Objectives: To examine the serum level of free fatty acid (FFA) in children with primary hypertension and its value in the pathogenesis, prevention, and treatment of primary hypertension in children.
Methods: In this retrospective study, 34 children with primary hypertension who were treated for the first time in Children's Hospital Affiliated to Capital Institute of Pediatrics from January to June, 2021, were enrolled as the hypertension group, and 32 children with normal blood pressure who underwent physical examination during the same period were enrolled as the control group. The two groups were compared in terms of the levels of fasting serum FFA, fasting serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C). The multivariate logistic regression model was used to analyze the influence of FFA on the development of primary hypertension.
Results: Compared with the control group, the hypertension group had significantly higher body mass index (BMI), systolic blood pressure, and diastolic blood pressure (P<0.05), as well as significantly higher serum levels of FFA, TG, LDL-C, and non-HDL-C and a significantly lower serum level of HDL-C (P<0.05). Compared with the control group, the hypertension group had significantly higher rates of elevated serum FFA (>0.45 mmol/L for girls and >0.60 mmol/L for boys) (P<0.05) and abnormal blood lipid levels (abnormality in at least one index among serum TG, TC, LDL-C, HDL-C, and non-HDL-C) (P<0.05). A multivariate logistic regression equation was established based on age, sex, BMI, elevated serum FFA, and abnormal blood lipid levels, and the results showed that elevated serum FFA was an independent risk factor for primary hypertension in children (OR=17.560, 95%CI: 1.964-157.003, P<0.05).
Conclusions: There is a significant increase in serum FFA level in children with primary hypertension, and the increase in serum FFA can increase the risk of primary hypertension in children.
目的: 研究儿童原发性高血压血清游离脂肪酸（free fatty acid，FFA）的水平，探讨其在儿童原发性高血压发病和防治中的临床意义。方法: 回顾性选取2021年1—6月首都儿科研究所附属儿童医院初治的34例原发性高血压儿童为高血压组，以同期体检的血压正常儿童32例为对照组。比较2组的空腹血清FFA、空腹血清三酰甘油（triglyceride，TG）、总胆固醇（total cholesterol，TC）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）和非高密度脂蛋白胆固醇（non-high-density lipoprotein cholesterol，non-HDL-C）水平。采用多因素logistic回归分析探讨血清FFA对原发性高血压发病的影响。结果: 高血压组体重指数（body mass index，BMI）、收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）高于对照组，差异有统计学意义（P<0.05）。高血压组血清FFA、TG、LDL-C、non-HDL-C高于对照组，而血清HDL-C低于对照组，差异均有统计学意义（P<0.05）。高血压组血清FFA升高（女性>0.45 mmol/L，男性>0.60 mmol/L）率和传统血脂异常（血清TG、TC、LDL-C、HDL-C、non-HDL-C中至少一项异常）率均高于对照组，差异有统计学意义（P<0.05）。纳入年龄、性别、BMI、血清FFA升高、传统血脂异常等指标构建多因素logistic回归方程，结果显示血清FFA升高是儿童原发性高血压的独立危险因素（OR=17.560，95%CI：1.964~157.003，P<0.05）。结论: 原发性高血压儿童血清FFA明显升高；血清FFA升高可增加儿童原发性高血压的发病风险。.
Keywords: Child; Lipid metabolism disorder; Primary hypertension; Serum free fatty acid.