Elevated blood pressure in obese children: influence of gender, age, weight and serum insulin levels.

Prepubescent and early pubescent obese children (n = 114, mean percent IBW = 165, mean age 7.3 years) were studied to determine the relationship of weight (WT), percent of ideal body weight (percent IBW), gender, and insulin (I) to systolic (SBP) and diastolic (DBP) blood pressure. Subjects were assessed for weight, height, percent IBW, systolic and diastolic blood pressure, and Tanner stage; subjects with Tanner stage greater than 3 were excluded. Multiple regression revealed that body weight accounted for the greatest variance in SBP (adj. R2 = 0.34, P less than 0.05), followed by the age. For DBP, weight also accounted for the greatest variance (adj. R2 = 0.16, P less than 0.05) followed by gender. A subgroup (n = 50) was evaluated for oral glucose tolerance. Subjects ingested 1.75 g glucose (GLU)/kg weight and had blood samples drawn at 0, 30, 60, 90, 120 and 180 min. Pearson correlations showed SBP correlated significantly to I at 0 (r = 0.44) and the total integrated area for insulin (r = 0.45); however, adjusting SBP for age by using z-score transformations negated all correlations between SBP and insulin. GLU at 0 and the total integrated area were not significantly correlated to SBP or DBP in absolute or age-adjusted terms. These data on prepubescent, nondiabetic, obese children suggest an association between insulin and elevations in SBP, but not DBP, that is largely due to a mutual association between age and weight. Also, insulin resistance as reflected in GLU response was not related to SBP or DBP.