Exp Clin Endocrinol Diabetes 2013; 121 - P24
DOI: 10.1055/s-0033-1336694

11β-Hydroxysteroid-dehydrogenase type 2 and dietary acid load are independently associated with blood pressure in healthy children and adolescents

D Krupp 1, L Shi 1, C Maser-Gluth 2, M Pietzarka 1, T Remer 1
  • 1IEL-Ernährungsepidemiologie, Universität Bonn, DONALD Studie am Forschungsinstitut für Kinderernährung, Dortmund, Germany
  • 2Universität Heidelberg, Steroidlabor, Pharmakologisches Institut, Heidelberg, Germany

Aims: Hypertension represents a major cardiovascular risk factor. Reduced activity of 11β-Hydroxysteroid-Dehydrogenase Type 2 (11βHSD2) contributes to elevated BP in clinical syndromes but its impact on BP in the physiological range is unclear. Diet is an additional important influencing factor for BP-development and recent observational studies suggest that a higher dietary acid load may adversely affect BP in the long term.

Objective: Objectives of the study were to examine the association of 11βHSD2-activity with BP-levels in healthy children independent of known BP-related dietary and other factors and to determine whether diet-dependent acid load may constitute a dietary factor associated with BP in this age group.

Methods: We conducted a cross-sectional analysis in 267 children (4 – 14y), who provided a 24-h urine, a parallel 3-d weighed dietary record and 1 – 3 BP-measurements ± 1.5y around the urine collection. The ratio of urinary free cortisone to cortisol, determined with a radioimmunometric assay, was used as an index for 11βHSD2. Urinary Net Acid Excretion as well as urinary and dietary Potential Renal Acid Load (PRAL) were used to predict diet-dependent acid load. PRAL was calculated as the sum of major mineral nonbicarbonate anions minus the sum of mineral cations. Sex-, age- and height independent SD scores (SDS) of systolic and diastolic BP were used as outcomes in linear regression analyses.

Results: 11βHSD2 was inversely associated with systolic BP-SDS in basic models and in analyses adjusted for body size, maternal BP, breast feeding, dietary intakes of total energy and salt as well as dietary acid load (P < 0.02). Concurrently, dietary PRAL and both urinary acid load biomarkers were all significantly (P = 0.006 – 0.02) directly related to systolic BP.

Conclusion: Lower 11βHSD2-activity and higher dietary acid load may independently contribute to higher systolic BP in healthy children.