Abstract 1561: Circulating Activated Endothelial Cells in Severely Obese Children
Background: Circulating endothelial cells (CEC), a marker of endothelial activation and vascular damage, have not been examined in children. We sought to characterize endothelial cell health in the context of childhood obesity by comparing severely obese (SO) children to normal weight (NW), overweight (OW), and obese (OB) children.
Methods: We used immunohistochemical examination of buffy-coat smears to enumerate whole blood CEC and immunofluorescence microscopy to quantify CEC activation phenotype (percent surface expression of vascular cell adhesion molecule) in 104 children and adolescents (age=13.0±3.8; 67 males). Participants in the NW (BMI <85th percentile), OW (BMI 85th-<95th percentile), and OB (BMI 95th-<99th percentile) groups were recruited from a longitudinal cohort study. The SO (BMI ≥99th percentile) group was recruited from a pediatric obesity clinic. Means across groups were compared with general linear model analysis, adjusted for gender and age. Pearson correlations were calculated to evaluate relations of CEC with cardiovascular (CV) risk factors.
Results: The number and percent activation of CEC were highest in the SO group. CV risk factors were incrementally worse across adiposity groups, most extremely in the SO group. Moreover, SBP throughout its range was monotonically associated with CEC number (r=0.32, p=0.004) and activated CEC (r=0.41, p<0.001). This relation was attenuated but remained significant after adjustment for BMI.
Conclusion: These data show that the vascular endothelium is activated in relation to severe obesity and elevated blood pressure in children. In concert with adverse CV risk factors this likely contributes to premature atherosclerosis.