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Elevated serum C-reactive protein levels and early arterial changes in healthy children
Mikko J Järvisalo1, Aimo Harmoinen, Maarit Hakanen
1Department of Clinical Physiology, University of Turku, Turku, Finland.
Insights
Elevated C-reactive protein (CRP) in children is linked to poorer endothelial function and thicker carotid arteries, suggesting CRP contributes to early atherosclerosis development.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Biomarkers of Atherosclerosis
Background:
- Elevated C-reactive protein (CRP) is a known predictor of cardiovascular events in adults.
- Atherosclerosis, a precursor to cardiovascular disease, originates in childhood.
- Early detection of atherosclerosis markers in children is crucial for preventative strategies.
Purpose of the Study:
- To investigate the relationship between serum C-reactive protein (CRP) levels and markers of early atherosclerosis in healthy children.
- To assess if CRP influences brachial artery endothelial function (flow-mediated dilation, FMD) and carotid intima-media thickness (IMT).
Main Methods:
- Ultrasound measurements of brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) were performed in 79 healthy children (mean age 10.5 years).
- Children were stratified into three groups based on serum CRP levels: <0.1 mg/L, 0.1-0.7 mg/L, and >0.7 mg/L.
- Multivariate analyses were conducted to identify independent predictors of FMD and IMT.
Main Results:
- Children with higher CRP levels exhibited significantly lower FMD (indicating impaired endothelial function).
- Higher CRP levels were associated with significantly greater carotid intima-media thickness (IMT), a marker of arterial wall thickening.
- CRP levels were identified as a significant independent predictor for both brachial FMD and carotid IMT.
Conclusions:
- Serum CRP levels are associated with adverse vascular changes in healthy children, including reduced endothelial function and increased intima-media thickness.
- These findings suggest that CRP plays a role in the early pathogenesis of atherosclerosis in pediatric populations.
- CRP may serve as a valuable biomarker for identifying children at risk for developing atherosclerosis.
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 10.5+/-1.1 years). Compared with the children with CRP levels under the detection limit (<0.1 mg/L, n=40, group 1), the children with higher CRP (0.1 mg/L< or =CRP< or =0.7 mg/L, n=20, group 2; CRP >0.7 mg/L, n=19, group 3) had lower FMD (9.0+/-4.4% versus 7.8+/-3.3% versus 6.5+/-2.6%, respectively; P=0.015 for trend) and greater carotid IMT (0.45+/-0.03 versus 0.46+/-0.04 versus 0.49+/-0.06 mm, respectively, P=0.002 for trend). CRP level remained a statistically significant independent predictor for brachial FMD and carotid IMT in multivariate analyses.
Conclusions:
These data suggest that CRP affects the arteries of healthy children by disturbing endothelial function and promoting intima-media thickening. The findings support the hypothesis that CRP plays a role in the pathogenesis of early atherosclerosis.