ESPE Abstracts

Introduction: Obesity as a chronic inflammatory disease is associated with impaired prothrombotic state leading to atherothrombosis. A variety of prothrombotic factors have been implicated in the pathophysiology of this phenomenon, especially the von Willebrand factor (vWF) produced in endothelium, megakaryocytes and subendothelial connective tissue. The aim of this study was to investigate any possible association between the new inflammatory marker chitinase 3-like protein 1 (YKL-40) and vWF levels in obese children.

Methods/design: Forty-one obese prepubertal children and 41 age-and gender-matched lean controls were included in the study. Children were classified as obese or non-obese according to international age- and gender-specific BMI cutoff points. In all participants, fasting levels of YKL40 were measured by a commercial ELISA Kit. The coagulation state was evaluated in obese children by assessment of vWF, plasminogen activator inhibitor -1 (PAI1), and fibrinogen levels.

Results: Obese children as compared with controls had higher YKL-40 and vWF (P<0.01) levels. A statistically significant correlation between these two parameters was also noted (r=0.467, P=0.016). No association was found between YKL-40 and PAI1 or fibrinogen levels. The children with vWF levels above median as compared to those with vWF below median also tended to present higher YKL-40 (P=0.09), indicating more severe inflammation. By contrast, although children with PAI1 or fibrinogen levels above median differed regarding YKL-40 as compared to those with PAI1 or fibrinogen below median, these differences did not reach the level of statistical significance.

Conclusions: Higher levels of vWF are more common among obese children that have higher YKL-40 levels. The coexistence of elevated levels of these markers may have a synergistically aggravating effect on atherosclerosis even in childhood obesity.