Gündüz Zübeyde, Dursun İsmail, Tülpar Sebahat, Baştuğ Funda, Baykan Ali, Yıkılmaz Ali, Patıroğlu Türkan, Poyrazoglu Hakan M, Akın Leyla, Yel Sibel, Düşünsel Ruhan
Faculty of Medicine, Department of Pediatric Nephrology, Erciyes University, 38039 Kayseri, Turkey.
J Pediatr Endocrinol Metab. 2012;25(11-12):1111-7. doi: 10.1515/jpem-2012-0194.
Obesity in children increases the risk of atherosclerosis. Endothelial dysfunction is an important factor in the pathogenesis of atherosclerosis, and endothelial microparticles (EMPs) are considered as markers of endothelial dysfunction. In this study, we aimed to evaluate circulating EMPs in obese and overweight children and to disclose the measure of obesity with the strongest relation with circulating microparticles and carotid atherosclerosis.
This prospective study included 55 obese and overweight children and 23 healthy controls. Insulin resistance was studied. Both in vivo and in vitro human umbilical vein endothelial cell evaluations were used for the study. Circulating EMPs (CD144 and CD146) were measured by flow cytometry. The carotid artery intima-media thickness (cIMT) and left ventricular mass index (LVMI) were measured using ultrasound and echocardiography, respectively. Study groups were compared for anthropometric measurement, insulin resistance, circulating EMP, cIMT, and LVMI. The relationship among overweight, obesity, and circulating EMPs were investigated.
Blood pressure, CD144+EMP levels, and LVMI were statistically higher in the patients group than in the control group. The multiple logistic regression analysis and the backward elimination method showed that CD144+EMP and systolic blood pressure had a linear relationship with overweight and obesity.
Our results suggest that endothelial damage starts in the early stage of childhood obesity and that obese and overweight children have increased circulating CD144+EMPs, showing that endothelial dysfunction and increased CD144+EMPs may be related to obesity.
儿童肥胖会增加动脉粥样硬化的风险。内皮功能障碍是动脉粥样硬化发病机制中的一个重要因素，而内皮微粒（EMPs）被视为内皮功能障碍的标志物。在本研究中，我们旨在评估肥胖和超重儿童的循环EMPs，并揭示与循环微粒和颈动脉粥样硬化关系最密切的肥胖测量指标。
这项前瞻性研究纳入了55名肥胖和超重儿童以及23名健康对照。对胰岛素抵抗进行了研究。研究采用了体内和体外人脐静脉内皮细胞评估。通过流式细胞术测量循环EMPs（CD144和CD146）。分别使用超声和超声心动图测量颈动脉内膜中层厚度（cIMT）和左心室质量指数（LVMI）。比较研究组在人体测量、胰岛素抵抗、循环EMPs、cIMT和LVMI方面的情况。研究了超重、肥胖与循环EMPs之间的关系。
患者组的血压、CD144+EMP水平和LVMI在统计学上高于对照组。多元逻辑回归分析和向后剔除法显示，CD144+EMP和收缩压与超重和肥胖呈线性关系。
我们的结果表明，内皮损伤在儿童肥胖的早期阶段就已开始，肥胖和超重儿童的循环CD144+EMPs增加，这表明内皮功能障碍和循环CD144+EMPs增加可能与肥胖有关。
