scholarly journals Assessment of Endothelial Dysfunction in Childhood Obesity and Clinical Use

2013 ◽  
pp. 201-242
2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Vaithinathan Selvaraju ◽  
Priscilla Ayine ◽  
Moni Fadamiro ◽  
Jeganathan Ramesh Babu ◽  
Michael Brown ◽  
...  

Obesity is a state of chronic low-level inflammation closely associated with oxidative stress. Childhood obesity is associated with endothelial dysfunction, inflammation, and oxidative stress markers individually. This study was aimed at determining the association between the biomarkers of inflammation, oxidative stress, and endothelial dysfunction in urine samples of healthy, overweight, and obese children. Eighty-eight elementary school children aged between 6 and 10 years participated in this study. Anthropometric measurements were measured using WHO recommendations. The biomarkers of low-grade inflammation such as C-reactive protein (CRP), interleukin-6 (IL-6), and α-1-acid glycoprotein (AGP); oxidative stress markers such as 8-isoprostane and 8-hydroxy-2′-deoxyguanosine (8-OHdG); and endothelin-1 (ET-1) were analyzed in urine samples. The area under the curve (AUC) by the receiver operating characteristics (ROC) was analyzed to identify the best urinary biomarker in childhood obesity. Linear regression and Pearson correlation were analyzed to determine the association between the parameters. The obese participants have significantly increased levels of CRP, AGP, IL-6, and 8-isoprostane compared to normal-weight participants. The overweight participants had significantly increased levels of ET-1 and 8-OHdG but not the obese group compared to the NW group. The AUC for urinary CRP (AUC: 0.847, 95% CI: 0.765-0.930; p<0.0001) and 8-isoprostane (AUC: 0.857, 95% CI: 0.783-0.932; p<0.0001) showed a greater area under ROC curves compared to other inflammatory and oxidative markers. The urinary CRP and 8-isoprostane significantly correlated with the obesity measures (body mass index, waist circumference, and waist-to- height ratio) and ET-1, inflammatory, and oxidative markers. The increased urinary inflammatory markers and 8-isoprostane can serve as a noninvasive benchmark for early detection of the risk of developing cardiovascular disease.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3338-3338
Author(s):  
Anamika Singh ◽  
Jay Gunawardana ◽  
Tara Alexis McCoy ◽  
Tina Nguyen ◽  
Stephanie Vander Veur ◽  
...  

Abstract Abstract 3338 Childhood obesity is increasing in prevalence and associated with risk of type 2 diabetes (T2DM) and coronary disease. Adult obesity and T2DM are associated with alterations in the coagulation and fibrinolytic systems. Tissue Factor (TF) is the principal initiator of blood coagulation and is both prothrombotic and proinflammatory. In mouse models of obesity, TF and plasminogen activator inhibitor (PAI)-1 genes are upregulated. We tested the hypothesis that childhood obesity is associated with elevated levels of circulating TF and markers of coagulation, fibrinolysis, and endothelial dysfunction. Forty-seven children were recruited and classified based on Body Mass Index (BMI) percentile (CDC growth curves) as underweight (≤5th percentile; n=1), healthy weight (>5–84.9th percentile; n=22), overweight (≥85%-94.9th percentile; n=3) and obese (≥95th percentile; n=21). We compared the findings in 21 obese children (10.1±1.5 years, mean age ± SD) and 22 healthy weight children (9.9±1.6 years). Circulating membrane bound TF procoagulant activity (TF-PCA), measured in whole blood lysates by a two-stage clotting assay (Key et al, Blood;1998:91), was elevated in obese compared to healthy weight children (60.6±32.5 vs 34.0±13.5 U/ml, mean ± SD, p=0.005). TF-PCA levels in obese children were comparable to levels observed by us in adults with T2DM (69.5±11.5; n=18). Plasma factor (F) VIIC (1.00±0.20 vs 0.90±0.20 U/ml; p=0.03) was elevated in obese group. Plasma FVIIa, FVIII, TF antigen, fibrinogen, and thrombin-antithrombin III, and microparticles (MP) were not different between groups. In fibrinolytic system, plasma PAI-1 was elevated in obese group (37.3±18.0 vs 25.6±15.0 ng/ml; p=0.03), and tissue plasminogen activator (tPA) antigen (6.7±3.4 vs 5.1±2.0 ng/ml, p=0.07) showed a similar trend. Endothelial markers, soluble vascular cell adhesion molecule-1 (sVCAM-1; 709.2±444.5 vs 526.5±184.8 ng/ml; p=0.05) and von-Willebrand Factor (VWF; 1057.4±139.8 vs 987.9±130.8 mU/ml; p=0.07) showed a trend towards higher levels in obesity, suggesting endothelial dysfunction. BMI correlated with circulating TF-PCA (r=0.36; p=0.01), FVIIC (r=0.36; p=0.01), and PAI-1 (r=0.38; p=0.009). TF-PCA correlated with sVCAM-1 (r=0.36; p=0.01), suggesting a potential endothelial contribution to the circulating TF-PCA. Plasma FVIIa (r=−0.29; p=0.053) appeared to be inversely related to TF-PCA possibly related to removal of FVIIa from plasma by binding to membrane TF. There was an inverse relationship between MP and FVIII (r= −0.42; p=0.004) and VWF (r=−0.37; p=0.01), which may reflect binding of FVIII and vWF to microparticles. Conclusions: Obesity, even in children, causes a potential procoagulant state characterized by increased circulating TF-PCA, FVIIC and PAI-1, and is associated with evidence suggesting endothelial dysfunction. Elevated levels of endothelial markers have been shown to predict development of T2DM, and elevated FVIIC has been associated with carotid intima-media thickness in young adults. Overall, these alterations may be basis for the increased risk of cardiovascular disease now documented in childhood obesity as well. Larger studies are needed to define the effect of childhood obesity on the hemostatic systems and the impact of intervention with weight reduction on the observed changes. Disclosures: No relevant conflicts of interest to declare.


