Abstract
Obesity is an independent risk factor for developing cardiovascular disease and increases insulin resistance in children. Interleukin (IL)-18 is a novel pro-inflammatory cytokine with potential atherogenetic properties. This study ai- med to identify circulating levels of IL-18 in obese children and examine the effects of combined nutritional education-physical activity course on circulating IL-18. Plasma IL-18, body mass index (BMI), fasting glucose and insulin, homeostasis model assessment insulin resistance (HOMA IR), lipid profile, uric acid, high- sensitive C-reactive protein (hs-CRP), and homocysteine were determined in 70 obese children aged 10-12 years before and after attending a 13-week weight reduction program, which included physical activities and nutritional education. Twenty-five age-matched non-obese children served as controls. At baseline, obese children had significantly higher levels of BMI, fasting insulin, HOMA IR, triglyceride (TG), uric acid, hs-CRP, and IL-18 but lower high-density lipoprotein-cholesterol (HDL-C) than non-obese children. Plasma IL-18 levels in obese children decreased significantly after the weight reduction program. At baseline, plasma IL-18 levels in obese children positively correlated with BMI, HOMA IR, insulin and TG but negatively correlated with HDL-C. There was a significant relationship between plasma IL-18 and BMI changes. Moreover, fasting insulin was responsible for IL-18 variability in obese children. These findings suggest that elevated plasma IL-18 levels in obese children are partly associated with parameters of obesity and insulin resistance, and are significantly affected by modest weight loss.
Highlights
The increasing prevalence of childhood obesity has significant medical and economical consequences
Differential low-grade inflammation is associated with obesity in the youth and some patterns of immune activation are related to insulin resistance [5]
Recent reports indicate that IL-18 concentrations may be linked to type 2 diabetes mellitus [7,8], metabolic syndrome [9], hyperhomocysteinemia [7,10], obesity [11,12] and insulin resistance [12]
Summary
The increasing prevalence of childhood obesity has significant medical and economical consequences. Obesity in the youth increases the risk for cardiovascular complications [1]. While mechanisms responsible for the increased prevalence of childhood obesity and associated chronic diseases have not been completely elucidated, its prevention and treatment play an important role in reducing cardiovascular risk. Weight loss induces decreased lipid profiles [2], insulin resistance [3], and chronic inflammatory markers [4] in obese children. Differential low-grade inflammation is associated with obesity in the youth and some patterns of immune activation are related to insulin resistance [5]. Recent reports indicate that IL-18 concentrations may be linked to type 2 diabetes mellitus [7,8], metabolic syndrome [9], hyperhomocysteinemia [7,10], obesity [11,12] and insulin resistance [12]. The association of IL-18 with childhood obesity has not been completely established
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