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Objective: To determine the role of low-grade, systemic inflammation and endothelial activation in the modulation of blood pressure (BP) independently of other traditional risk factors in obese children and adolescents., Design: We surveyed 281 obese subjects, aged 6-18 years to investigate the relationship of serum inflammation and endothelial activation markers and blood pressure., Measurements: Clinical variables, indices of obesity, ambulatory 24-h blood pressure and serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), glucose and insulin. HOMA IR was used as a marker of insulin resistance (IR)., Results: CRP, IL-6, IL-1 beta, and ICAM-1 correlated significantly with mean 24-h systolic BP, whereas CRP and IL-6 was positively correlated with mean 24-h diastolic BP. Multiple regression analysis showed that serum IL-6 (P < .001) concentration, HOMA IR (P < .01), and waist to hip ratio (P < .05) were the significant determinants of systolic BP, whereas CRP (P < .05) level was the only predictor of diastolic BP. There were no significant associations of cell adhesion molecules with BP., Conclusions: These results indicate that low-grade inflammation may play a role in the modulation of arterial BP relatively early in life.

Background: There is growing evidence that low-grade systemic inflammation is closely involved in the pathogenesis of type 2 diabetes., Objective: The aim of this study was to investigate the relationship between serum inflammatory markers and selected parameters known as risk factors of type 2 diabetes in obese children and adolescents., Subjects and Methods: Fasting levels of C-reactive protein (CRP), fibrinogen (FB) interleukin-6 (IL-6), interleukin 1-beta (IL-1beta), glucose, insulin, total, HDL and LDL cholesterol, triglycerides, white blood cell count (WBC) and fasting glucose to insulin ratio (FGIR) were measured in 281 obese children and adolescents. Pearson's correlation was used for assessing the relationship between inflammatory markers and selected clinical parameters., Results: Inflammatory markers correlated significantly with insulin resistance indices, HbA1c, lipid profile, hypertension, positive family history of type 2 diabetes, low physical fitness, and mixed high-fat and high-carbohydrate diet., Conclusions: Serum inflammatory markers were significantly correlated with most factors implicated in the development of type 2 diabetes. These data provide additional support for previously reported in adults relationship between subclinical inflammation and the risk of type 2 diabetes.

Objectives: There is increasing evidence that an ongoing cytokine-induced acute-phase response is closely involved in the pathogenesis of type 2 diabetes and associated complications such as dyslipidemia and atherosclerosis. The aim of this study was to investigate the relationship of inflammation and endothelial activation with insulin resistance in childhood obesity., Methods: Two hundred and eleven (122 boys) obese children and adolescents were examined. Fasting levels of ultra-sensitive C-reactive protein (CRP), fibrinogen (FB), interleukin-6 (IL-6), interleukin-1beta (IL-1beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand factor (vWF), glucose, insulin, and HbA1c were determined. Insulin resistance was assessed by the homeostasis method., Results: HOMA IR correlated significantly with all measures of adiposity as well as with majority of inflammation and endothelial dysfunction markers. After adjustment for age, gender, BMI and fat mass, the correlation with insulin resistance remained significant for CRP, ICAM-1 and von Willebrand factor. There was a trend for association between HOMA IR and IL-6 as well as HOMA IR and fibrinogen., Conclusion: Acute-phase reaction and endothelial activation correlate with insulin resistance in obese youth. It is possible that the cluster of these pro-atherogenic factors may contribute to the accelerated atherosclerosis in obese children.

Objectives: It has been suggested that a rise in blood pressure (BP) causes low-grade inflammation of the endothelium which, in turn, may be responsible for further damage of endothelium and worsening of BP control. The aim of the study was to evaluate serum levels of inflammation and endothelial activation markers in children with obesity-related hypertension and normotensive controls in relation to other traditional risk factors of arterial hypertension., Methods: Plasma insulin, glucose, C-reactive protein (CRP), fibrinogen (FB) interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and lipids levels were determined in 50 children with obesity-related hypertension and 143 obese children with normal BP. Insulin resistance was assessed by the homeostasis model., Results: Children with hypertension had significantly higher levels of all inflammatory markers as well as endothelial activation indices compared with normotensive subjects. In the stepwise regression model significant independent correlates for systolic BP were CRP, FB, VCAM-1, HOMA IR, LDL cholesterol and fat mass, whereas CRP, IL-6, ICAM-1, FB, LDL and HDL cholesterol were the determinants of diastolic BP in children with obesity-related hypertension., Conclusion: These results indicate that low-grade inflammation and endothelial dysfunction are closely involved in the pathogenesis of obesity-related hypertension relatively early in life.