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High-sensitivity C-reactive protein and mean platelet volume in paediatric hypertension

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Abstract

The purpose of the study was to investigate serum uric acid (SUA), high-sensitivity C-reactive protein (hs-CRP) and mean platelet volume (MPV) in pre-hypertensive (PH) and hypertensive (HT) children and adolescents. The study group consisted of 80 patients aged 10–19 years subdivided into PH and HT groups according to mean daytime or night-time systolic or diastolic blood pressure (BP) levels (>90th percentile, but <95th percentile and ≥95th percentile, respectively). The control group (C) contained 25 normotensive subjects. Serum hs-CRP level was determined by a nephelometric method (Behring); platelets (PLTs) were counted, and MPV was assessed by a Coulter Analyzer MAXM. SUA was measured with an Hitachi instrument. The median SUA and hs-CRP levels in PH and HT subjects were significantly higher than those of the controls (P < 0.01) and were higher in the HT group than in the PH group (P < 0.05). An increase in SUA above 5.5 mg/dl was associated with an increase in hs-CRP [odds ratio (OR) 4.8; confidence interval (CI) 1.3–17.4; P < 0.01]. MPV values in the PH group did not differ from those of the controls (P > 0.05), but it was significantly higher in HT patients (P < 0.01). Serum hs-CRP and MPV concentrations were positively correlated with all BP measurements except night-time diastolic blood pressure (DBP). We demonstrated that, in HT children and adolescents, increased SUA with a parallel increase in hs-CRP and PLTs with MPV is observed. Although large, multicentre, prospective studies are needed to confirm this observation, hyperuricaemia seems to be associated with an increase in hs-CRP in PH and HT patients.

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References

  1. Backes JM, Howard PA, Moriarty PM (2004) Role of C-reactive protein in cardiovascular disease. Ann Pharmacother 38:110–118

    Article  CAS  PubMed  Google Scholar 

  2. Feig DI, Johnson RJ (2007) The role of uric acid in pediatric hypertension. J Ren Nutr 17:79–83

    Article  PubMed  Google Scholar 

  3. Jossa F, Farinaro E, Panico S, Krogh V, Celentano E, Galasso R, Mancini M, Trevisan M (1994) Serum uric acid and hypertension: the Olivetti heart study. J Hum Hypertens 8:677–681

    CAS  PubMed  Google Scholar 

  4. Alper AB Jr, Chen W, Yau L, Srinivasan SR, Berenson GS, Hamm LL (2005) Childhood uric acid predicts adult blood pressure: the Bogalusa Heart Study. Hypertension 45:34–38

    CAS  PubMed  Google Scholar 

  5. Menè P, Punzo G (2008) Uric acid: bystander or culprit in hypertension and progressive renal disease? J Hypertens 26:2085–2092

    Article  PubMed  CAS  Google Scholar 

  6. Feig DI, Nakagawa T, Karumanchi SA, Oliver WJ, Kang DH, Finch J, Johnson RJ (2004) Hypothesis: uric acid, nephron number, and the pathogenesis of essential hypertension. Kidney Int 66:281–287

    Article  CAS  PubMed  Google Scholar 

  7. Rao GN, Corson MA, Berk BC (1991) Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem 266:8604–8608

    Google Scholar 

  8. Kang DH, Park SK, Lee IK, Johnson RJ (2005) Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 16:3553–3562

    Article  CAS  PubMed  Google Scholar 

  9. Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, Krotova K, Block ER, Prabhakar S, Johnson RJ (2005) Hyperuricemia induces endothelial dysfunction. Kidney Int 67:1739–1742

    Article  PubMed  Google Scholar 

  10. Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW (1999) C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction. A potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 19:972–978

    CAS  PubMed  Google Scholar 

  11. Retnakaran R, Zinman B, Connelly PW, Harris SB, Hanley AJ (2006) Nontraditional cardiovascular risk factors in pediatric metabolic syndrome. J Pediatr 148:176–182

    Article  PubMed  Google Scholar 

  12. Kim YG, Huang XR, Suga S, Mazzali M, Tang D, Metz C, Bucala R, Kivlighn S, Johnson RJ, Lan HY (2000) Involvement of macrophage migration inhibitory factor (MIF) in experimental uric acid nephropathy. Mol Med 6:837–848

    CAS  PubMed  Google Scholar 

  13. Bath PM, Butterworth RJ (1996) Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 7:157–161

    Article  CAS  PubMed  Google Scholar 

  14. Tschöpe D, Langer E, Schauseil S, Rösen P, Kaufmann L, Gries FA (1989) Increased platelet volume—sign of impaired thrombopoiesis in diabetes mellitus. Klin Wochenschr 67:253–259

    Article  PubMed  Google Scholar 

  15. Senaran H, Ileri M, Altinbaş A, Koşar A, Yetkin E, Oztürk M, Karaaslan Y, Kirazli S (2001) Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 24:405–408

    Article  CAS  PubMed  Google Scholar 

  16. Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY (2004) Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol 44:415–422

    Article  PubMed  Google Scholar 

  17. van der Loo B, Martin JF (1997) Megakaryocytes and platelets in vascular disease. Baillieres Clin Haematol 10:109–123

