ABSTRACT:We examined the associations of two functional variants 866GϾA and DEL/INS polymorphisms of UCP2 gene with low-grade inflammatory proteins (C-reactive protein, fibrinogen, complement C3 [C3], and complement C4 [C4]) in 131 children (52.7% boys, aged 9.5 Ϯ 0.4 y) and 118 adolescents (44.1% males, aged 15.5 Ϯ 0.4 y) selected from the European Youth Heart Study. Differences in inflammatory markers among the genotype variants of the two UCP2 gene polymorphisms were analyzed after adjusting for sex, age, pubertal stage, fitness, and fatness. The results showed that fibrinogen, C3, and C4 were higher in GG carriers than in subjects carrying the A allele of the 866GϾA polymorphism of the UCP2 gene (UCP2 Ϫ866GϾA) polymorphism (all p Ͻ 0.05). The DEL/ DEL genotype of 45nt deletion/insertion variant polymorphism of the UCP2 gene (UCP2 DEL/INS) was associated with higher C3 (p Ͻ 0.05) than DEL/INS and INS/INS genotypes. This study provides evidence of a role of UCP2 Ϫ866GϾA in modifying low-grade inflammatory state in apparently healthy children and adolescents. Given the implication of complement factors on atherosclerosis process, these results contribute to explain the reduced cardiovascular risk associated with the A allele of the UCP2 Ϫ866GϾA polymorphism. (Pediatr Res 66: 350-354, 2009) L ow-grade inflammation seems to play an important role in the development of cardiovascular disease from early stages in life (1,2). High concentration of C-reactive protein (CRP) and fibrinogen are considered a major cardiovascular risk factor (2,3). Likewise, the complement system has been implicated in the pathogenesis of atherosclerosis from early ages (4). It has been suggested that different complement factors have different preferential association with traditional risk factors (5). Complement C3 (C3) seems to represent a signal of the inflammatory process implicated in the appearance of the main endogenous risk factors such as glucose intolerance, type 2 diabetes, hypercholesterolemia, and hypertension (6 -8). Complement C4 (C4) concentration has been point out as an independent predictor of the future development of stroke (9).The uncoupling protein (UCP) 2 is expressed in many tissues and cells, including macrophages (10) and it seems to have an important role in the regulation of production of reactive oxygen species (ROS), inhibition of inflammation as well as inhibition of cell death (11,12), which are central features in cardiovascular disease. UCP2 has also an important role in the pathogenesis of type 2 diabetes by inhibiting insulin secretion in islet beta cells (13). At the same time, type 2 diabetes is associated with increased risk of cardiovascular disease and atherosclerosis, where an increased expression of UCP2 seems to be beneficial (14).The 866GϾA polymorphism of the UCP2 gene (UCP2 Ϫ866GϾA) and the 45nt deletion/insertion variant polymorphism (UCP2 DEL/INS) located in the 3Ј-untranslated region of exon 8 are common variants in UCP2 gene. Because of their implication on obesity or type 2 diabetes a...