Cortisol Awakening Response in Saliva in Hypertensive Children with Metabolic Syndrome

Background: Earlier studies showed that hypertension (HTN) burdens the course of metabolic syndrome (Mets). One of the reasons for HTN may be sleep pathology, including frequent waking up, sleep apnoea etc. It is known that cortisol secretion shows profound circadian rhythmicity and responsiveness to physical activity and psychological stress factors. It is important to determine this cause of HTN to find the way of an individual treatment for children with metabolic syndrome.

Objective: The aim of this work is to compare the cortisol level in children with Mets associated with hypertension and without one.

Methods: A cross-sectional study was accomplished in a group of 30 children (10-17 years old) with the diagnosis of Mets according to IDF criteria Patients were classified into main group (15 patients with Mets and hypertension) and comparison group (15 children with Mets without hypertension). All children were measured by Body Mass Index (BMI) and 24-h ambulatory blood pressure monitoring was performed. The cortisol level was determined immediately upon awaking using the immunochemical testing method (Cobas 6000. Switherland) The statistical analysis was done using the SPSS 22.0.

Results: There were determinated significant difference (p = 0.014) between the mean BMI in children of the main group (30.65 ± 0.61) compared with the control group (28.71 ± 0.45).According to the results of the examination at the main group average value of early cortisol levels of saliva was significantly higher than in the comparison group (0,5±1,1 and 0.3±0,006, p <0.027).

Conclusion: Increased body mass index and elevated levels of early cortisol in children of the main group may indicate increased anxiety and sleep fragmentation in these children, which affects the development of hypertension