Determinants of early atherosclerosis in obese children and adolescents
Determinants of early atherosclerosis in obese children and adolescents
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DOI：
10.1210/jc.2007-0619
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发表时间：
2007-08-01
影响因子：
5.8
通讯作者：
Brichard, Sonia M.
中科院分区：
文献类型：
--
作者：
Beauloye, Veronique;Zech, Francis;Brichard, Sonia M.
背景：儿童期肥胖与成年期心血管疾病死亡率增加相关，与成年体重无关。最近在儿童中的研究表明动脉粥样硬化过程在早期开始并且与肥胖有关。目的：该研究的目的是调查肥胖儿童中颈动脉内膜中层厚度（IMT）增加的决定因素，IMT是动脉粥样硬化的早期标志。设计：总共104名肥胖儿童[年龄，12.7 ± 0.2岁;体重指数（BMI）-z-评分，2.8 +/-0.7]进行口服葡萄糖耐量试验。测定空腹血糖、胰岛素、C-反应蛋白和粘附分子（sICAM、sVCAM、sE-选择素）、血脂、脂联素和β-内酰胺酶。超声测量IMT。用稳态模型评价指数评价胰岛素抵抗。从93名非肥胖儿童中获得血液参数的基线测量值（年龄，13.0 ± 0.2岁; BMI-z- score，-0.2 ± 0.9），并在其他23名具有类似特征的对照儿童中测量IMT。单因素分析显示，IMT与相对BMI、收缩期高血压程度、空腹胰岛素水平，内膜厚度与经典心血管危险因素如2型糖尿病家族史、早发性心血管疾病、内脏肥胖、血脂谱等无相关性。在我们的肥胖人群中，C反应蛋白和粘附分子水平与IMT无关。当控制性别、坦纳分期和相对BMI时，只有脂联素水平仍然是IMT的独立决定因素。结论：脂联素水平较常规CV危险因素和炎症状态可能与肥胖儿童早期动脉粥样硬化有关。
Context: Obesity in childhood is associated with an increased mortality due to cardiovascular (CV) diseases in adulthood, independent of adult weight. Recent studies in children indicate that the atherosclerosis process starts at an early age and is linked to obesity.Objective: The aim of the study was to investigate determinants of increased carotid intima-media thickness (IMT), an early marker of atherosclerosis, in obese children.Design: A total of 104 obese children [age, 12.7 +/- 0.2 yr; body mass index (BMI)-z-score, 2.8 +/- 0.7] underwent an oral glucose tolerance test. Fasting levels of glucose, insulin, C-reactive protein and adhesion molecules (sICAM, sVCAM, sE-selectin), lipid profile, adiponectin, and resistin were determined. IMT was measured by ultrasound. Insulin resistance was estimated by the homeostatic model assessment index. Baseline measurements of blood parameters were obtained from 93 nonobese children (age, 13.0 +/- 0.2 yr; BMI- z- score, -0.2 +/- 0.9), and IMT was measured in 23 other control children with similar characteristics.Results: Univariate analysis showed a significant positive correlation between IMT and relative BMI, the degree of systolic hypertension, fasting insulin levels, homeostatic model assessment- R index, and resistin concentrations, whereas an inverse correlation with adiponectin levels was found. No correlation was obtained between IMT and classical CV risk factors such as positive familial history of type 2 diabetes or precocious CV disease, visceral obesity, or the lipid profile. C-reactive protein and adhesion molecule levels were not associated with IMT in our obese population. When controlled for sex, Tanner stage, and relative BMI, only adiponectin levels remained an independent determinant of IMT.Conclusion: Adiponectin more than conventional CV risk factors and inflammation status may be related to early atherosclerosis in obese children.