Research Article Identification of Potential Metabolic Markers of Hypertension in Chinese Children Jiahong Sun , 1 Min Zhao , 2 Liu Yang , 1 Xue Liu , 1 Lucia Pacifico , 3 Claudio Chiesa , 4 andBoXi 1 1 Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China 2 Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China 3 Department of Maternal and Child Health, Sapienza University of Rome, Rome, Italy 4 Institute of Translational Pharmacology, National Research Council, Rome, Italy Correspondence should be addressed to Bo Xi; xibo2007@126.com Received 20 December 2020; Revised 14 July 2021; Accepted 16 August 2021; Published 25 August 2021 Academic Editor: Yimin Zhu Copyright © 2021 Jiahong Sun et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Studies in adults have shown that several metabolites across multiple pathways are strongly associated with hy- pertension. However, as yet, to our knowledge, no study has investigated such association in childhood. We, therefore, compared the serum metabolite profile of children with normal and elevated blood pressure (BP) to identify potential metabolic markers and pathways that could be useful for the assessment of pediatric hypertension. Methods. e study included 26 hypertensive children (age range, 6–11 years) and 26 age- and sex-matched ones with normal BP, who were recruited from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study. Ultrahigh-performance liquid chromatography-quadrupole time-of- flight-mass spectrometry was performed to assess the serum metabolite profile. Logistic regression analysis was used to select significant metabolites associated with hypertension after adjustment for body mass index, waist circumference, and lipid profile. Kyoto Encyclopedia of Genes and Genomes (KEGG) and MetaboAnalyst were utilized to search for the potential pathways of metabolites. Results. A total of 45 and 34 metabolites were preliminarily screened in positive and negative modes, respectively (variable importance in the projection (VIP) > 1.0 and P < 0.05). After adjustment for the false discovery rate, 7 and 1 differential metabolites in the positive and negative modes, respectively, remained significant (VIP > 1.0 and q < 0.05). ese metabolites were mainly involved in amino acid metabolism and glycerophospholipid metabolism. Among these, two significant metabolites including ethanolamine and 2-methyl-3-hydroxy-5-formylpyridine-4-carboxylate displayed an area under the curve value of 0.820 (95% confidence interval, 0.688–0.951), with a sensitivity of 0.846 and a specificity of 0.769. Conclusion. e untargeted metabolomics approach effectively identified the differential serum metabolite profile in children with and without hypertension. Notably, two metabolites including ethanolamine and 2-methyl-3-hydroxy-5-formylpyridine-4-carboxylate exhibited a good discriminative ability to identify children with hypertension, providing new insights into potential mechanisms of pediatric hypertension. 1.Introduction Hypertension ranks as the predominant risk factor for cardiovascular disease (CVD) and related mortality worldwide [1, 2]. In addition to its high prevalence in adults, hypertension has recently shown a rapid rise in prevalence among children and adolescents, trending to manifest at an earlier age. Based on 179,561 children and adolescents aged 3–20 years, a recent meta-analysis showed that the global prevalence of pediatric hypertension, defined as having an elevated blood pressure (BP) at all three different visits, was about 3.0% [3]. Compelling evidence has shown a positive association between pediatric hypertension and target organ damage, such as microalbuminuria, left ventricular Hindawi International Journal of Hypertension Volume 2021, Article ID 6691734, 8 pages https://doi.org/10.1155/2021/6691734