It is known that inflammation accompanies atherosclerotic disease and even the
CRP is a predictor of increased risk for patients with cardiovascular diseases. Obesity
belongs among the conditions that cause chronic systemic inflammation (low grade),
because fat tissue secretes host of inflammatory cytokines (leptin and adiponectin
among others). The association of chronic systemic inflammation induced by obesity
with increased cardiovascular risk has not been fully studied in childhood. This
connection is explored in this study through correlation of inflammatory cytokines in
adipose tissue (adipokines) leptin and adiponectin with cardiovascular risk factors,
such as blood pressure, blood glucose, exercise, CRP and lipid profile. Furthermore,
we studied factors that may affect these adipokines, so that the modification of them
reduce cardiovascular risk in obese children.
We studied 170 healthy children aged approximately 10±2 years, male and
female. We measured height, weight, body mass index (BMI), blood pressure,
physical activity was assessed and recorded in two categories. Peripheral venous
blood was collected from each child, fasting and we identified the + blood glucose, lipid profile, apolipoproteins and the levels of leptin, adiponectin and
CRP. Differences between groups were studied either by Student's t-test for normal
values or Mann-Whitney U-test for abnormal values. The correlation of leptin and
adiponectin with various parameters was analyzed with linear regression (Pearson's
Correlation analysis) and multiple linear regression analysis. The values of leptin and
adiponectin were divided into quartiles according to their percentile scores (25th,
50th, 75th) and were compared with ANOVA the differences in values of measured
parameters between the quarters.
The results indicate significant positive correlations of leptin with BMI, blood
pressure, glucose levels, CRP and negative correlation of leptin with HDL. Higher
leptin values were observed in the most obese children, children who gained weight
very rapidly from birth, girls, infants who do not breastfeed, those who did not
exercise and those whose parents smoked. Adiponectin correlations were opposed. It
was observed negative correlation with BMI, blood pressure and CRP. Higher values
of adiponectin were present in children who got less weight from birth and very low
values ones quickly gained much weight since birth. The children were divided into
two groups, high and low risk according to BMI, blood pressure, fasting glucose, lipid
profile, physical activity and smoking of parents. Children at risk had typically much
higher values of leptin, significantly lower prices of adiponectin and significantly
higher levels of CRP.
Children with high levels of leptin and/or low levels of adiponectin together pose
multiple cardiovascular risk factors such as higher blood pressure and fasting glucose,
higher BMI, lower HDL cholesterol, especially high levels of CRP. These children
gather many of the features of the metabolic syndrome and likely there is a link
between inflammation (CRP), obesity (leptin and adiponectin) and cardiovascular
risk, already visible in childhood. Modifiable factors that reduce the levels of leptin (if
implicated in increased cardiovascular risk) may be the gradual rather than accelerated
growth in early childhood, the breastfeeding, the normal weight, the physical activity,
the absence of parenteral smoking.
National Documentation Centre (EKT)
