Metabolic syndrome and serum uric acid level in children and adolescents with hypertension.

Metabolic syndrome prevalence by IDF criteria was 14.5% in hypertensive children and adolescents, with higher rates in younger children.

• Study included 420 patients aged 10-18 years with hypertension confirmed by ambulatory blood pressure monitoring (ABPM).
• MS prevalence was 18.3% in children aged 10-15 years and 9.4% in those aged 16-18 years.
• All patients underwent anthropometric evaluation, office BP and ABPM measurements, and biochemical testing including serum uric acid.

Metabolic syndrome occurred significantly more often in primary hypertension than in secondary hypertension.

• MS prevalence was 17.7% in primary hypertension versus 5.5% in secondary hypertension (P = 0.003).
• Serum uric acid levels were also higher in primary vs. secondary hypertension (5.8 vs. 5.2 mg/dl; P < 0.001).

Children with metabolic syndrome had worse lipid profiles and higher serum uric acid levels compared to non-MS patients.

• MS patients had higher triglycerides and LDL compared to non-MS patients.
• HDL was lower in MS vs. non-MS patients (P < 0.001).
• Fasting plasma glucose was slightly higher in MS patients, though not statistically significant (P = 0.061).
• Serum uric acid levels were higher in MS vs. non-MS patients (6.3 vs. 5.5 mg/dl; P < 0.001).

Metabolic syndrome was associated with greater carotid intima-media thickness and more frequent left ventricular hypertrophy.

• MS patients had higher cIMT-SDS compared to non-MS patients (1.26 vs. 0.92; P = 0.012).
• Left ventricular hypertrophy was more frequent in MS vs. non-MS patients (42% vs. 29%; P = 0.08).
• Hypertension-mediated organ damage assessment included left ventricular mass index (LVMi), carotid intima-media thickness (cIMT), and pulse wave velocity (PWV).
• Results were consistent across both primary and secondary hypertension subgroups.

Adding uric acid to the metabolic syndrome definition improved prediction of left ventricular hypertrophy.

• Agreement for LVH prediction increased from κ = 0.086 with classical MS definition to κ = 0.190 when uric acid was added to the MS definition.
• The improvement in prediction was noted specifically for left ventricular hypertrophy among the hypertension-mediated organ damage outcomes assessed.