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Relevance of increased serum cystatin C to vascular alterations in obese children
Author(s) -
Dubern B.,
Lafarge J.C.,
Fellahi S.,
Naour N.,
Copin N.,
Bastard J.P.,
Simon C.,
Clément K.,
Bonnet D.,
Tounian P.,
GuerreMillo M.
Publication year - 2012
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/j.2047-6310.2012.00053.x
Subject(s) - cystatin c , medicine , adiponectin , body mass index , biomarker , cystatin , endocrinology , clinical significance , obesity , adipose tissue , gastroenterology , insulin resistance , renal function , biochemistry , chemistry
Summary Objective Epidemiological studies report a positive relationship between serum cystatin C and cardiovascular outcomes in adults. Here, we tested the relevance of cystatin C as a biomarker for early vascular alterations in severely obese children. Methods Two hundred nineteen obese (140 girls; age = 11.7 ± 2.7 years, BMI Z ‐score = 4.7 ± 1.2 SD ) and 262 non‐obese children (129 girls; age = 11.6 ± 0.6 years, body mass index [ BMI ] Z ‐score = 0.1 ± 1.0 SD ). Serum cystatin C was measured by immunonephelometry. Intima media thickness ( IMT ), incremental elastic modulus, and flow‐mediated and glyceryl‐trinitrate‐mediated dilations were determined at the common carotid artery and the brachial artery in obese children. Results Obese children had significantly higher serum cystatin C than normal weight controls (0.86 ± 0.01 vs. 0.80 ± 0.01, P < 0.0001). In obese children, serum cystatin C correlates positively with BMI and the homeostasis model assessment index and negatively with the quantitative insulin sensitivity check index and adiponectin. A positive relationship was found between serum cystatin C and carotid IMT ( r = 0.23, P = 0.0005), which remained significant in multivariate models adjusted for BMI ( P = 0.01) and adiponectin with a trend towards significance ( P = 0.05). Conclusion This study positions cystatin C and adiponectin as covariables associated with arterial wall thickness in obese children. Although the underlying pathophysiology linking cystatin C to early vascular disease remains to be deciphered, cystatin C may represent a novel adipose tissue‐derived biomarker implicated in obesity‐related comorbidities early in life.