Correlations Between Lipid Profile, High-Sensitivity C-Reactive Protein, Matrix Metalloproteinase, and Left Ventricular Mass and Function Among Adolescents With Obesity

Document Type : Original Article

Authors

1 Prof. Dr. R. D. Kandou General Hospital, Medical Faculty of Sam Ratulangi University, Manado, Indonesia.

2 Medical Faculty of Hasanuddin University, Makassar, Indonesia.

3 Department of Cardiology, Medical Faculty of Hasanuddin University, Makassar, Indonesia.

Abstract

Background: The prevalence of obesity among adolescents is steadily increasing. Obese adolescents are thought to have impaired lipid profile, high-sensitivity C-reactive protein (hs-CRP), matrix metalloproteinase 9 (MMP-9), and left ventricular mass and function, which are potential for further research. This study aimed to compare total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, hs-CRP, MMP-9, and left ventricular mass and function between obese and nonobese adolescents.
 
Methods: A cohort study was conducted in Manado from August 2013 to February 2014. This study enrolled adolescents aged between 13 and 18 years whose body mass index (BMI) was greater than 95th percentile according to CDC 2000 recommendation.
 
Results: A total of 80 subjects, consisting of 40 subjects in both obese and nonobese arms, were included in this study. The results from the comparative analysis were as follows: total cholesterol: 194.25/160.88 mg/dL, LDL: 136.63/104.65 mg/dL, HDL: 46.13/48.60 mg/dL, triglycerides: 113.10/69.68 mg/dL, hs-CRP: 3.60/0.64 mg/dL, and MMP-9: 620.50/391.64 mg/dL. There were significant differences in total cholesterol, LDL, hs-CRP, and MMP-9 levels (P < 0.001) between the obese and nonobese groups. The univariate analysis showed a significant relationship between BMI and left ventricular mass (P < 0.01), HDL and left ventricular mass (P = 0.036), triglycerides and left ventricular mass (P = 0.01), MMP-9 and left ventricular mass (P < 0.01), and hs-CRP and left ventricular mass (P = 0.001).
 
Conclusions: Among the obese adolescents in the age group of 13 to 18 years old, there was an alteration in lipid profile, hs-CRP levels, MMP-9 levels, and left ventricular mass and function. (Iranian Heart Journal 2021; 22(1): 57-65)

