PERINATOLOGIYA I PEDIATRIYA. 2014. 3(59):86-90; doi 10.15574/PP.2014.59.86

High-sensitivity C-reactive protein as a marker of cardiovascular risk at children with arterial hypertension, obesity or overweight 
 

Kozhokar  S. V. 
Institute of Cardiology of Moldova Republic, Kishinev 
 

Vascular inflammation has a decisive role in the pathogenesis of atherosclerosis and mediates different development stages of the atherosclerosis that precede clinical symptoms of the cardio-vascular diseases. Biomarkers of the inflammation are valuable 'tools' for the early diagnosis of the process. Currently C-reactive protein (CRP-hs) determined through the method of high sensitivity is the most studied biomarker at adults, but its role at children is less studied. 
 

Objectives of the research: Evaluation of the C_reactive protein as a marker of the cardio-vascular risk at children with arterial hypertension, overweight or obesity. 
 

Materials and methods. The research was made in the period of 2010–2013 in the scientific laboratory of paediatric cardiology, Cardiological Institute, Moldova and included 240 children (average age14.2±2.47), 124 boys (51.7%) and 116 girls (48.3%) that were classified according to their weight status and arterial hypertension values. There were appreciated parameters of the lipid metabolism (total cholesterol, HDL and LDL cholesterol, triglycerides), carbohydrate metabolism (glucose a jeun, serum insulin, HOMA_IR index), serum leptin and adiponectin, TNF a (tumor necrosis factor a) and C-reactive protein of high sensitivity (CRP hs). Metabolic syndrome was determined according to the criteria IDF 2007. 
 

Results. The most important metabolic changes were found at children with arterial hypertension, overweight or obesity as compared with the children with normal tension, overweight or obesity and with the control group including children with normal tension and weight. The median of serum adiponectin was greatly lower, but that of leptin higher mainly at children with arterial hypertension, obesity or overweight, as well as at children with metabolic syndrome in comparison with the control group. Metabolic Syndrome (MS) was diagnosed at 40 children (16.7%) according to the criteria of IDF 2007. CRP-hs showed positive correlation in the course of age (r=+0.33, p<0.001), BMI (r=+0.69, p<0.001), weist (r=+0.74, p<0.001), levels of systolic (r=+0.63, p<0.001) and diastolic (r=+0.49, p<0.001) arterial tension, total cholesterol (r=+0.43, p<0.001), LDL (r=+0.52, p<0.001), triglycerides (r=+0.47, p<0.001), glucose a jeun (r=+030, p<0.001), insulin (r=+0.65, p<0.001), HOMA-IR index (r=+0.65, p<0.001), leptin (r=+0.72, p<0.001), TNF ar=+0.80, p<0.001) and in negative correlation with HDL (r=-0.59, p<0.001) and adiponectin (r=-0.75, p<0.001). 
 

Conclusion. CRP-hs as an informative marker of the inflammation can be used as a screening test in prognostication of cardiovascular changes at children suffering from obesity. 
 

Key words: children, obesity, arterial hypertension, metabolic syndrome, chronic inflammation, cardiovascular risk. 
 

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