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Infantile obesity: a situation of atherothrombotic risk?
1Clinical Laboratory, Valle de los Pedroches Hospital, Pozoblanco, Córdoba, Spain.
Insights
Obese children show increased risk factors for cardiovascular disease, including elevated insulin, tissue-plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen levels. These factors correlate with body mass index (BMI) and suggest a heightened risk.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Hemostasis and Thrombosis
Background:
- Obesity is a significant risk factor for cardiovascular disease (CVD), often co-occurring with hypertension, dyslipidemia, and diabetes.
- Recent research indicates that the hemostatic system is also affected by obesity, adding to the list of associated dysfunctions.
- Understanding these hemostatic alterations in obese children is crucial for early CVD risk assessment.
Purpose of the Study:
- To investigate alterations in coagulation and fibrinolysis within the hemostatic system of obese children.
- To compare hemostatic markers between obese children and a non-obese control group.
- To explore correlations between body mass index (BMI), insulin levels, and specific hemostatic factors in obese children.
Main Methods:
- A case-control study involving 61 obese children (ages 6-9) and 70 non-obese children.
- Measurement of body mass index (BMI), insulin, glucose, fibrinogen, tissue-plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), and fragment 1 + 2 of prothrombin (F1 + 2).
- Statistical analysis to compare groups and assess correlations between variables.
Main Results:
- Obese children exhibited significantly higher levels of insulin, t-PA, PAI-1, and fibrinogen compared to controls (P < .001 for all).
- No significant differences were observed in glucose or F1 + 2 levels between the groups.
- In obese subjects, insulin, PAI-1, and F1 + 2 positively correlated with BMI, while t-PA correlated with insulin and PAI-1 but not BMI.
Conclusions:
- Obese children demonstrate significant alterations in hemostatic factors, including elevated t-PA and PAI-1.
- These hemostatic changes, along with increased insulin and fibrinogen, contribute to an elevated risk profile for cardiovascular disease in obese children.
- The findings underscore the importance of monitoring hemostatic function in pediatric obesity for CVD prevention.
Abstract:
Obesity is a major risk factor for cardiovascular disease frequently associated with hypertension, dyslipidemia, and diabetes. In recent years, alterations in the hemostatic system have been added to these dysfunctions. We analyzed some of these alterations in coagulation and fibrinolysis in obese children (6 to 9 years old) of both sexes. We studied 61 obese children (mean body mass index [BMI], 22.35 kg/m2; 95% confidence interval [CI], 21.82 to 22.87) and 70 non-obese children (mean BMI, 16.58 kg/m2; 95% CI, 16.24 to 16.93) as a control group. The obese subjects presented significantly elevated values for insulin (P < .001), tissue-plasminogen activator ([t-PA] P < .001), plasminogen activator inhibitor-1 ([PAI-1] P < .001), and fibrinogen (P < .001) with respect to the control group. We found no significant differences in the concentration of glucose and fragment 1 + 2 of prothrombin (F1 + 2). In the obese subjects, insulin, PAI-1, and F1 + 2 were positively correlated with the BMI. On the other hand, t-PA was correlated with insulin and PAI-1 but not with the BMI. Therefore, in the obese children, there was an increment of the risk factors for cardiovascular disease.