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肥胖儿童早期血小板激活的相关因素。

Factors associated with early platelet activation in obese children.

作者信息

Gómez García Anel, Núñez Guillermina García, Sandoval Martha Eva Viveros, Castellanos Sergio Gutierrez, Alvarez Aguilar Cleto

机构信息

Biomedical Research Center of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, México.

Department of Pediatrics, Mexican Institute of Social Security, Morelia, Michoacán, Mexico.

出版信息

Clin Med Res. 2014 Sep;12(1-2):21-6. doi: 10.3121/cmr.2013.1166. Epub 2014 Jan 10.

Abstract

OBJECTIVE

To investigate the factors associated with platelet activation in obese children.

DESIGN

Cross-sectional study.

SETTING

Department of Pediatrics of Regional Hospital N∘ 1 of Mexican Institute of Social Security in Morelia, Michoacán, Mexico.

PARTICIPANTS

79 obese and 64 non-obese children between the ages of 5 and 10 years.

MAIN OUTCOMES MEASURES

Obese children (body mass index [BMI] >85 in growth curves for Centers for Disease Control/National Center for Health Statistics), and the control group of 64 non-obese children (percentile <85), % body fat, platelet activation was assessed by sP-selectin. Other measures were leptin, uric acid (UA), von Willebrand Factor (vWF), plasminogen activator inhibitor (PAI-1), lipid profile, and glucose.

RESULTS

Obese children displayed higher plasma sP-selectin, leptin, PAI-1, and vWF than non-obese children. In the univariate logistic regression analysis, leptin, vWF, UA, and high density lipoprotein (HDL), but not with PAI-1, were factors associated with platelet activation. By stepwise linear regression analysis adjusted by sex and age, the best predictor variables for platelet activation were leptin (β:0.381; t:4.665; P=0.0001), vWF (β:0.211; t:2.926; P=0.004), UA (β:0.166; t:2.146; P=0.034), and HDL (β:-0.215; t:-2.819; P=0.006).

CONCLUSIONS

Obese children have a higher risk of developing early platelet activation. Factors associated with platelet activation were Leptin, vWF, UA, and HDL. Further studies involving larger numbers of patients over a longer duration are needed to understand the possible molecular mechanism underlying the association between leptin, vWF, and UA and endothelial activation and/or endothelial damage/dysfunction in obese children and its influence in cardiovascular disease in adults.

摘要

目的

研究肥胖儿童血小板活化的相关因素。

设计

横断面研究。

地点

墨西哥米却肯州莫雷利亚市墨西哥社会保障局第一地区医院儿科。

参与者

79名5至10岁的肥胖儿童和64名非肥胖儿童。

主要观察指标

肥胖儿童(根据疾病控制中心/国家卫生统计中心生长曲线,体重指数[BMI]>85),以及64名非肥胖儿童对照组(百分位数<85),体脂百分比,通过可溶性P选择素评估血小板活化。其他指标包括瘦素、尿酸(UA)、血管性血友病因子(vWF)、纤溶酶原激活物抑制剂(PAI-1)、血脂谱和血糖。

结果

肥胖儿童的血浆可溶性P选择素、瘦素、PAI-1和vWF水平高于非肥胖儿童。在单因素逻辑回归分析中,瘦素、vWF、UA和高密度脂蛋白(HDL)与血小板活化相关,而PAI-1与血小板活化无关。经性别和年龄校正的逐步线性回归分析显示,血小板活化的最佳预测变量为瘦素(β:0.381;t:4.665;P = 0.0001)、vWF(β:0.211;t:2.926;P = 0.004)、UA(β:0.166;t:2.146;P = 0.034)和HDL(β:-0.215;t:-2.819;P = 0.006)。

结论

肥胖儿童早期血小板活化风险较高。与血小板活化相关的因素为瘦素、vWF、UA和HDL。需要开展更多涉及大量患者且持续时间更长的研究,以了解瘦素、vWF和UA与肥胖儿童内皮细胞活化和/或内皮损伤/功能障碍之间关联的潜在分子机制,及其对成人心血管疾病的影响。

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