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肥胖和代谢综合征学龄儿童亚临床动脉粥样硬化的标志物

Markers of subclinical atherosclerosis in schoolchildren with obesity and metabolic syndrome.

作者信息

Al-Shorman Alaa, Al-Domi Hayder, Faqih Ahmad

机构信息

Department of Nutrition and Food Science, School of Agriculture, The University of Jordan, Amman, Jordan.

出版信息

Swiss Med Wkly. 2017 Jun 21;147:w14446. doi: 10.4414/smw.2017.14446. eCollection 2017.

DOI:10.4414/smw.2017.14446
PMID:28634974
Abstract

BACKGROUND

Although increased carotid intima-media thickness (cIMT), soluble adhesion molecules and proinflammatory biomarkers are strongly implicated in the development of atherosclerotic lesions, the role of obesity and metabolic syndrome (MetS) in atherogenicity and inflammation among schoolchildren is not well investigated.

AIM

To determine the levels of cIMT, endothelial dysfunction and inflammatory biomarkers in a group of schoolchildren with obesity and MetS.

METHODS

Eighty-seven schoolchildren (age 10-15 years) were categorised into three groups: normal bodyweight group, obese group and severely obese with MetS group (17 boys and 12 girls in each group). Levels of cIMT were measured with high-resolution B-mode ultrasound. Serum proinflammatory cytokines interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), and soluble adhesion molecules E-selectin, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1(ICAM-1) were measured.

RESULTS

Mean cIMT levels were significantly higher (p 0.05) among severely obese schoolchildren with MetS (0.49 ± 0.02 mm) compared with both the obese (0.43 ± 0.03 mm) and the normal bodyweight counterparts (0.36 ± 0.03 mm). Serum levels of IL-6, TNF-α, IL-1β, E-selectin, VCAM-1 and ICAM-1 were significantly higher (p 0.05) in severely obese with MetS and obese children compared with the normal bodyweight group. However, no significant differences (p >0.05) were found between the severely obese schoolchildren with MetS and the obese without MetS.

CONCLUSIONS

Severely obese schoolchildren having MetS exhibited higher cIMT levels than obese and normal bodyweight counterparts. Biomarkers of inflammation and endothelial dysfunction were higher in obese schoolchildren, but biomarkers were not increased any further by the degree of obesity nor the MetS cluster.

摘要

背景

尽管颈动脉内膜中层厚度(cIMT)增加、可溶性黏附分子和促炎生物标志物与动脉粥样硬化病变的发展密切相关,但肥胖和代谢综合征(MetS)在学龄儿童动脉粥样硬化形成和炎症中的作用尚未得到充分研究。

目的

确定一组患有肥胖和MetS的学龄儿童的cIMT水平、内皮功能障碍和炎症生物标志物水平。

方法

87名学龄儿童(年龄10 - 15岁)被分为三组:正常体重组、肥胖组和患有MetS的重度肥胖组(每组17名男孩和12名女孩)。使用高分辨率B型超声测量cIMT水平。检测血清促炎细胞因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β),以及可溶性黏附分子E-选择素、血管细胞黏附分子-1(VCAM-1)和细胞间黏附分子-1(ICAM-1)。

结果

与肥胖组(0.43±0.03mm)和正常体重组(0.36±0.03mm)相比,患有MetS的重度肥胖学龄儿童的平均cIMT水平显著更高(p≤0.05)(0.49±0.02mm)。与正常体重组相比,患有MetS的重度肥胖儿童和肥胖儿童的血清IL-6、TNF-α、IL-1β、E-选择素、VCAM-1和ICAM-1水平显著更高(p≤0.05)。然而,患有MetS的重度肥胖学龄儿童与无MetS的肥胖儿童之间未发现显著差异(p>0.05)。

结论

患有MetS的重度肥胖学龄儿童的cIMT水平高于肥胖和正常体重的同龄人。肥胖学龄儿童的炎症和内皮功能障碍生物标志物水平较高,但这些生物标志物并未因肥胖程度或MetS聚类而进一步升高。

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