Proteína C reactiva y su relación con adiposidad, factores de riesgo cardiovascular y aterosclerosis subclínica en niños sanos

Abstract

In adults, C-reactive protein is a marker of cardiovascular risk. It is associated with both classical and metabolic risk factors and is a predictor of cardiovascular events. The aim was to investigate the relationship of the C-reactive protein concentration to classical cardiovascular risk factors, measures of adiposity subclinical atherosclerosis in children. The values of traditional risk factors, anthropometric parameters, fasting lipids, glucose and C-reactive protein levels were recorded. In addition, the carotid artery intima-media thickness was measured, and brachial artery endothelial function was assessed using flow-mediated dilation. The study included 112 children (58 male) with a mean age of 11.3+/-1.9 years. The mean C-reactive protein concentration was 0.9+/-1.5 mg/L. In males, there were significant direct correlations between the C-reactive protein concentration and body mass index, total fat mass, central adiposity, waist circumference, and low-density lipoprotein (LDL) cholesterol level. In females, C-reactive protein was associated with only body mass index. Boys in the highest C-reactive protein tertile had a significantly higher body mass index, total fat mass, LDL cholesterol level, and waist circumference. In the whole group, the best predictor of an elevated ultrasensitive C-reactive protein concentration was the body mass index (odds ratio=2.04 [1.30-3.21]). No relationship was found between the C-reactive protein concentration and the percentage flow-mediated dilation of the brachial artery or the carotid intima-media thickness. The results indicate that, in children, there is a significant direct relationship between the ultrasensitive C-reactive protein concentration and measures of adiposity, particularly body mass index. However, no relationship between C-reactive protein and subclinical atherosclerosis was observed.