Association between markers of endothelial dysfunction and early signs of renal dysfunction in pediatric obesity and type 1 diabetes

作者：Marcovecchio M L^*; de Giorgis T; Di Giovanni I; Chiavaroli V; Chiarelli F; Mohn A

来源：Pediatric Diabetes, 2017, 18(4): 283-289.

DOI：10.1111/pedi.12391

• children
• intercellular adhesion molecule-1
• myeloperoxidase
• obesity
• type 1 diabetes

Marcovecchio ML, de Giorgis T, Di Giovanni I, Chiavaroli V, Chiarelli F, Mohn A. Association between markers of endothelial dysfunction and early signs of renal dysfunction in pediatric obesity and type 1 diabetes+. Pediatric Diabetes 2017: 18: 283-289.
Background: To evaluate whether circulating markers of endothelial dysfunction, such as intercellular adhesion molecule-1 (ICAM-1) and myeloperoxidase (MPO), are increased in youth with obesity and in those with type 1 diabetes (T1D) at similar levels, and whether their levels are associated with markers of renal function.
Methods: A total of 60 obese youth [M/F: 30/30, age: 12.5 +/- 2.8 yr; body mass index (BMI) z-score: 2.26 +/- 0.46], 30 with T1D (M/F: 15/15; age: 12.9 +/- 2.4 yr; BMI z-score: 0.45 +/- 0.77), and 30 healthy controls (M/F: 15/15, age: 12.4 +/- 3.3 yr, BMI z-score: -0.25 +/- 0.56) were recruited. Anthropometric measurements were assessed and a blood sample was collected to measure ICAM-1, MPO, creatinine, cystatin C and lipid levels. A 24-h urine collection was obtained for assessing albumin excretion rate (AER).
Results: Levels of ICAM-1 and MPO were significantly higher in obese [ICAM-1: 0.606 (0.460-1.033) mu g/mL; MPO: 136.6 (69.7-220.8) ng/mL] and T1D children [ICAM-1: 0.729 (0.507-0.990) mu g/mL; MPO: 139.5 (51.0-321.3) ng/mL] compared with control children [ICAM-1: 0.395 (0.272-0.596) mu g/mL MPO: 41.3 (39.7-106.9) ng/mL], whereas no significant difference was found between T1D and obese children. BMI z-score was significantly associated with ICAM-1 (beta=0.21, p=0.02) and MPO (beta=0.41, p<0.001). A statistically significant association was also found between ICAM-1 and markers of renal AER: beta=0.21, p=0.03; e-GFR: beta=0.19, p=0.04), after adjusting for BMI.
Conclusions: Obese children have increased markers of endothelial dysfunction and early signs of renal damage, similarly to children with T1D, confirming obesity to be a cardiovascular risk factor as T1D. The association between ICAM-1 with e-GFR and AER confirm the known the association between general endothelial and renal dysfunction.

• 出版日期2017-6