2013 ◽  
Vol 2013 ◽  
pp. 1-19 ◽  
Author(s):  
Luc Bruyndonckx ◽  
Vicky Y. Hoymans ◽  
Amaryllis H. Van Craenenbroeck ◽  
Dirk K. Vissers ◽  
Christiaan J. Vrints ◽  
...  

The association of obesity with noncommunicable diseases, such as cardiovascular complications and diabetes, is considered a major threat to the management of health care worldwide. Epidemiological findings show that childhood obesity is rapidly rising in Western society, as well as in developing countries. This pandemic is not without consequences and can affect the risk of future cardiovascular disease in these children. Childhood obesity is associated with endothelial dysfunction, the first yet still reversible step towards atherosclerosis. Advanced research techniques have added further insight on how childhood obesity and associated comorbidities lead to endothelial dysfunction. Techniques used to measure endothelial function were further brought to perfection, and novel biomarkers, including endothelial progenitor cells, were discovered. The aim of this paper is to provide a critical overview on bothin vivoas well asin vitromarkers for endothelial integrity. Additionally, an in-depth description of the mechanisms that disrupt the delicate balance between endothelial damage and repair will be given. Finally, the effects of lifestyle interventions and pharmacotherapy on endothelial dysfunction will be reviewed.


2015 ◽  
Vol 69 (6) ◽  
pp. 649-658 ◽  
Author(s):  
A. Cardona ◽  
S. R. Kondapally Seshasai ◽  
J. Davey ◽  
A. L. Arrebola-Moreno ◽  
G. Ambrosio ◽  
...  

2014 ◽  
Vol 13 (5) ◽  
pp. 169-178
Author(s):  
I. A. Khripun ◽  
Z. R. Gtisova ◽  
H. S. Ibishev ◽  
A. S. Sultanmuradova ◽  
S. V. Vorobiev ◽  
...  

Endothelial dysfunction is an early marker for the development and progression of cardiovascular diseases. Scientific studies in recent years have shown the necessity to study the endothelial function in different groups of patients in clinical practice. This article is focused on the possibilities and perspectives for clinical use of laboratory and instrumental methods for the study of endothelial function. One of the factors causing the development of vascular disease in men is testosterone deficiency. The review highlights the most important mechanisms of action of sex hormones on the vascular endothelium and its function in men. The data about the effects of hormone replacement therapy with testosterone on endothelial function in patients with late onset hypogonadism were critically analyzed.


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