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. 2021 Apr 20;11(4):735.
doi: 10.3390/diagnostics11040735.

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

Laura Mihaela Trandafir  1 , Elena Cojocaru  2 , Mihaela Moscalu  3 , Maria Magdalena Leon Constantin  4 , Ingrith Miron  1 , Alexandra Mastaleru  4 , Oana Teslariu  1 , Madalina Elena Datcu  5 , Silvia Fotea  6 , Otilia Frăsinariu  1
Affiliations

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

Laura Mihaela Trandafir et al. Diagnostics (Basel). .

Abstract

Background: The increased prevalence of obesity among children determined the rising number of its comorbidities in children and adults, too. This study aimed to evaluate certain markers of inflammation and insulin resistance in obese pediatric patients, identifying those who are more likely to develop further complications.

Methods: We included 115 obese pediatric patients: 85 overweight and obese patients in the study group and 30 normal-weight patients in the control group. We calculated the body mass index (BMI) and we evaluated markers (biological, inflammatory) and the hormones profile.

Results: Low-threshold inflammation was assessed by measuring interleukin 6 IL-6 and Intercellular Adhesion Molecules (ICAM). The analysis showed that IL-6 is significantly correlated with glucose (p = 0.001) and BMI value (p = 0.031). ICAM correlates significantly with triglycerides (p = 0.001), glucose (p = 0.044) and BMI percentile (p = 0.037). For pediatric obese patients, endotoxemia has been significantly correlated only with BMI percentile (p = 0.001). Plasma cortisol did not show significant correlations with total cholesterol, triglycerides, glucose or BMI percentile. The results indicated a significant predictive power of BMI percentile on inflammatory markers: IL-6 (AUC = 0.803, p < 0.001), ICAM (AUC = 0.806, p < 0.001) and endotoxemia (AUC = 0.762, p = 0.019). Additionally, BMI percentile has a significant predictive power for metabolic markers of insulin resistance (insulin value: AUC = 0.72, p < 0.001 and HOMA index: AUC = 0.68, p = 0.003).

Conclusions: The study highlighted the importance of early markers of cardiovascular risk in obese pediatric patients represented by IL-6, ICAM, endotoxemia and their correlation with metabolic markers of insulin resistance represented by insulinemia, HOMA index and plasma cortisol. It can clearly be considered that the BMI percentile has significant predictive power for metabolic markers of insulin resistance.

Keywords: cardiovascular; comorbidities; inflammation markers; insulin resistance markers; obese pediatric patients.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The regression line in the correlation of IL-6 and ICAM values.
Figure 2
Figure 2
ROC curves for BMI vs. (a) IL-6 and ICAM and (b) endotoxemia.
Figure 3
Figure 3
ROC curves for IL-6 and ICAM and endotoxemia vs. (a) plasma glucose level and (b) serum triglycerides.
Figure 4
Figure 4
Identifying cut-off values predictive for vascular impairment in obese children (dot histogram) for: (a) IL-6; (b) ICAM; (c) endotoxemia.
Figure 5
Figure 5
ROC curves for metabolic markers of insulin resistance and obesity in children and adolescents.
Figure 6
Figure 6
Identifying cut-off values predictive for vascular impairment in obese children and adolescents (dot histogram) for metabolic markers of insulin resistance: (a) insulin; (b) HOMA index.
Figure 7
Figure 7
The regression line in the correlation of the HOMA index and (a) IL-6 values, (b) ICAM and (c) endotoxemia.
See this image and copyright information in PMC

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