在肥胖儿童中可检测到促炎状态，且伴有血管功能和形态学改变。

A proinflammatory state is detectable in obese children and is accompanied by functional and morphological vascular changes.

作者信息

Kapiotis Stylianos, Holzer Gregor, Schaller Georg, Haumer Markus, Widhalm Harald, Weghuber Daniel, Jilma Bernd, Röggla Georg, Wolzt Michael, Widhalm Kurt, Wagner Oswald F

机构信息

Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria.

出版信息

Arterioscler Thromb Vasc Biol. 2006 Nov;26(11):2541-6. doi: 10.1161/01.ATV.0000245795.08139.70. Epub 2006 Sep 14.

DOI:10.1161/01.ATV.0000245795.08139.70

PMID:16973973

Abstract

BACKGROUND

Obesity is generally accepted as a risk factor for premature atherosclerosis. Subclinical inflammation as quantified by blood levels of C-reactive protein (CRP) contributes to the development and progression of atherosclerosis. We hypothesized that inflammation in obese children is related to functional and early morphological vascular changes.

METHODS AND RESULTS

Blood levels of high sensitivity (hs) CRP, hsIL-6, the soluble intercellular adhesion molecule1 (ICAM-1), vascular cell adhesion molecule (VCAM)-1, and E-selectin were measured in 145 severely obese (body mass index [BMI], 32.2+/-5.8 kg/m2) and 54 lean (BMI, 18.9+/-3.2 kg/m2) children 12+/-4 years old. Flow-mediated dilation (FMD) of the brachial artery and carotid intima-media thickness (IMT) measured by high-resolution ultrasound as markers of early vascular changes were assessed in 92 (77 obese and 15 lean) and 59 (50 obese and 9 lean) children, respectively. Obese children had significantly higher levels of hsCRP, hsIL-6, and E-selectin than healthy controls (4.1+/-4.8 versus 0.9+/-1.5 mg/L, P<0.001 for hsCRP; 1.99+/-1.30 versus 1.42+/-1.01 pg/mL, P=0.05 for hsIL-6; and 78+/-38 versus 59+/-29 ng/mL, P=0.01 for E-selectin). There were no differences in the levels of ICAM-1 and VCAM-1 between groups. Obese children had lower peak FMD response (7.70+/-6.14 versus 11.06+/-3.07%, P=0.006) and increased IMT (0.37+/-0.04 versus 0.34+/-0.03 mm, P=0.03) compared with controls. Morbidly obese children (n=14, BMI 44.1+/-3.9 kg/m2) had highest levels of hsCRP (8.7+/-0.7 mg/L), hsIL-6 (3.32+/-1.1 pg/mL), and E-selectin (83+/-40 ng/mL).

CONCLUSIONS

A proinflammatory state is detectable in obese children, which is accompanied by impaired vascular endothelial function and early structural changes of arteries, even in young subjects at risk. It remains to be determined whether high hsCRP in obese children predicts cardiovascular events.

摘要

背景

肥胖通常被认为是过早发生动脉粥样硬化的危险因素。通过血液中C反应蛋白（CRP）水平量化的亚临床炎症促进了动脉粥样硬化的发生和发展。我们推测肥胖儿童的炎症与血管功能和早期形态学改变有关。

方法与结果

对145名12±4岁的重度肥胖儿童（体重指数[BMI]，32.2±5.8kg/m²）和54名瘦儿童（BMI，18.9±3.2kg/m²）测量了高敏（hs）CRP、hsIL-6、可溶性细胞间黏附分子1（ICAM-1）、血管细胞黏附分子（VCAM）-1和E-选择素的血液水平。分别对92名（77名肥胖儿童和15名瘦儿童）和59名（50名肥胖儿童和9名瘦儿童）儿童评估了肱动脉血流介导的舒张功能（FMD）以及通过高分辨率超声测量的颈动脉内膜中层厚度（IMT），作为早期血管改变的标志物。肥胖儿童的hsCRP、hsIL-6和E-选择素水平显著高于健康对照（hsCRP：4.1±4.8对0.9±1.5mg/L，P<0.001；hsIL-6：1.99±1.30对1.42±1.01pg/mL，P=0.05；E-选择素：78±38对59±29ng/mL，P=0.01）。两组间ICAM-1和VCAM-1水平无差异。与对照组相比，肥胖儿童的FMD峰值反应较低（7.70±6.14对11.06±3.07%，P=0.006），IMT增加（0.37±0.04对0.34±0.03mm，P=0.03）。病态肥胖儿童（n=14，BMI 44.1±3.9kg/m²）的hsCRP（8.7±0.7mg/L）、hsIL-6（3.32±1.1pg/mL）和E-选择素（83±40ng/mL）水平最高。