Domouzoglou Eleni M, Vlahos Antonios P, Papafaklis Michail I, Cholevas Vasileios K, 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, Stavrou Niarchou, 45110 Ioannina, Greece.
Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece.
J Pers Med. 2023 Dec 3;13(12):1680. doi: 10.3390/jpm13121680.
Obesity and unfavorable metabolic profiles increase the risk for cardiovascular complications in adults. Although it is important to distinguish different metabolic health states at an early stage, there are limited data on the related value of biomarkers in childhood. We aimed to identify biomarkers for the detection of different metabolic health states in children with and without obesity. The serum levels of metabolic regulators (fibroblast growth factor 21 [FGF21], leptin, adiponectin and insulin-like growth factor binding protein 1) and vascular indices (flow-mediated dilation [FMD] and carotid intima-media thickness) were assessed in 78 children. Differences between the metabolically healthy and unhealthy state within children with normal weight (MHN vs. MUN), and within children with overweight/obesity (MHO vs. MUO) were investigated; the discriminatory power of the biomarkers was studied. Both MUN and MUO groups expressed altered lipid and glucose homeostasis compared to their healthy counterparts. The metabolic unhealthy state in children with normal weight was linked to higher FGF21 levels which had good discriminatory ability (area under the curve [AUC]: 0.71, 95% CI: 0.54-0.88; = 0.044). In overweight/obese children, leptin was increased in the metabolically unhealthy subgroup (AUC: 0.81, 95% CI: 0.68-0.95; = 0.01). There was a decrease in FMD indicating worse endothelial function in overweight/obese children versus those with normal weight. Distinct states of metabolic health exist in both children with normal weight and overweight/obese children. FGF21 and leptin may help to identify the metabolic unhealthy state in children with normal weight and in overweight/obese children, respectively, early in life.
肥胖和不良的代谢状况会增加成年人发生心血管并发症的风险。尽管在早期区分不同的代谢健康状态很重要，但关于儿童生物标志物相关价值的数据有限。我们旨在识别用于检测肥胖和非肥胖儿童不同代谢健康状态的生物标志物。对78名儿童的代谢调节因子（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）血清水平以及血管指标（血流介导的血管舒张 [FMD] 和颈动脉内膜中层厚度）进行了评估。研究了正常体重儿童（MHN与MUN）以及超重/肥胖儿童（MHO与MUO）中代谢健康与不健康状态之间的差异；研究了生物标志物的鉴别能力。与健康儿童相比，MUN组和MUO组均表现出脂质和葡萄糖稳态的改变。正常体重儿童的代谢不健康状态与较高的FGF21水平相关，FGF21具有良好的鉴别能力（曲线下面积 [AUC]：0.71，95% CI：0.54 - 0.88；P = 0.044）。在超重/肥胖儿童中，代谢不健康亚组的瘦素水平升高（AUC：0.81，95% CI：0.68 - 0.95；P = 0.01）。与正常体重儿童相比，超重/肥胖儿童的FMD降低，表明内皮功能较差。正常体重儿童和超重/肥胖儿童均存在不同的代谢健康状态。FGF21和瘦素可能分别有助于在生命早期识别正常体重儿童和超重/肥胖儿童的代谢不健康状态。
