C-reactive protein and cardiometabolic risk factors in overweight or obese children and adolescents
Palabras clave:
C-reactive protein, Cardiovascular diseases, Obesity, Risk factorsResumen
Objective
To investigate the relationship between ultrasensitive C-reactive protein and cardiometabolic risk factors in overweight or obese childrenand adolescents.
Methods
Cross-sectional study conducted at the Center for Childhood Obesity in the period from April 2009 to April 2010, involving 185 overweight children and adolescents aged 2 to 18 years. Measures of ultrasensitive Creactive protein according to age, nutritional status, gender, race, cardiometabolic risk factors (waist circumference, lipid profile, impaired fasting glucose, high blood pressure and presence of insulin resistance) were compared through the Chi-square test and analysis of variance. All analyses were performed using the Statistical Package for the Social Sciences software version 17.0, adopting a significance level of 5%.
Results
Altered high-density lipoprotein was the most frequent cardiometabolic risk factor, and there was a significant association between altered ultrasensitive C-reactive protein values and severe obesity (p=0.005), high waist circumference (p<0.001), hypertriglyceridemia (p=0.037) and insulin resistance (p=0.002), as well as significantly higher body mass index (p=0.000), waist circumference (p=0.001), insulin (p=0.005) and index of glucose homeostasis values(p=0.005).
Conclusion
High prevalence of altered ultrasensitive C-reactive protein and significant association with severe obesity, waist circumference, hypertriglyceridemia and insulin resistance were observed.
Citas
Goldani MZ, Mosca PRF, Portella AK, Silveira PP, Silva CH. O impacto da transição demográfico epidemiológica na saúde da criança e do ado lescente do Brasil. Rev HCPA. 2012; 32(1):49-57.
Rodrigues NA, Perez AJP, PiresJGP, Carletti L, Araújo MTM, Moyses MR, et al. Cardiovascular risk factors, their associations and presence of metabolic syndrome in adolescents. J Pediatr. 2009; 85(1):55-60. doi: 10.2223/JPED.1867
Gobel RJ, Jensen SM, Frokiaer H, Molgaard C, Michaelsen KF. Obesity, inflammation and metabolic syndrome in Danish adolescents. Acta Paediatr. 2012; 101(2):192-200. doi: 10.1111/j.1651-222 7.2011.02493.x
Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: Risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009; 53(21):1925-32. doi: 10.1016/j.jacc.2008.12.068
Gomes F, Telo DF, Souza HP, Nicolau JC, Halpern A, Carlos V, et al. Obesidade e doença arterial coro nariana: papel da inflamação vascular. Arq Bras Cardiol. 2010; 94(2):273-9.
Borges RL, Ribeiro-Filho FF, Carvalho KMB, Zanella MT. Impacto da perda de peso nas adipocitocinas, na proteína C-reativa e na sensibilidade à insulina em mulheres hipertensas com obesidade central. Arq Bras Cardiol. 2007; 89(6):409-14. doi: 10.15 90/S0066-782X2007001800010
Miller M, Zhan M, Havas S. High attributable risk of elevated C-reactive protein level to conventionalcoronary heart disease risk factors: The Third National Health and Nutrition Examination Survey. Arch Intern Med. 2005; 165(18):2063-8. doi: 10.1001/archinte.165.18.2063
Pai JK, Pischon T, Ma J, Manson JE, Hankinson SE, Joshipura K, et al. Inflammatory markers and the risk of coronary heart disease in men and women. N Engl J Med. 2004; 351(25):2599-610. doi: 10.10 56/NEJMoa040967
Pepys M, Hirschfield G. C-Reactive Protein: A critical update. J Clin Invest. 2003; 111(12):1805-12. doi: 10.1172/JCI200318921
World Health Organization. Physical status: The study and interpretation of anthropometry. Geneva: WHO; 1995. Technical Report Series, nº 854. 11. Centers of Disease Control and Prevention. Table for calculated body mass index values for selected highs and weights for ages 2 to 20 years. Atlanta (GA): National Center for Health Statistc; 2002 [cited 2013 Jul 15]. Available from: .
Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Nefrologia. V Diretrizes Brasileiras de Hipertensão Arterial. São Paulo: Sociedade Brasileira de Car diologia; 2006 [acesso 2013 jul 14]. Disponível em: .
Giuliano ICB, Caramelli B, Pellanda L, Duncan B, Mattos S, Fonseca FH. I Diretriz de Prevenção da Aterosclerose na Infância e na Adolescência. Rio de Janeiro: Sociedade Brasileira de Cardiologia; 2005 [acesso 2013 jul 15]. Disponível em: .