    Article  PubMed  Google Scholar 

  18. Graessler J, Graessler A, Unger S, Kopprasch S, Tausche AK, Kuhlisch E, Schroeder HE (2006) Association of the human urate transporter 1 with reduced renal uric acid excretion and hyperuricemia in a German Caucasian population. Arthritis Rheum 54:292–300

    Article  CAS  PubMed  Google Scholar 

  19. Neilson EG (2007) The fructose nation. J Am Soc Nephrol 18:2619–2621

    Article  PubMed  Google Scholar 

  20. Taniguchi Y, Hayashi T, Tsumura K, Endo G, Fujii S, Okada K (2001) Serum uric acid and the risk for hypertension and type 2 diabetes in Japanese men. The Osaka Health Survey. J Hypertens 19:1209–1215

    Article  CAS  PubMed  Google Scholar 

  21. Kułaga Z, Litwin M, Zajączkowska M, Wasilewska A, Tkaczyk M, Gurzkowska G, Świąder A, Różdżyńska A, Napieralska E, Grajda A, Barwicka K, Researchers OLAF (2009) Regional differences of anthropometric parameters and arterial blood pressure in pupils aged 7–18 years. Probl Hig Epidemiol 90:32–41

    Google Scholar 

  22. Nawarycz T, Ostrowska-Nawarycz L (2007) Body mass index in the school age children and youth from the city of Lodz. Pol Merkuriusz Lek 23:264–270

    Google Scholar 

  23. Verdecchia P, Schillaci G, Reboldi G, Santeusanio F, Porcellati C, Brunetti P (2000) Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study. Hypertension 36:1072–1078

    CAS  PubMed  Google Scholar 

  24. Soergel M, Kirschstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W (1997) Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 130:178–184

    Article  CAS  PubMed  Google Scholar 

  25. Wühl E, Witte K, Soergel M, Mehls O, Schaefer F; German Working Group on Pediatric Hypertension (2002) Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 20:1995–2007

    Article  Google Scholar 

  26. Morgenstern B Z, Butani L (2004) Casual blood pressure measurement methodology. In: Portman R, Sorof J, Ingelfinger J (eds) Pediatric Hypertension, Totowa, NJ: Humana Press, pp. 77–97

  27. Sorof J, Daniels S (2002) Obesity hypertension in children: a problem of epidemic proportions. Hypertension 40:441–447

    Article  CAS  PubMed  Google Scholar 

  28. Johnson RJ, Titte S, Cade JR, Rideout BA, Oliver WJ (2005) Uric acid, evolution and primitive cultures. Semin Nephrol 25:3–8

    Article  CAS  PubMed  Google Scholar 

  29. Sundström J, Sullivan L, D’Agostino RB, Levy D, Kannel WB, Vasan RS (2005) Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension 45:28–33

    PubMed  Google Scholar 

  30. Rovda IuI, Kazakova LM, Plaksina EA (1999) Parameters of uric acid metabolism in healthy children and in patients with arterial hypertension. Pediatriia 8:19–22

    Google Scholar 

  31. Jones DP, Richey PA, Alpert BS, Li R (2008) Serum uric acid and ambulatory blood pressure in children with primary hypertension. Pediatr Res 64:556–561

    Article  CAS  PubMed  Google Scholar 

  32. Hoeschen RJ (1997) Oxidative stress and cardiovascular disease. Can J Cardiol 13:1021–1025

    CAS  PubMed  Google Scholar 

  33. Boogaerts MA, Hammerschmidt DE, Roelant C, Verwilghen RL, Jacob HS (1983) Mechanisms of vascular damage in gout and oxalosis: crystal induced, granulocyte mediated, endothelial injury. Thromb Haemost 50:576–580

    CAS  PubMed  Google Scholar 

  34. Leyva F, Anker SD, Godsland IF, Teixeira M, Hellewell PG, Kox WJ, Poole-Wilson PA, Coats AJ (1998) Uric acid in chronic heart failure: a marker of chronic inflammation. Eur Heart J 19:1814–1822

    Article  CAS  PubMed  Google Scholar 

  35. Sung KC, Suh JY, Kim BS, Kang JH, Kim H, Lee MH, Park JR, Kim SW (2003) High sensitivity C-reactive protein as an independent risk factor for essential hypertension. Am J Hypertens 16:429–433

    Article  CAS  PubMed  Google Scholar 

  36. Lande MB, Pearson TA, Vermilion RP, Auinger P, Fernandez ID (2008) Elevated blood pressure, race/ethnicity, and C-reactive protein levels in children and adolescents. Pediatrics 122:1252–1257

    Article  PubMed  Google Scholar 

  37. Semiz S, Rota S, Ozdemir O, Ozdemir A, Kaptanoğlu B (2008) Are C-reactive protein and homocysteine cardiovascular risk factors in obese children and adolescents? Pediatr Int 50:419–423

    Article  CAS  PubMed  Google Scholar 

  38. Soriano-Guillén L, Hernández-García B, Pita J, Domínguez-Garrido N, Del Río-Camacho G, Rovira A (2008) High-sensitivity C-reactive protein is a good marker of cardiovascular risk In obese children and adolescents. Eur J Endocrinol 159:R1–R4

