title: Plasminogen activator inhibitor-1 (PAI-1) gene polymorphism (-675 4G/5G) associated with obesity and vascular risk in children.
abstract: Atherothrombotic complications in insulin resistance are partly attributed to impaired fibrinolysis caused by increased PAI-1 plasma levels, and 4G/5G promotor polymorphism of the PAI-1 gene may modulate PAI-1 transcription.
  
  
  OBJECTIVE
  To investigate PAI-1-675 4G/5G allele gene polymorphism and its relationship with obesity in children. CHILDREN AND METHOD: The study participants were 133 apparently healthy non-obese children, 24 probable exogenously obese without family history (Group I), 66 probable familial obese (Group II), and 44 obese children who were referred to the pediatric endocrinology department with any complication of obesity (Group III). Group I and Group II obese children were gathered from a school-based epidemiological study.
  
  
  RESULTS
  Incidence of obesity was 19% in a school with high socio-economic status, whereas it was 4% in a school with low socio-economic status. Frequencies of 4G/4G gene polymorphisms were 24.81%, 37.50%, 64.80% and 61.11% in the control group, and groups I, II, and III, respectively. In groups II and III, 4G/4G gene polymorphism, and in non-obese control children 5G/5G gene polymorphism, was common. In obese children in the presence of family history for obesity and metabolic syndrome (odds ratio [OR]: 4.48, 95% confidence interval [CI]: 1.26-15.82), carriage of the 4G allele either in heterozygous or homozygous state increased the risk of vascular disease (OR: 6.10, 95% CI 1.64-22.90). In patients with acanthosis nigricans, high HOMA-IR values, hypertriglyceridemia and elevated atherogenic index, 4G/4G genotype frequency was remarkably higher compared to patients with other features of metabolic syndrome.
  
  
  CONCLUSIONS
  The increasing prevalence of childhood obesity in high socio-economic status is associated with health risks. In obese children with family history of obesity and cardiovascular disease or type 2 diabetes mellitus and in obese children who had any feature of metabolic syndrome, frequency of 4G/4G genotype was more than the 4G/5G and 5G/5G genotypes in the PAI-1 gene. These patients can be at increased risk for developing vascular disease. Acanthosis nigricans, high HOMA-IR value, hypertriglyceridemia and high atherogenic index can also reflect the high risk of vascular disease in metabolic syndrome.
authors.affiliation: Department of Pediatric Endocrinology, Ankara University Faculty of Medicine, Ankara, Turkey. merihbtr@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Berberoğlu
authors.forename: O
authors.initials: O
authors.lastname: Evliyaoğlu
authors.forename: P
authors.initials: P
authors.lastname: Adiyaman
authors.forename: G
authors.initials: G
authors.lastname: Ocal
authors.forename: B
authors.initials: B
authors.lastname: Ulukol
authors.forename: F
authors.initials: F
authors.lastname: Simşek
authors.forename: Z
authors.initials: Z
authors.lastname: Siklar
authors.forename: A
authors.initials: A
authors.lastname: Törel
authors.forename: D
authors.initials: D
authors.lastname: Ozel
authors.forename: N
authors.initials: N
authors.lastname: Akar
mesh_terms: D000328:Adult; D000483:Alleles; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002648:Child; D005787:Gene Frequency; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood; D007328:Insulin / Q000097:blood; D024821:Metabolic Syndrome / Q000235:genetics / Q000378:metabolism; D009765:Obesity / Q000235:genetics*; D016017:Odds Ratio; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics*; D012307:Risk Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000235:genetics*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D017395:Plasminogen Activator Inhibitor 1