title: Endothelial dysfunction is related to insulin resistance and inflammatory biomarker levels in obese prepubertal children.
abstract: BACKGROUND
  The metabolic syndrome (MS) is associated with insulin resistance (IR), a systemic low-grade inflammatory state and endothelial dysfunction. These disorders may arise at a very early age in obese children. This study aimed to investigate the relationship between endothelial dysfunction and both IR and inflammation in prepubertal obese children.
  
  
  RESULTS
  Von Willebrand factor (vWF) and soluble intercellular adhesion molecule-1 (sICAM-1) levels were measured in 46 obese prepubertal children aged 6-9, and in 46 non-obese, age-and sex-matched controls; the possible association of these levels with MS, various inflammatory biomarkers and plasminogen activator inhibitor-1 (PAI-1) was analyzed. Obese children displayed significantly elevated values for sICAM-1 (P=0.008), vWF (P=0.034), insulin (P=0.006), homeostasis model assessment for IR (HOMA-IR; P=0.003), C-reactive protein (CRP) (P<0.001), PAI-1 (P=0.002) and leptin (P<0.001). Nonsignificant differences were found in interleukin 6 (IL-6) levels. In the obese group, sICAM-1 showed a positive correlation with insulin (P=0.013), HOMA-IR (P=0.015), CRP (P=0.020), IL-6 (P=0.023) and PAI-1 (P=0.015). Corrected for age and sex, insulin, HOMA-IR, IL-6 and CPR were found to be independent predictive factors for sICAM-1.
  
  
  CONCLUSIONS
  Prepubertal obese children displayed alterations indicative of endothelial dysfunction as well as disorders typical of MS. An association was established between endothelial dysfunction, IR, inflammation and inappropriate fibrinolysis in the children studied.
authors: Clinical Laboratory Department, Valle de los Pedroches Hospital, 14400 Pozoblanco, Córdoba, Spain. vallej90@yahoo.es
authors: Miguel
authors: M
authors: Valle Jiménez
authors: Rosario Martos
authors: RM
authors: Estepa
authors: Rosario Ma  Morales
authors: RM
authors: Camacho
authors: Ramón Cañete
authors: RC
authors: Estrada
authors: Félix Gascón
authors: FG
authors: Luna
authors: Francisco Bermudo
authors: FB
authors: Guitarte
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005342:Fibrinolysis; D006706:Homeostasis; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000503:physiopathology; D009765:Obesity / Q000097:blood / Q000503:physiopathology*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011237:Predictive Value of Tests; D011627:Puberty
chemical_list: D015415:Biomarkers; D007328:Insulin; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein