| Abstract | Pretilost u ranoj životnoj dobi je jedan od vodećih javno zdravstvenih problema u
svijetu. Poznato je da pretilost u ranoj životnoj dobi većinom perzistira u odrasloj dobi, a što
je važan čimbenik razvoja kardiovaskularnih komplikacija i metaboličkog sindroma (MS).
Zbog svega navedenoga postoji stalna potreba za pronalaskom novih molekularnih biljega
koji bi dodatno pomogli u praćenju napredovanja metaboličkog poremećaja. Katestatin je
peptid koji proteolitičikim cijepanjem nastaje iz kromogranina A te ima široki spektar
biološke aktivnosti, poput inhibicije otpuštanja katekolamina, smanjenja krvnog tlaka,
poticanja oslobađanja histamina, smanjenja beta-adrenergičke stimulacije i regulacije
oksidativnog stresa. Do sada je objavljeno nekoliko studija na odrasloj populaciji, a koje su
pokazale da je katestatin značajan rizični faktor za hipertenziju, a koliko nam je poznato,
ovo je prvo izvješće o serumskim koncentracijama katestatina u pretile djece i adolescenata.
Također, manjkavost vitamina D povezana je s nizom različitih kronični bolesti uključujući
pretilost. Uloga vitamina D u pretilosti nije u potpunosti razjašnjena, a potencijalni učinci
uključuju regulaciju upalnog odgovora, ekspresiju gena koji reguliraju adipogenezu i
adipocitnu apoptozu te utjecaj na lučenje leptina i adiponektina i regulaciju intenziteta
metabolizma.
Cilj ovoga istraživanja je bio usporediti serumske koncentracije katestatina i 25-
hidroksi vitamin D (25(OH)D) s odrednicama MS-a i ostalim kardiovaskularnim rizičnim
čimbenicima između pretilih ispitanika i odgovarajuće kontrolne skupine ispitanika.
U studiju je uključeno 91 pretilo dijete i adolescent s ITM z vrijednosti >2 i kao
kontrolna skupina 39 zdrave djece (ITM z vrijednosti <1) koji su usklađeni prema dobi i
spolu ispitanika. Svim ispitanicima napravljena su antropometrijska mjerenja, klinički
pregled i laboratorijske analiza (katestatin, 25(OH)D i druge laboratorijske vrijednosti) te su
pretili ispitanici podvrgnuti oralnom testu opterećenja glukozom (OGTT).
Statistički značajno niže koncentracije katestatina u serumu zabilježene su u skupini
pretilih ispitanika u usporedbi s kontrolnom skupinom (10,03 ± 5,05 vs. 13,13 ± 6,25 ng/mL,
P=0,004). Daljnjim analizama utvrđena je statistički značajno niža koncentracije katestatina
u podskupini pretilih ispitanika s MS-om (9,02 ± 4,3 vs. 10,54 ± 5,36 vs. 13,13 ± 6,25, P =
0,008). Serumske koncentracije katestatina su značajno negativno korelirale s dijastoličkim
krvnim tlakom (r =-0,255, P =0,014), homeostatskim modelom procjene inzulinske
rezistencije (HOMA-IR) (r=-0,215, P = 0,037) i visoko osjetljivim C reaktivnim proteinom (hsCRP) (r=-0,208) , P=0,044). Dodatno, skupina pretilih ispitanika s MS-om imala je
značajno niže serumske koncentracije 25(OH)D u usporedbi sa skupinom pretilih ispitanika
bez MS-a i kontrolnom skupinom (46,99 ± 17,11 vs. 54,58 ± 17,93 vs. 64,09 ± 25,82 nmol/L
, P=0,003). HOMA-IR je značajno i negativno korelirala sa serumskim koncentracijama
25(OH)D (r =-0,196, P=0,026).
Zaključno, naša studija je demonstrirala da su serumske koncentracije katestatina i
25(OH)D bile značajno niže u pretilih ispitanika s MS-om, u usporedbi s pretilim
ispitanicima bez MS-a i kontrolnom skupinom. Serumske koncentracije katestatina su
pokazale značajnu korelaciju s HOMA-IR i hsCRP, a dok su serumske koncentracije
25(OH)D pokazale značajnu korelaciju s HOMA-IR. |
| Abstract (english) | Childhood obesity is one of the leading public health problems in the world and it is
well known that early childhood obesity persists most into adulthood, an important factor in
the development of cardiovascular complications and metabolic syndrome (MS). There is a
constant need for new molecular biomarkers that will help clinicians decipher the
progression of the metabolic disorder. Catestatin is a peptide by proteolytic cleavage derived
from chromogranin A and has a wide range of biological activities, such as inhibition of
catecholamine release, reduction of blood pressure, stimulation of histamine release,
reduction of beta-adrenergic stimulation and regulation of oxidative stress. So far, several
studies have been published in the adult population that have shown that catestatin is a
significant risk factor for hypertension, and to our knowledge, this is the first report of serum
catestatin levels in obese children and adolescents. Also, vitamin D deficiency is associated
with a number of different chronic diseases including obesity. The role of vitamin D in obese
individuals has not been fully elucidated, but it is considered possible to regulate the
inflammatory response, the expression of genes that regulate adipogenesis and adipocyte
apoptosis and also affect leptin and adiponectin secretion and regulate energy metabolism.
The aim of this study was to compare serum levels of catestatin and 25-hydroxy
vitamin D (25 (OH) D) with components of MS and other cardiovascular risk factors among
obese subjects, with control group.
The study included 91 obese children and adolescents with BMI z score >2 and
control group of 39 healthy children and adolescents (BMI z score <1), matched by age and
gender of the subjects. Anthropometric measurements, clinical examination and laboratory
analysis (catestatin, 25(OH)D and other laboratory parameters) were made and all obese
subjects were subjected to an oral glucose tolerance test (OGTT).
Significantly lower serum catestatin concentrations were recorded in the group of
obese subjects compared with a control group (10.03 ± 5.05 vs. 13.13 ± 6.25 ng/mL, P =
0.004). Further analyses revealed significantly lower catestatin concentrations in the subgroup
of obese patients with MS (9.02 ± 4.3 vs. 10.54 ± 5.36 vs. 13.13 ± 6.25, P = 0.008).
Serum catestatin concentrations were significantly negatively correlated with homeostatic
model assessment of insulin resistance (HOMA-IR) (r=-0.215, P=0.037) and high sensitivity
C-reactive protein (hsCRP) (r=-0.208, P=0.044). Additionally, group of obese patients with
MS had significantly lower levels of serum 25(OH)D when compared to the group of obese patients without MS and the control group (46.99 ± 17.11 vs. 54.58 ± 17.93 vs. 64.09 ± 25.82
nmol/L, P=0.003). HOMA-IR was in negative correlation with serum concentrations of
25(OH)D (r=-0,196, P=0,026).
In conclusion, our study demonstrated that serum concentrations of catestatin and
25(OH)D were significantly lower in obese subjects with MS, compared with obese subjects
without MS and health controls. Serum concentrations of catestatin showed a significant
correlation with HOMA-IR and hsCRP, while serum concentrations of 25(OH)D showed a
significant correlation with HOMA-IR. |
