title: Pregnancy-associated plasma protein A in obese children: relationship to markers and risk factors of atherosclerosis and members of the IGF system.
abstract: BACKGROUND
  Pregnancy-associated plasma protein A (PAPPA) is a large placenta-derived glycoprotein, which serves as a protease of several IGF-binding proteins (IGFBPs). In non-pregnant adults, measurable PAPPA levels were detected and have been implicated in the pathophysiology of atherosclerotic plaques. However, data in children is lacking.
  
  
  OBJECTIVE
  To study the relationship between PAPPA, markers of atherosclerosis, and members of the IGF system in pediatric obesity.
  
  
  METHODS
  Eighty-two obese and 52 nonobese children and 1-year longitudinal follow-up study for obese cohort.
  
  
  METHODS
  Outpatient 1-year intervention program based on exercise, behavior, and nutrition therapy.
  
  
  METHODS
  Changes in PAPPA levels, carotid intima media thickness (IMT), weight, blood pressure, lipids, metabolic markers, and members of IGF system.
  
  
  RESULTS
  Baseline PAPPA (PAPPA(BL)) serum levels did not differ between obese and lean subjects. PAPPA(BL) correlated significantly with IGF1, IGFBP1, and serum cholesterol. During the 1-year-program mean IMT decreased from 0.66 ± 0.01 to 0.63 ± 0.01 mm (P<0.05) and PAPPA from 1.83 ± 0.12 to 1.58 ± 0.11 μU/l (P<0.00). In linear regression analysis with IMT after intervention as dependent variable, PAPPA contributed significantly to the observed variance. The longitudinal change of PAPPA correlated significantly with the change of serum triglycerides.
  
  
  CONCLUSIONS
  In this cohort of obese children, PAPPA serum levels correlated significantly with other cardiovascular risk factors. The lack of a direct correlation between PAPPA and IMT suggests that the described association of atherosclerotic plaques and increased PAPPA levels might reflect an indirect mechanism of PAPPA with cardiovascular risk factors such as serum lipids rather than a direct effect on the vasculature.
authors.affiliation: Pediatric Endocrinology Division, Children's Hospital, University of Bonn, Adenauerallee 119, 53113 Bonn, Germany. joachim.woelfle@ukb.uni-bonn.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Woelfle
authors.forename: Christian L
authors.initials: CL
authors.lastname: Roth
authors.forename: Rainer
authors.initials: R
authors.lastname: Wunsch
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinehr
mesh_terms: D050197:Atherosclerosis / Q000097:blood* / Q000453:epidemiology; D015415:Biomarkers; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy; D050177:Overweight / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011627:Puberty / Q000502:physiology; D012307:Risk Factors; D013002:Somatomedins / Q000502:physiology*; D014463:Ultrasonography; D015431:Weight Loss / Q000502:physiology
chemical_list: D015415:Biomarkers; D007328:Insulin; D008055:Lipids; D013002:Somatomedins; D011266:Pregnancy-Associated Plasma Protein-A