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Systemic Inflammation, Oxidative Stress and Cardiovascular Health in Children and Adolescents: A Systematic Review
Tjaša Hertiš Petek1,2, Tadej Petek1,2, Mirjam Močnik1,2
1Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia.
Insights
Pediatric cardiovascular health is impacted by chronic inflammation and oxidative stress. Lifestyle changes and targeted antioxidant use may help manage these risks in children with chronic conditions.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Biochemistry
Background:
- Cerebrovascular diseases and atherosclerosis may originate in childhood, influenced by chronic inflammation.
- Vascular dysfunction in adults can be programmed prenatally.
- Oxidative stress (imbalance of reactive oxygen species and antioxidants) is linked to adult cardiovascular issues but understudied in children.
Purpose of the Study:
- To systematically review the role of systemic inflammation and oxidative stress in pediatric cardiovascular health.
- To assess the impact of these factors on chronic pediatric conditions.
- To evaluate the efficacy of lifestyle interventions and antioxidant use.
Main Methods:
- Systematic literature search using PRISMA guidelines in PubMed/Medline and Cochrane Reviews.
- Screening of 1228 potentially eligible pediatric articles.
- Inclusion of 160 articles focusing on inflammation, oxidative stress, antioxidants, cardiovascular disease, and endothelial dysfunction in children.
Main Results:
- Systemic inflammation and oxidative stress significantly influence cardiovascular health in pediatric chronic conditions like hypertension, obesity, and diabetes.
- Conditions reviewed include type 1 and 2 diabetes mellitus, chronic kidney disease, hyperlipidemia, and obstructive sleep apnea.
- Exercise and diet may reduce reactive oxygen species (ROS) and increase antioxidant capacity.
Conclusions:
- Lifestyle interventions (exercise, diet) show potential in mitigating oxidative stress and improving cardiovascular health in children.
- Antioxidant supplementation may benefit specific pediatric conditions, but results are often inconclusive.
- Further research is needed to clarify the role and optimal management of oxidative stress and inflammation in pediatric cardiovascular disease.
Abstract:
Recent studies indicate that cerebrovascular diseases and processes of atherosclerosis originate in the childhood era and are largely influenced by chronic inflammation. Some features of vascular dysfunction in adulthood may even be programmed prenatally via genetic influences and an unfavorable intrauterine milieu. Oxidative stress, defined by an imbalance between the production and generation of reactive oxygen species (ROS) in cells and tissues and the capability of an organism to scavenge these molecules via antioxidant mechanisms, has been linked to adverse cardiovascular health in adults, yet has not been systematically reviewed in the pediatric population. We performed a systematic search as per the PRISMA guidelines in PubMed/Medline and Cochrane Reviews and detected, in total, 1228 potentially eligible pediatric articles on systemic inflammation, oxidative stress, antioxidant use, cardiovascular disease and endothelial dysfunction. The abstracts and full-text manuscripts of these were screened for inclusion and exclusion criteria, and a total of 160 articles were included. The results indicate that systemic inflammation and oxidative stress influence cardiovascular health in many chronic pediatric conditions, including hypertension, obesity, diabetes mellitus types 1 and 2, chronic kidney disease, hyperlipidemia and obstructive sleep apnea. Exercise and diet may diminish ROS formation and enhance the total serum antioxidant capacity. Antioxidant supplementation may, in selected conditions, contribute to the diminution of the oxidative state and improve endothelial function; yet, in many areas, studies provide unsatisfactory results.
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