Relevance of increased serum cystatin C to vascular alterations in obese children.
OBJECTIVE
Epidemiological studies report a positive relationship between serum cystatin C and cardiovascular outcomes in adults. Here, we tested the relevance of cystatin C as a biomarker for early vascular alterations in severely obese children.


METHODS
Two hundred nineteen obese (140 girls; age = 11.7 ± 2.7 years, BMI Z-score = 4.7 ± 1.2 SD) and 262 non-obese children (129 girls; age = 11.6 ± 0.6 years, body mass index [BMI] Z-score = 0.1 ± 1.0 SD). Serum cystatin C was measured by immunonephelometry. Intima media thickness (IMT), incremental elastic modulus, and flow-mediated and glyceryl-trinitrate-mediated dilations were determined at the common carotid artery and the brachial artery in obese children.


RESULTS
Obese children had significantly higher serum cystatin C than normal weight controls (0.86 ± 0.01 vs. 0.80 ± 0.01, P < 0.0001). In obese children, serum cystatin C correlates positively with BMI and the homeostasis model assessment index and negatively with the quantitative insulin sensitivity check index and adiponectin. A positive relationship was found between serum cystatin C and carotid IMT (r = 0.23, P = 0.0005), which remained significant in multivariate models adjusted for BMI (P = 0.01) and adiponectin with a trend towards significance (P = 0.05).


CONCLUSIONS
This study positions cystatin C and adiponectin as covariables associated with arterial wall thickness in obese children. Although the underlying pathophysiology linking cystatin C to early vascular disease remains to be deciphered, cystatin C may represent a novel adipose tissue-derived biomarker implicated in obesity-related comorbidities early in life.
Institute of Cardiometabolism and Nutrition, Paris, France; INSERM, Paris, France.
B
B
Dubern
J C
JC
Lafarge
S
S
Fellahi
N
N
Naour
N
N
Copin
J P
JP
Bastard
C
C
Simon
K
K
Clément
D
D
Bonnet
P
P
Tounian
M
M
Guerre-Millo
D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D015992:Body Mass Index; D001916:Brachial Artery / Q000473:pathology*; D017536:Carotid Artery, Common / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000150:complications / Q000473:pathology*; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
D052242:Adiponectin; D055316:Cystatin C