In obesity, cardiometabolic risk markers show worsening trends with increasing blood pressure (BP). We assumed that risk markers show similar trends across BP categories (normotension, high normal BP, hypertension) in metabolic abnormalities-free subjects (without obesity, insulin resistance, atherogenic dyslipidemia, hyperuricemia, microinflammation) and those presenting them. Data from 2547 (48.1% males) subjects aged 16-23 years were analyzed. The prevalence of males increased across BP categories. Forty-seven percent of individuals with elevated BP were metabolic abnormalities-free. Among 1461 metabolic abnormalities-free subjects, 9% had high normal BP, and 4% hypertension; among 1086 individuals presenting metabolic abnormalities, the prevalence reached 13% and 6%, respectively, (p < 0.001). Both groups displayed similar BP values in corresponding BP categories and significant trends in markers of adiposity, insulin resistance, HDL-cholesterol, atherogenic index of plasma, uric acid, adiponectinemia, and antioxidant capacity of plasma across BP categories. In metabolic abnormalities-free individuals, also significant trends in soluble receptors for advanced glycation end products were revealed. Continuous metabolic syndrome score, a measure of cardiometabolic risk, increased across BP categories regardless of presence or absence of metabolic abnormalities. Multivariate regression models selected male gender, fat-free mass, and uric acid as significant independent predictors for determining BP. Our data emphasize that having a BP outside the normal range significantly worsens risk for cardiometabolic disease in young individuals even if the thresholds for any of the risk factors are not exceeded. Longitudinal studies are needed to assess whether in patients with elevated BP the prognosis of adverse outcomes differs between those presenting and not presenting metabolic abnormalities.

中文翻译：

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有或没有代谢异常的 16-23 岁学生血压升高相关的心脏代谢危险因素和生物标志物。

在肥胖症中，心脏代谢风险标志物显示出随着血压 (BP) 升高而恶化的趋势。我们假设风险标志物在无代谢异常的受试者（无肥胖、胰岛素抵抗、致动脉粥样硬化性血脂异常、高尿酸血症、微炎症）和出现这些异常的受试者的血压类别（正常血压、正常高血压、高血压）中显示出相似的趋势。分析了 2547 名（48.1% 男性）年龄在 16-23 岁之间的受试者的数据。男性的患病率在 BP 类别中有所增加。47% 的血压升高的个体没有代谢异常。在 1461 名无代谢异常的受试者中，9% 的人血压正常值偏高，4% 的人患有高血压；在 1086 名出现代谢异常的个体中，患病率分别达到 13% 和 6%（p < 0.001）。两组在相应的 BP 类别中都显示出相似的 BP 值，并且在肥胖、胰岛素抵抗、高密度脂蛋白胆固醇、血浆动脉粥样硬化指数、尿酸、脂联素血症和血浆抗氧化能力的标志物方面具有显着趋势。在无代谢异常的个体中，还揭示了晚期糖基化终产物的可溶性受体的显着趋势。无论是否存在代谢异常，连续代谢综合征评分（衡量心脏代谢风险的指标）在 BP 类别中均有所增加。多变量回归模型选择男性、无脂肪质量和尿酸作为确定血压的重要独立预测因子。我们的数据强调，即使没有超过任何风险因素的阈值，血压超出正常范围也会显着增加年轻人患心脏代谢疾病的风险。需要进行纵向研究来评估血压升高患者的不良结局预后是否在出现和未出现代谢异常的患者之间有所不同。