Pediatric Endocrine and Diabetes Unit, Children's Hospital, University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Obesity (Silver Spring). 2012 Aug;20(8):1662-8. doi: 10.1038/oby.2012.85. Epub 2012 Apr 9.
Adipose tissue may release mediators that induce a chronic inflammatory state and alterations in coagulation, which contribute to insulin resistance, atherosclerosis, and thrombosis. We investigated whether inflammatory and/or prothrombotic states exist in obese children and assessed their interrelationship. Sixty-one subjects were recruited, aged between 6 and 16 years, to participate in a cross-sectional study at Children's University Hospital of Geneva. Selected pro/anti-inflammatory cytokines/chemokines and hemostasis parameters were measured in obese children and lean controls. Cardiovascular risk factors in the family were indexed. Fasting glucose level, insulin, prothrombin time (PT), fibrinogen, activated partial thromboplastin time (aPTT), D-dimer, endogenous thrombin potential (ETP), C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), interferon-γ-inducible-protein (IP-10), monocyte chemoattractant protein 1 (MCP-1), and interleukin-1 receptor antagonist (IL-1Ra) were measured. We estimated insulin resistance by homeostatic model assessment (HOMA). Anti- (IL-1Ra) and proinflammatory cytokines (MCP-1, IL-6) were significantly increased in obese children in comparison to the control group, even before puberty. Hemostasis was also altered in obese children with a significantly increased fibrinogen level, increased D-dimer, a shortened PT, as well as an increased ETP. No correlation was found between cytokine levels and hemostasis parameters, except for IL-6 and fibrinogen. Obese children present with inflammatory and prothrombotic states as early as 6 years of age and these states are similar in prepubertal and pubertal obese children. The cytokines IL-1Ra and MCP-1 were most significantly increased in obese children. Further investigation is necessary to determine if these cytokines, together with ETP, can reliably predict the development of diabetes and atherosclerosis.
脂肪组织可能会释放介质，诱导慢性炎症状态和凝血改变，从而导致胰岛素抵抗、动脉粥样硬化和血栓形成。我们研究了肥胖儿童是否存在炎症和/或促血栓形成状态，并评估了它们之间的相互关系。在日内瓦儿童大学医院进行了一项横断面研究，共招募了 61 名年龄在 6 至 16 岁之间的受试者。在肥胖儿童和瘦对照组中测量了选定的促/抗炎细胞因子/趋化因子和止血参数。评估了家族中的心血管危险因素。测量了空腹血糖水平、胰岛素、凝血酶原时间（PT）、纤维蛋白原、活化部分凝血活酶时间（aPTT）、D-二聚体、内源性凝血酶潜能（ETP）、C 反应蛋白（CRP）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、干扰素-γ诱导蛋白（IP-10）、单核细胞趋化蛋白 1（MCP-1）和白细胞介素-1 受体拮抗剂（IL-1Ra）。我们通过稳态模型评估（HOMA）估计胰岛素抵抗。与对照组相比，肥胖儿童的抗（IL-1Ra）和促炎细胞因子（MCP-1、IL-6）明显升高，甚至在青春期之前。肥胖儿童的止血功能也发生了改变，表现为纤维蛋白原水平升高、D-二聚体升高、PT 缩短以及 ETP 增加。细胞因子水平与止血参数之间除了 IL-6 和纤维蛋白原外没有相关性。肥胖儿童早在 6 岁时就出现炎症和促血栓形成状态，青春期前和青春期肥胖儿童的这些状态相似。细胞因子 IL-1Ra 和 MCP-1 在肥胖儿童中增加最为明显。需要进一步研究以确定这些细胞因子是否与 ETP 一起能可靠地预测糖尿病和动脉粥样硬化的发展。
