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(Hypertension. 2002;40:18.)
© 2002 American Heart Association, Inc.
Scientific Contributions |
From the Institute for Health Promotion and Disease Prevention Research and Departments of Preventive Medicine and Physiology and Biophysics, Keck School of Medicine, University of Southern California (M.L.C., T.T-K.H., M.I.G.), Los Angeles; and Division of Physiology and Metabolism, Department of Nutrition Sciences, School of Health-Related Professions, University of Alabama at Birmingham (M.S.J., B.A.G.).
Correspondence to Michael I. Goran, Professor of Preventive Medicine and Physiology and Biophysics, University of Southern California, 1540 Alcazar St, CHP Room 208-D, Los Angeles, CA 90089-9008. E-mail goran{at}usc.edu
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.
Key Words: insulin resistance blood pressure ethnicity children
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