Elevated Serum C-Reactive Protein Levels and Early Arterial Changes in Healthy Children

Abstract

Objective-Elevated serum concentration of C-reactive protein (CRP) predicts cardiovascular events in adults. Because atherosclerosis begins in childhood, we undertook a study to determine whether changes in brachial artery endothelial function and the thickness of the carotid intima-media complex, 2 markers of early atherosclerosis, are related to CRP levels in healthy children. Methods and Results-Brachial artery flow-mediated dilatation (FMD) and carotid artery intima-media thickness (IMT) were measured with ultrasound in 79 children (aged 10.5Ϯ1.1 years). Compared with the children with CRP levels under the detection limit (Ͻ0.1 mg/L, nϭ40, group 1), the children with higher CRP (0. 4 -8 Experimental studies have shown that CRP can be found in arterial walls affected by atherosclerosis but not in healthy vessel walls. 9 In a concentrationdependent manner, CRP directly increases endothelial production and the expression of monocyte chemoattractant protein-1 10 and adhesion molecules, including intercellular adhesion molecule-1 (ICAM-1). 11 CRP also influences monocyte chemotaxis during atherogenesis, and the deposition of CRP precedes and mediates the appearance of monocytes in early atherosclerotic lesions. 12 Recently, it has been shown that CRP mediates the uptake of native LDL into macrophages, which is a novel mechanism for foam cell formation without biochemical modification of LDL. 13 Thus, together, these data suggest that CRP may have a direct proatherogenic role by disturbing endothelial function and promoting the formation of early atherosclerotic lesions. Because atherosclerosis begins in childhood, we undertook a study to assess whether changes in brachial artery reactivity and the thickness of the carotid intima-media complex (intima-media thickness [IMT]), 2 markers of early atherosclerosis, are related to serum CRP levels in healthy children. The study of arterial changes in children can provide unique data on early atherosclerosis and its determinants that are not obscured by other chronic diseases or lifestyle habits. Methods SubjectsWe studied 79 children; all were healthy nonsmokers without any regular medication and with no family history of premature vascular disease. None of the children had had symptoms of infection during the 2 weeks before the study. Subjects were children of the hospital staff members (nϭ36) and children participating in a risk factor study (nϭ44). 14 Children's parents were asked about their smoking (smoking/nonsmoking) on a questionnaire. The study protocol was approved by the local Ethics Committee. Legal guardians gave written informed consent. Ultrasound StudiesAll studies were performed in the morning to fasting subjects with the use of a Sequoia 512 mainframe (Acuson) and 13.0-MHz linear array transducer. All ultrasound scans were performed by an expe-

Relationship of High Sensitivity C-Reactive Protein Levels to Anthropometric and other Metabolic Parameters in Indian Children with Simple Overweight and Obesity

“…These results are consistent with some previous studies [10,11]. Our observation adds to the hypothesis that inflammatory state that occurs in obesity may contribute to elevation of blood pressure [23]. Elevated blood pressure and in particular the pulse pressure has been associated with an increased risk of cardiovascular disease and the underlying mechanism may be inflammation as demonstrated by elevated CRP levels [24].…”

Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction

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Associations of physical activity, cardiorespiratory fitness and fatness with low-grade inflammation in adolescents: the AFINOS Study

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