ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Cardiology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1585032
This article is part of the Research TopicRecent advances with orthostatic intolerance/tachycardia in children and adolescents: International perspectivesView all 4 articles
Correlation between Orthostatic Intolerance in Children and Levels of ACE2-Ang(1-7)-Mas Axis and Vitamin D
Provisionally accepted
- 1The Third Hospital of Changsha, Changsha, China
- 2Kaili First People's Hospital, Kaili, China
- 3Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
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Objective: To explore the correlation between orthostatic intolerance in children and levels of the ACE2-Ang (1-7)-Mas axis and vitamin D.Methods: Blood samples were collected from 84 children with orthostatic intolerance and 307 healthy controls. After matching for age and sex, 84 children from each group were studied. The orthostatic intolerance group was divided into vasovagal syncope (n=51) and postural orthostatic tachycardia syndrome (n=33). Fasting blood samples were analyzed for 25(OH)D, ACE2, Ang(1-7), and hydroxylases using ELISA.Results: (1) The orthostatic intolerance group had significantly lower levels of ACE2, Ang (1-7), 25(OH)D, and hydroxylases compared to controls (P< 0.05). ( 2) No sex differences in biomarker levels were found in the orthostatic intolerance group (P > 0.05), but boys in the control group had higher 25(OH)D levels (P< 0.001). ( 3) No significant differences between the two intolerance subgroups (p > 0.05). ( 4) Logistic regression showed lower levels of 25(OH)D, 25-hydroxylase, and Ang(1-7) correlated with higher orthostatic intolerance incidence. (5) Ang(1-7) levels of 19.39 ng/ml provided 86.9% sensitivity and 61.9% specificity for diagnosis. Conclusion: Reduced levels of Ang(1-7)/ACE2, 25(OH)D, and 25-hydroxylase are linked to orthostatic intolerance in children, highlighting vitamin D deficiency's role and suggesting Ang(1-7) and ACE2 as potential biomarkers. Sex does not significantly affect these biomarker levels.
Keywords: Orthostatic intolerance (OI), Angiotensin-converting enzyme 2 (ACE2), angiotensin (1-7), Vitamin D, 25-hydroxylase
Received: 28 Feb 2025; Accepted: 29 Apr 2025.
Copyright: © 2025 Xiao, Wu, Wang, He and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yao Xiao, The Third Hospital of Changsha, Changsha, China
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