Η φλεγμονή ως παράγων κινδύνου για αθηροσκλήρωση: η σχέση της με την παχυσαρκία και άλλους καρδιαγγειακούς παράγοντες στην παιδική ηλικία

Abstract

It is known that inflammation accompanies atherosclerotic disease and even the CRP is a predictor of increased risk for patients with cardiovascular diseases. Obesity belongs among the conditions that cause chronic systemic inflammation (low grade), because fat tissue secretes host of inflammatory cytokines (leptin and adiponectin among others). The association of chronic systemic inflammation induced by obesity with increased cardiovascular risk has not been fully studied in childhood. This connection is explored in this study through correlation of inflammatory cytokines in adipose tissue (adipokines) leptin and adiponectin with cardiovascular risk factors, such as blood pressure, blood glucose, exercise, CRP and lipid profile. Furthermore, we studied factors that may affect these adipokines, so that the modification of them reduce cardiovascular risk in obese children. We studied 170 healthy children aged approximately 10±2 years, male and female. We measured height, weight, body mass index (BMI), blood pressure, physical activity was assessed and recorded in two categories. Peripheral venous blood was collected from each child, fasting and we identified the + blood glucose, lipid profile, apolipoproteins and the levels of leptin, adiponectin and CRP. Differences between groups were studied either by Student's t-test for normal values or Mann-Whitney U-test for abnormal values. The correlation of leptin and adiponectin with various parameters was analyzed with linear regression (Pearson's Correlation analysis) and multiple linear regression analysis. The values of leptin and adiponectin were divided into quartiles according to their percentile scores (25th, 50th, 75th) and were compared with ANOVA the differences in values of measured parameters between the quarters. The results indicate significant positive correlations of leptin with BMI, blood pressure, glucose levels, CRP and negative correlation of leptin with HDL. Higher leptin values were observed in the most obese children, children who gained weight very rapidly from birth, girls, infants who do not breastfeed, those who did not exercise and those whose parents smoked. Adiponectin correlations were opposed. It was observed negative correlation with BMI, blood pressure and CRP. Higher values of adiponectin were present in children who got less weight from birth and very low values ones quickly gained much weight since birth. The children were divided into two groups, high and low risk according to BMI, blood pressure, fasting glucose, lipid profile, physical activity and smoking of parents. Children at risk had typically much higher values of leptin, significantly lower prices of adiponectin and significantly higher levels of CRP. Children with high levels of leptin and/or low levels of adiponectin together pose multiple cardiovascular risk factors such as higher blood pressure and fasting glucose, higher BMI, lower HDL cholesterol, especially high levels of CRP. These children gather many of the features of the metabolic syndrome and likely there is a link between inflammation (CRP), obesity (leptin and adiponectin) and cardiovascular risk, already visible in childhood. Modifiable factors that reduce the levels of leptin (if implicated in increased cardiovascular risk) may be the gradual rather than accelerated growth in early childhood, the breastfeeding, the normal weight, the physical activity, the absence of parenteral smoking.