Kynde Iben, Heitmann Berit L, Bygbjerg Ib C, Andersen Lars B, Helge Jørn W
Department of Biomedical Sciences, Centre for Healthy Ageing, University of Copenhagen, 2200 Copenhagen, Denmark.
Metabolism. 2009 Dec;58(12):1817-24. doi: 10.1016/j.metabol.2009.06.014. Epub 2009 Aug 27.
Prognostic biomarkers are needed to identify children at increased cardiometabolic risk. The objective was to study whether markers of metabolism and inflammation, for example, circulating plasma adiponectin, leptin, interleukin-8, and hepatocyte growth factor, are associated with cardiometabolic risk factors in childhood and adolescence. This was a cross-sectional and prospective study, and the setting was the Danish part of the European Youth Heart Studies I and II. Participants were randomly selected girls and boys 8 to 10 years of age with complete baseline data (n = 256) and complete follow-up data 6 years later (n = 169). Cardiometabolic risk profile was calculated using a continuous composite score derived from summing of 6 factors standardized to the sample means (Z scores): body mass index, homeostasis model assessment of insulin resistance, total serum cholesterol to serum high-density lipoprotein cholesterol ratio, serum triglycerides, systolic blood pressure, and the reciprocal value of fitness (maximum watts per kilogram). Overweight was defined using international classification of body mass index cutoff points for children. Plasma adiponectin, leptin, interleukin-8, and hepatocyte growth factor were assessed using immunochemical assays. Linear relationships were found between metabolic risk score and both plasma adiponectin (inverse, P = .02) and plasma leptin (P < .0001) at baseline after adjustment for several confounders. In overweight but not normal-weight children, plasma adiponectin at baseline was inversely associated with metabolic risk score 6 years later (P = .04). In childhood, both hypoadiponectinemia and hyperleptinemia accompany a negative metabolic risk profile. In addition, circulating plasma adiponectin may be a useful biomarker to identify overweight children at greater future risk of the cardiometabolic adverse effects of overweight.
需要预后生物标志物来识别心血管代谢风险增加的儿童。目的是研究代谢和炎症标志物，例如循环血浆脂联素、瘦素、白细胞介素-8和肝细胞生长因子，是否与儿童期和青少年期的心血管代谢危险因素相关。这是一项横断面和前瞻性研究，研究背景为欧洲青少年心脏研究I和II的丹麦部分。参与者是随机选取的8至10岁女孩和男孩，他们有完整的基线数据（n = 256），并在6年后有完整的随访数据（n = 169）。心血管代谢风险概况是使用一个连续综合评分来计算的，该评分是通过将6个标准化到样本均值的因素（Z分数）相加得到的：体重指数、胰岛素抵抗的稳态模型评估、总血清胆固醇与血清高密度脂蛋白胆固醇比值、血清甘油三酯、收缩压以及体能的倒数（每千克最大瓦数）。超重是根据国际儿童体重指数分类切点来定义的。使用免疫化学测定法评估血浆脂联素、瘦素、白细胞介素-8和肝细胞生长因子。在对多个混杂因素进行调整后，发现基线时代谢风险评分与血浆脂联素（呈负相关，P = 0.02）和血浆瘦素（P < 0.0001）之间存在线性关系。在超重但非正常体重的儿童中，基线时的血浆脂联素与6年后的代谢风险评分呈负相关（P = 0.04）。在儿童期，低脂联素血症和高瘦素血症均与不良的代谢风险概况相关。此外，循环血浆脂联素可能是一种有用的生物标志物，可用于识别未来超重的心血管代谢不良影响风险更高的超重儿童。
