The associations between some biological markers, obesity, and cardiovascular risk in Slovenian children and adolescents

Abstract

Introduction: The occurrence of cardiovascular diseases and metabolic disorders steadily increases with the body mass index (BMI). Since the latter is not the best and earliest indicator of obesity and cardiovascular risk, the aim of the study was to evaluate some potential biological markers that would allow us to detect children and adolescents at higher risk at an early stage. Methods: A sample of 330 children and adolescents were included in the study and divided into four groups: obese patients with hypertension, normal-weight patients with hypertension, patients with mildly elevated lipids and a control group of healthy children and adolescents. Some clinical parameters (age, body weight, body height, BMI, waist circumference, hip circumference, blood pressure), biochemical parameters (glucose, total cholesterol, triglycerides, HDL, LDL, apolipoprotein A1, homocysteine) and biological markers of obesity (ghrelin, adiponectin, leptin) were evaluated. Results: Ghrelin and adiponectin were found to have a strong negative statistically significant correlation with BMI in all three observed groups (p < 0.001), but not in the control group (p = 0.053 and p = 0.316, respectively). In addition, leptin had a strong positive statistically significant correlation with BMI in all four groups (p < 0.001 for the research groups, p = 0.009 for the controls). In the group of obese patients with hypertension, statistically significant differences in all three markers of obesity were found in comparison to the control group (p < 0.001 for all markers). In the group of patients with mildly elevated lipids, ghrelin and leptin were significantly different (p = 0.002 and p < 0.001, respectively). In the group of normal-weight hypertensive patients, only values of ghrelin were different compared to the control group (p = 0.001). Conclusion: In the research groups, significant differences were found in clinical, biochemical and biological parameters compared to the control group. The observed biological markers of obesity are useful early markers for identifying groups of patients that are at cardiovascular risk.

Predictive Markers of Early Cardiovascular Impairment and Insulin Resistance in Obese Pediatric Patients

“…One of the crucial aims to prevent pediatric obesity complications is to detect children with higher cardiovascular risk and IR at an early stage [ 14 , 21 ]. Among clinical markers, BMI percentile and WC are frequently used in practice but with certain limitations [ 22 ].…”

“…Among clinical markers, BMI percentile and WC are frequently used in practice but with certain limitations [ 22 ]. Although BMI is used as a measure of obesity, it is not sensitive enough to detect early fat accumulation and early CVD risk [ 14 , 23 , 24 ].…”

“…One of the crucial aims of preventing the comorbid conditions associated with obesity is to detect children with higher cardiovascular risk at an early stage [ 14 ]. In this study, we evaluated the presence of early markers of cardiovascular risk represented by interleukine-6 (IL-6), Intercellular Adhesion Molecules (ICAM) and endotoxemia and their correlation with metabolic markers of IR represented by insulinemia, HOMA index and plasma cortisol.…”

Cardiometabolic and Cardiovascular Complications of Obesity in Children

“…Regarding the relationship between leptin and adiponectin, in spite of the many studies which have shown decreased levels of adiponectin and increased levels of leptin in children with obesity, their codependency is not well understood [85]. High leptin to adiponectin ratio is also a predictive value for obesity and an adverse metabolic profile in children that seems to be sex-specific [86].…”

“…High leptin to adiponectin ratio is also a predictive value for obesity and an adverse metabolic profile in children that seems to be sex-specific [86]. Both adipokines, leptin and adiponectin, have been shown to be good biomarkers of future cardiometabolic risk, and have been found to be associated with adiposity biomarkers such as BMI and WHR, both in children and adolescents with obesity [85,86]. High leptin levels along with elevated circulating triglycerides in children with obesity are associated with BMI, WC and WHR [87].…”