Domouzoglou Eleni M, Vlahos Antonios P, Cholevas Vasileios K, Papafaklis Michail I, Chaliasos Nikolaos, Siomou Ekaterini, Michalis Lampros K, Tsatsoulis Agathocles, Naka Katerina K
Child Health Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Ann Pediatr Endocrinol Metab. 2021 Dec;26(4):242-251. doi: 10.6065/apem.2040258.129. Epub 2021 May 17.
Metabolic and cardiovascular disease prevention starting in childhood is critical for reducing morbidity later in life. In the present study, the association of novel biomarkers with metabolic syndrome (MS) and vascular function/structure indices of early atherosclerosis in children was investigated.
This was a prospective study of 78 children (8-16 years of age) grouped based on the presence or absence of MS. The serum biomarkers investigated included fibroblast growth factor 21 (FGF21), leptin, adiponectin, and insulinlike growth factor binding protein-1 (IGFBP1). Endothelial function and carotid atherosclerosis were assessed based on brachial artery flow-mediated dilation (FMD) and carotid intima-media thickness, respectively.
Children with MS (n=12) had higher levels of FGF21 (median [interquartile range]: 128 [76-189] pg/mL vs. 60 [20-98] pg/mL, P=0.003) and leptin (18.1 [11-34.8] pg/mL vs. 7.5 [1.9-16.5] ng/mL, P=0.003), and lower levels of IGFBP1 (1.5 [1.2-2.1] ng/mL vs. 2.3 [1.5-6] ng/mL, P=0.028) compared with children without MS. FMD inversely correlated with FGF21 (Spearman rho= -0.24, P=0.035) and leptin (rho= -0.24, P=0.002) in all children. The best cutoff value of FGF21 levels for MS diagnosis was above 121.3 pg/mL (sensitivity/specificity, 58/86%). Only FGF21 was significantly associated with the presence of MS after adjustment for body mass index, age, and sex (odds ratio per 10 pg/mL increase: 1.10 [95% confidence interval, 1.01-1.22]; P=0.043).
Increased FGF21 levels were associated with the presence of MS and worse endothelial function in children. Larger studies are needed to evaluate the potential value of FGF21 as a biomarker that could predict future metabolic/cardiovascular disease at an early stage.
从儿童期开始预防代谢性疾病和心血管疾病对于降低日后的发病率至关重要。在本研究中，调查了新型生物标志物与儿童代谢综合征（MS）以及早期动脉粥样硬化的血管功能/结构指标之间的关联。
这是一项对78名8至16岁儿童进行的前瞻性研究，根据是否患有MS进行分组。所研究的血清生物标志物包括成纤维细胞生长因子21（FGF21）、瘦素、脂联素和胰岛素样生长因子结合蛋白1（IGFBP1）。分别基于肱动脉血流介导的舒张功能（FMD）和颈动脉内膜中层厚度评估内皮功能和颈动脉粥样硬化情况。
与未患MS的儿童相比，患有MS的儿童（n = 12）FGF21水平更高（中位数[四分位间距]：128[76 - 189]pg/mL对60[20 - 98]pg/mL，P = 0.003）、瘦素水平更高（18.1[11 - 34.8]pg/mL对7.5[1.9 - 16.5]ng/mL，P = 0.003），而IGFBP1水平更低（1.5[1.2 - 2.1]ng/mL对2.3[1.5 - 6]ng/mL，P = 0.028）。在所有儿童中，FMD与FGF21（Spearman秩相关系数 = -0.24，P = 0.035）和瘦素（秩相关系数 = -0.24，P = 0.002）呈负相关。MS诊断的FGF21水平最佳截断值高于121.3 pg/mL（敏感度/特异度，58/86%）。在调整体重指数、年龄和性别后，只有FGF21与MS的存在显著相关（每增加10 pg/mL的比值比：1.10[95%置信区间，1.01 - 1.22]；P = 0.043）。
儿童中FGF21水平升高与MS的存在以及较差的内皮功能相关。需要开展更大规模的研究来评估FGF21作为一种能够早期预测未来代谢性/心血管疾病的生物标志物的潜在价值。
