and waist-to-height ratio were confirmed as significant risk factors for prehypertension and hypertension.
  • The standardized HOMA index demonstrated an independent contribution to hypertension risk when analyzed alongside BMI or waist-to-height ratio.
  • An odds ratio of 1.23 was observed for HOMA index in multivariate models, indicating its independent predictive value.

Conclusions:

  • Insulin resistance is a significant independent predictor of hypertension in children.
  • This association persists regardless of obesity levels, body fat distribution, and pubertal status.
  • The findings underscore the importance of addressing insulin resistance in pediatric hypertension management.
Abstract

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