title: Circulating oxidized LDL and inflammation in extreme pediatric obesity.
abstract: Oxidative stress and inflammation have not been well-characterized in extreme pediatric obesity. We compared levels of circulating oxidized low-density lipoprotein (oxLDL), C-reactive protein (CRP), and interleukin-6 (IL-6) in extremely obese (EO) children to normal weight (NW) and overweight/obese (OW/OB) children. OxLDL, CRP, IL-6, BMI, blood pressure, and fasting glucose, insulin, and lipids were obtained in 225 children and adolescents (age 13.5 ± 2.5 years; boys 55%). Participants were classified into three groups based on gender- and age-specific BMI percentile: NW (<85th, n = 127), OW/OB (85th- <1.2 times the 95th percentile, n = 64) and EO (≥1.2 times the 95th percentile or BMI ≥35 kg/m(2), n = 34). Measures were compared across groups using analysis of covariance, adjusted for gender, age, and race. Blood pressure, insulin, and lipids worsened across BMI groups (all P < 0.0001). OxLDL (NW: 40.8 ± 9.0 U/l, OW/OB: 45.7 ± 12.1 U/l, EO: 63.5 ± 13.8 U/l) and CRP (NW: 0.5 ± 1.0 mg/l, OW/OB: 1.4 ± 2.9 mg/l, EO: 5.6 ± 4.9 mg/l) increased significantly across BMI groups (all groups differed with P < 0.01). IL-6 was significantly higher in EO (2.0 ± 0.9 pg/ml) compared to OW/OB (1.3 ± 1.2 pg/ml, P < 0.001) and NW (1.1 ± 1.0 pg/ml, P < 0.0001) but was not different between NW and OW/OB. Extreme pediatric obesity, compared to milder forms of adiposity and NW, is associated with higher levels of oxidative stress and inflammation, suggesting that markers of early cardiovascular disease and type 2 diabetes mellitus are already present in this young population.
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Norris
authors.forename: Julia
authors.initials: J
authors.lastname: Steinberger
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Steffen
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Metzig
authors.forename: Sarah Jane
authors.initials: SJ
authors.lastname: Schwarzenberg
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000209:etiology; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D015850:Interleukin-6 / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009765:Obesity / Q000097:blood* / Q000276:immunology* / Q000503:physiopathology; D050177:Overweight / Q000097:blood / Q000276:immunology / Q000503:physiopathology; D018384:Oxidative Stress; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D002097:C-Reactive Protein