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Serum cardiovascular risk biomarkers in pre-pubertal obese children
Albane B R Maggio1, Nathalie J Farpour-Lambert2,3, Yacine Aggoun4
1Santé et Mouvement Consultation, Service of Paediatric Specialties, Department of Child and Adolescent, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
Insights
A family-based behavioral intervention for childhood obesity showed that increased CCL2 levels were linked to lower diastolic blood pressure. Adiponectin changes correlated with improved arterial function, suggesting potential cardiovascular benefits.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Biomarkers
- Obesity Intervention
Background:
- Childhood obesity is a risk factor for early cardiovascular complications.
- Limited data exists on family-based interventions' impact on arterial function, blood pressure, and biomarkers in pre-pubertal children with obesity.
Purpose of the Study:
- To investigate the effect of a 6-month family-based behavioral intervention on arterial function, blood pressure, and serum biomarkers in pre-pubertal children with obesity.
- To explore the relationships between cardiovascular risk factors and specific biomarkers.
Main Methods:
- A single-center randomized controlled trial (RCT) involving 74 children.
- Intervention group received a 6-month behavioral treatment for obesity.
- Assessed serum levels of cytokine CCL2, adiponectin, neutrophil product MMP-8, carotid intima-media thickness, flow-mediated dilation (FMD), nitroglycerin-mediated dilation, arterial stiffness (Einc, PWV), and resting/24-hour blood pressure (BP).
Main Results:
- Baseline systolic BP correlated with MMP-8; MMP-8 was higher in hypertensive children.
- Biochemical markers increased post-intervention, with CCL2 increase associated with decreased diastolic BP.
- Adiponectin changes positively related to FMD changes and negatively to arterial stiffness (Einc, PWV) changes.
Conclusions:
- Serum biomarker utility for pediatric cardiovascular disease detection needs further validation.
- MMP-8 levels were elevated in hypertensive children.
- Behavioral interventions may paradoxically increase some biomarkers, but CCL2 changes suggest potential cardiovascular benefits. Caution advised when using nonspecific biomarkers for monitoring.
Background:
Childhood obesity is associated with premature cardiovascular complications. However, little is known about the effect of a family-based behavioural intervention on the relationship between arterial function, blood pressure and biomarkers in pre-pubertal children with obesity.
Design:
This was a single centre randomized controlled trial (RCT) including 74 children randomized to a 6-month behavioural intervention to treat obesity. In 48 children (13 controls and 35 interventions), we assessed: serum level of cytokine (CCL2), adiponectin, and neutrophil product (MMP-8), as well as carotid intima-media thickness, flow-mediated dilation (FMD), nitroglycerin-mediated dilation; arterial stiffness (incremental elastic modulus, Einc), pulse wave velocity (PWV), resting and 24-hour blood pressure (BP).
Results:
At baseline, resting systolic BP was positively associated with MMP-8 levels which was significantly higher in children with hypertension (P = 0.033). Biochemical markers were not related to endothelial function at baseline, but they globally increased after 6 months in the intervention group. The significant increase of CCL2 levels in the intervention group was associated with a decrease in diastolic BP. Furthermore, adiponectin change was positively related to a change in FMD and negatively to change in Einc and PWV.
Conclusions:
The usefulness of serum biomarkers for the detection of cardiovascular diseases is not well established in children. In our population, MMP-8 concentration was higher in hypertensive children. Furthermore, behavioural interventions resulted in a paradoxical increase in some biomarkers in children, with potentially beneficial effects detected with CCL2 changes. Caution should be taken when using nonspecific serum biomarkers for the clinical monitoring of children with obesity.
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