Niveles elevados de e-selectina soluble en una población infantojuvenil con sobrepeso

El sobrepeso infantil se asocia a sobrepeso/obesidad en la edad adulta y constituye un factor de riesgo de diabetes y enfermedad cardiovascular. La disfuncion endotelial es la etapa inicial de ateroesclerosis y precede a las evidencias anatomicas mas tempranas de la misma. Este proceso esta regulado por moleculas de adhesion localizadas en la superficie de leucocitos y celulas endoteliales y que tendrian un papel importante en la prediccion de los eventos cardiovasculares. Entre estas moleculas, la E-Selectina (E-S) es una glicoproteina que se expresa exclusivamente en las celulas endoteliales activadas, en respuesta a citoquinas inflamatorias. Se ha sugerido que niveles aumentados de forma solubles de E-Selectina (sE-S) podrian ser marcadores especificos del endotelio vascular danado. El objetivo de este trabajo fue determinar los niveles plasmaticos de sE-S en ninos y adolescentes con sobrepeso y su relacion con variables antropometricas y bioquimicas. Se estudiaron 40 ninos con sobrepeso, de edades comprendidas entre 7 y 14 anos y 20 ninos controles de edad y sexo semejantes. Se considero criterio de inclusion un IMC ≥ al percentilo 85 y menor al percentilo 95 para edad y sexo. Se determino circunferencia de cintura (CC), IMC, estadio de Tanner y presion arterial. En ambos grupos se analizo: glucemia en ayunas, insulina plasmatica, fibrinogeno (Fg), proteina C reactiva ultrasensible (uPCR), sE-S en plasma y perfil lipidico. Los datos se expresaron como mediana y rango intercuartil, empleandose el coeficiente de Spearman para las correlaciones entre variables. En los sujetos con sobrepeso fueron mayores los niveles de sE-S [72,0 (50,5-92,5) vs. 24,0(18,5-35,0) ng/ml; p = 0,0001], uPCR [1,9 (0,8-4,4) vs. 0,3 (0,2-1,1) mg/l; p = 0,001], Fg [350 (315-460) mg/dl vs. 247 (235-265) mg/dl; p = 0,0001]. Tambien resultaron elevados los valores de insulina y trigliceridos. La sE-S se correlaciono con CC (r = 0,40; p = 0,02), uPCR (r = 0,58; p = 0,0001) y Fg (r = 0,50; p = 0,004). Estos resultados sugieren la presencia de activacion endotelial y estado proinflamatorio en la poblacion estudiada, destacandose la importancia del control del peso en los ninos con el fin de reducir el riesgo cardiovascular en la adultez. Los autores declaran no poseer conflictos de interes. Childhood overweight is associated to overweight/obesity adulthood and it is a risk factor for diabetes and cardiovascular disease. Endothelial dysfunction is the initial stage of atherosclerosis and precedes earliest anatomical evidence thereof. This process is regulated by adhesion molecules located on the surface of leucocytes and endothelial cells and would have an important role in the prediction of cardiovascular events. Between these molecules, E-selectin (E-S) is a glycoprotein that is express exclusively on activated endothelial cells in response to inflammatory cytokines. It has suggested that increases of soluble form of E-S (sE-S) could be an specific marker of damaged vascular endhotelium. The aim of this study was determine plasma levels of sE-S in overweight children and its relationship with anthropometric and biochemical variables. Forty overweight children aged between 7 to 14 years, and 20 control children of similar age and sex, were studied. Inclusion criteria was a BMI ≥ 85th percentile and below 95th percentile, for age and sex. Waist circunference (WC), BMI, Tanner stage and blood pressure were determined. In both groups fasting blood glucose and insulin, fibrinogen (Fg), high sensitivity C-reactive protein (hsCRP), sE-S and lipid profile were analyzed. The data were analyzed with the SPSS 15.0 program for Windows, expressed as the median and interquartile range. The Spearman's coefficient were used to measure correlations between the studied variables. Overweight subjects presented higher levels of sE-S [72.0 (50.5-92.5) vs. 24.0 (18.5-5,0) ng/ml, p = 0.0001], hsCPR [1.9 (0.8-4.4) vs. 0.3 (0.2-1.1) mg/l, p = 0.001], Fg [350 (315-460) vs. 247 (235-265) mg/dl, p = 0.0001]. Also insulin and triglycerides values were elevated. sE-S was correlated positivily with WC (r = 0.40, p = 002), hs PCR (r = 0.58, p = 0.0001) and Fg (r = 0.50, p = 0.004). These results suggest the presence of endothelial activation and a proinflammatory state in the studied population, and highlight the importance of weight control in children to reduce cardiovascular risk in adulthood. The authors do not have conflicts of interest.