Keywords


  1. Sjarif DR, Nasar SS. 2010. Obesity. In: Pudjiadi AH, Hegar B, Handryastuti S, Idris NS, Gandaputra EP, Harmoniati ED, editor. Guidelines for medical services for Indonesian pediatric associations. Jakarta: Indonesian Pediatric Society. page. 197-204.
  2. Sjarif DR. 2011. Obesity in children and adolescents. In: Sjarif DR, Lestari ED, Mexitalia M, Nasar SS, editor. Pediatric Nutrition and Metabolic Diseases. Jakarta: Indonesian Pediatric Society. page 230-43.
  3. Basic Health Research. 2009. Report on the results of basic health research in North Sulawesi province.
  4. Singh GK, Kogan MD. 2010. Childhood Obesity in the United States, 1976-2008: Trends and Current and Racial/Ethnic, Socioeconomic, and Geographic Disparities. A 75th Anniversary Publication. Health Resources and Services Administration, Maternal and Child Health Bureau. Rockville, Maryland: U.S. Department of Health and Human Services. 5.
  5. Michael B, Clearfield DO. C-reactive protein: a new risk assessment tool for cardiovascular disease. JAOA 2005;105: 409-16.
  6. Verma S, Buchanan MR Anderson TJ. Endothelial function testing as a biomarker of vascular disease. Circulation 2003;108: 2054-9.
  7. Ridker PM. High-Sensitivity C-Reactinve Protein: Potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001;103: 1813-8.
  8. Strong JP, Malcom GT, McMahan CA, et al. Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study. JAMA 2009;281: 727-35.
  9. Halenka M. Noninvasive measurement of early atherosclerosis by high resolution B-mode ultrasonography. Acta Univ Palacki Olomuc Fac Med. 2009;142: 1-12.
  10. Abraham J, Campbell CY, Cheema A, Gluckman TJ, and Blumenthal RS. C-Reactive Protein in cardiovascular risk assessment: a review of the evidence. JCMS 2007;2: 119-23.
  11. Belo VA, Costa DCS, Luizon MR, Lanna CMM, Cameiro PC, Toledo TCI, et al. Matrix metalloproteinase-9 genetic variations affect MMP-9 levels in obese children. International Journal of Obesity 2012;36:69-75.
  12. Setianto BY, Mubarika S, Astuti I, Irawan B. Relationship between matrix metalloproteinase-9 (MMP-9) with complications of acute heart failure in myocardial infarction with ST-Elevation (STEMI) and acute coronary syndrome without ST-Elevation (NSTEACS). J Kardiol Indones. 2011;32: 229-35.
  13. Fox E, Taylor H, Andrew M. Body Mass Index and blood pressure influences on left ventricular mass and geometry in African Americans. Hypertension 2004; 44: 55-60.
  14. Marinov L. Changes in the left ventricular mescle mass in adolescents. J of IMAB 2009;16-8.
  15. Baker JL, Olsen LW, Sorensen TIA. Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med. 2007;357: 2329-37.
  16. Daniels SR. Complications of obesity in children and adolescents. Int J Obes. 2009;33: 60-5.
  17. Hanevold C, Waller J, Daniels S, Portman R, Sorof J. The effect of obesity, gender and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the international pediatric hypertension association. Pediatrics 2004;113: 328-32.
  18. Steinberger J, Daniels SR. Obesity, insulin resistance, diabetes, and cardiovascular risk in children. An American heart association scientific statement from the atherosclerosis, hypertension, and obesity in the young committe (council on cardiovascular disease in the young) and the diabetes committee (council on nutrition, physical activity, and metabolism). Circulation. 2009;119: 628-47.
  19. Soenarto, Tangkilisan HA. Relationship between obesity and leptin serum among low socioeconomic primary school children aged 5-7 years. Paediatrica Indonesiana. 2010; 50:166-8.
  20. Simsek E, Balta H, Balta Z, Dallar Y. Childhood obesity-related cardiovascular risk factors and carotid intima-media thickness. Pediatrics 2010;52: 602-11.
  21. Stabouli S, Kotsis V, Karagianni C, Zakopoulos N, Konstantopoulos A. Blood pressure and carotid artery intima-media thickness in children and adolescents: the role of obesity. Hellenic J Cardiol. 2012;53: 41-7.
  22. Klop B, Elte JW, Cabezas MC. Dyslipidemia in Obesity: Mechanisms and Potential Targets. Nutrients 2013;5:1218-40.
  23. Franssen R, Monajemi H. Stroes ES, Kastelein JJ. Obesity and Dyslipidemia. Med Clin North Am. 2011;95: 893-902.
  24. Ghanem S, Mostafa M, Ayad S. Early echocardiography abnormalities in obese chilldren and adolescent and reversibility of these abnormalities after significant weight reduction. Journal of the Saudi Heart Association. 2010; 22: 13-8.
  25. Guardamagna O, Abello F, Saracco P, Baracco V, Rolfo E, Pirro M. Endothelial activation, inflammation and premature atherosclerosis in Children with familial dyslipidemia. Atherosclerosis. 2009; 207:471-5.
  26. Pascual M, Pascual DA, Vicente T. Effect of isolated obesity on systolic and diastolic left ventricular function. Heart 2003;89:1152-6.
  27. Silva D, Lacerda AP. High sensitivity c-reactive protein as a biomarker of risk in coronary artery disease. Rev port cardiol. 2012; 31:733-45.