American Journal of Epidemiology Vol. 140, No. 2: 123-131
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Familial and Metabolic Factors Related to Blood Pressure in Pima Indian Children
1Diabetes and Arthritis Epidemiology Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases Phoenix, AZ
2Present address:H{ring}pital Henri Mondor 51 ab du Maréchal de Lattre de Passigny, 94,000 Crétell, France
3Present address:Department of Medicine, School of Medicine, University of Southern California Los Angeles, CA
High blood pressure, abnormal glucose tolerance, and obesity are frequently associated with each other, but the mechanism of these associations is poorly understood. Studying them in children may help in understanding the pathogenesis of hypertension. Blood pressure, height, weight, and plasma glucose and serum insulin concentrations during a 75-g oral glucose tolerance test were measured in 1,698 Pima Indian children aged 6–17 years who participated in an ongoing epidemiologic study. Weight relative to height was used as an index of obesity. The parents of many of the children were also examined. Fasting and 2-hour glucose and insulin concentrations, adjusted for age, sex, and relative weight, were positively related to systolic blood pressure but not to diastolic blood pressure. Relative weight, 2-hour glucose, and fasting insulin concentrations were independently and significantly associated with systolic blood pressure in a stepwise regression analysis that included age and sex. After parental hypertension was taken into account, maternal but not paternal non-insulin-dependent diabetes mellitus, controlled for the child's relative weight and glucose and insulin concentrations, was significantly associated with higher blood pressure in children. The stronger association with maternal diabetes suggests a greater sharing of environmental factors between mother and child than between father and child, but familial similarities in obesity and glucose and insulin concentrations, the diabetic intrauterine milieu, and shared environmental factors probably all contribute to this association.
blood pressure; child; diabetes mellitus,; non-insulin-dependent; family characteristics; glucose; hypertension; insulin; obesity
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