Ford ES. C-reactive protein concentration and cardiovascular disease risk factors in children: Findings from the National Health and Nutrition Examination Survey 1999-2000. Circulation. 2003; 108(9):1053-8.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. 16. Vasques AC, Rosado LE, Cássia G, Alfenas RC, Geloneze B. Análise crítica do uso dos índices do Homeostasis Model Assessment (HOMA) na avaliação da resistência à insulina e capacidade funcional das células-β pancreáticas. Arq Bras Endocrinol Metabol. 2008; 52(1):32-9. doi: 10.15 90/S0004-27302008000100006
Huang TT, Johnson MS, Goran MI. Development of a prediction equation for insulin sensitivity from anthropometry and fasting insulin in prepubertal and early pubertal children. Diabetes Care. 2002; 25(7):1203-10.
Madeira IR, Carvalho CNM, Gazolla FM, Matos HJ, Borges MA, Bordallo MAN. Ponto de corte do índice Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) avaliado pela curva Receiver Operating Characteristic (ROC) na detecção de síndrome metabólica em crianças pré-púberes com excesso de peso. Arq Bras Endocrinol Metab. 2008; 52(9):1466-73.
International Diabetes Federation. Worldwide definition of metabolic syndrome. Brussels: International Diabetes Federation; 2005 [cited 2012 Jul 24]. Available from: .
Norton ARBRC, Rossetti MB, Leão E, Mendes RP. Proteína C-reativa como indicador de inflamação de baixa intensidade em crianças e adolescentes com e sem obesidade. J Pediatr. 2007; 83(5). doi: 10.1590/S0021-75572007000600014
Thomas NE, Baker JS, Graham MR, Cooper SM, Davies B. C-reactive protein in schoolchildren and its relation to adiposity, physical activity, aerobic fitness and habitual diet. Br J Sports Med. 2008; 42(5):357-60.
Siervo M, Ruggiero D, Sorice R, Nutile T, Aversano M, Iafusco M, et al. Body mass index is directly associated with biomarkers of angiogenesis and inflammation in children and adolescent. Nutrition. 2012; 28(3):262-6. doi: 10.1016/j.nut.2011.0 6.007
Emanuela F, Grazia M, De Robertis M, Luconi MP, Furlani G, Boscaro M. Inflammation as a link between obesity and metabolic syndrome. J Nutr Metab. 2012; 2012(476380):1-7. doi: 10.1155/20 12/476380
Denney-Wilson E, Hardy LL, Dobbins T, Okely AD, Baur LA. Body mass index, waist circumference, and chronic disease risk factors in Australian adolescents. Arch Pediatr Adolesc Med. 2008 [cited 2012 Jul 10]; 162(6):566-73. Available from: .
Cameron AJ, Boyko EJ, Sicree RA, Zimmet PZ, Soderberg S, Alberti KG, et al. Central obesity as a precursor to the metabolic syndrome in the AusDiab Study and Mauritius. Obesity. 2008; 16(12):2707-16. doi: 10.1038/oby.2008.412
Arnaiz P, Pino F, Marín A, Barja S, Aglony M, Cassis B, et al. Association between a cardiovascular risk score and early markers of atherosclerotic disease in Chilean children. Rev Med Chil. 2010; 138(10):1226-31. doi: S0034-9887201000110 0003.
Serrano HMS, Carvalho GQ, Pereira PF, Peluzio MCG, Franceschini SCC, Priore SE. Composição corpórea, alterações bioquímicas e clínicas de adolescentes com excesso de adiposidade. Arq Bras Cardiol. 2010; 95(4):464-72.
Silva IT, Sanches LB, Mello APQ, Damasceno NRT. Impacto da proteína C-reativa no risco cardiovas cular de adolescentes. Arq Bras Cardiol. 2010 [cited 2012 Oct 10]; 94(5):585-91. doi: 10.1590/S0066- 782X2010005000027
Simões AFR. Níveis séricos de proteína C-reactiva e perfil lipídico numa população de crianças e adolescentes com diabetes Mellitus tipo 1 [Dissertação]. Porto: Universidade do Porto; 2008.
Bridger T. Childhood obesity and cardiovascular disease. Paediatr Child Health. 2009; 14(3):177-82.
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Derechos de autor 2023 Anajás da Silva CARDOSO, Renata Oliveira CARDOSO, Danielle Franklin de CARVALHO, Danielle Franklin de CARVALHO, Neusa COLLET, Carla Campos Muniz MEDEIROS
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