    Article  PubMed  CAS  Google Scholar 

  39. Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM (2003) C-reactive protein and the risk of developing hypertension. JAMA 290:2945–2951

    Article  CAS  PubMed  Google Scholar 

  40. Intengan HD, Schiffrin EL (2001) Vascular remodeling in hypertension: roles of apoptosis, inflammation, and fibrosis. Hypertension 38:581–587

    Article  CAS  PubMed  Google Scholar 

  41. Tatasciore A, Zimarino M, Renda G, Zurro M, Soccio M, Prontera C, Emdin M, Flacco M, Schillaci G, DE Caterina R (2008) Awake blood pressure variability, inflammatory markers and target organ damage in newly diagnosed hypertension. Hypertens Res 31:2137–2146

    Article  CAS  PubMed  Google Scholar 

  42. Abramson JL, Lewis C, Murrah NV, Anderson GT, Vaccarino V (2006) Relation of C-reactive protein and tumor necrosis factor-alpha to ambulatory blood pressure variability in healthy adults. Am J Cardiol 98:649–652

    Article  CAS  PubMed  Google Scholar 

  43. Kaya MG, Yarlioglues M, Gunebakmaz O, Gunturk E, Inanc T, Dogan A, Kalay N, Topsakal R (2010) Platelet activation and inflammatory response in patients with non-dipper hypertension. Atherosclerosis 209:278–282

    Article  CAS  PubMed  Google Scholar 

  44. Andrioli G, Ortolani R, Fontana L, Gaino S, Bellavite P, Lechi C, Minuz P, Manzato F, Tridente G, Lechi A (1996) Study of platelet adhesion in patients with uncomplicated hypertension. J Hypertens 14:1215–1221

    Article  CAS  PubMed  Google Scholar 

  45. Bruschi G, Bruschi ME, Caroppo M, Orlandini G, Spaggiari M, Cavatorta A (1985) Cytoplasmic free [Ca2+] is increased in the platelets of spontaneously hypertensive rats and essential hypertensive patients. Clin Sci (Lond) 68:179–184

    CAS  Google Scholar 

  46. Erne P, Bolli P, Bürgisser E, Bühler FR (1984) Correlation of platelet calcium with blood pressure. Effect of antihypertensive therapy. N Engl J Med 310:1084–1088

    Article  CAS  PubMed  Google Scholar 

  47. Camilletti A, Moretti N, Giacchetti G, Faloia E, Martarelli D, Mantero F, Mazzanti L (2001) Decreased nitric oxide levels and increased calcium content in platelets of hypertensive patients. Am J Hypertens 14:382–386

    Article  CAS  PubMed  Google Scholar 

  48. Blann AD, Lip GY, Islim IF, Beevers DG (1997) Evidence of platelet activation in hypertension. J Hum Hypertens 11:607–609

    Article  CAS  PubMed  Google Scholar 

  49. Pathansali R, Smith NM, Bath PM (2001) Prothrombotic megakaryocyte and platelet changes in hypertension are reversed following treatment: a pilot study. Platelets 12:144–149

    Article  CAS  PubMed  Google Scholar 

  50. Yazici M, Kaya A, Kaya Y, Albayrak S, Cinemre H, Ozhan H (2009) Lifestyle modification decreases the mean platelet volume in prehypertensive patients. Platelets 20:58–63

    Article  CAS  PubMed  Google Scholar 

  51. Tavil Y, Sen N, Yazici HU, Hizal F, Abaci A, Cengel A (2007) Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res 120:245–250

    Article  CAS  PubMed  Google Scholar 

  52. Giles C, Inglis TC (1981) Thrombocytopenia and macrothrombocytosis in gestational hypertension. Br J Obstet Gynaecol 88:1115–1119

    CAS  PubMed  Google Scholar 

  53. Coban E, Yazicioglu G, Berkant Avci A, Akcit F (2005) The mean platelet volume in patients with essential and white coat hypertension. Platelets 16:435–438

    Article  CAS  PubMed  Google Scholar 

  54. Ross R (1999) Atherosclerosis is an inflammatory disease. Am Heart J 138:S419–S420

    Article  CAS  PubMed  Google Scholar 

  55. Dastjerdi MS, Emami T, Najafian A, Amini M (2006) Mean platelet volume measurement, EDTA or citrate? Hematology 11:317–319

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics and Nephrology, Medical University of Bialystok, ul. Waszyngtona 17, 15–274, Białystok, Poland

    Anna Wasilewska, Edyta Tenderenda, Katarzyna Taranta-Janusz & Walentyna Zoch-Zwierz

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  1. Anna Wasilewska
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  2. Edyta Tenderenda
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Correspondence to Anna Wasilewska.

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Wasilewska, A., Tenderenda, E., Taranta-Janusz, K. et al. High-sensitivity C-reactive protein and mean platelet volume in paediatric hypertension. Pediatr Nephrol 25, 1519–1527 (2010). https://doi.org/10.1007/s00467-010-1513-2

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