ESPE Abstracts

Introduction: Endocan is a soluble dermatan sulfate PG (50kDa), composed by 165 amino acid core protein, that is expressed and secreted by endothelial cells of dermal microvasculature, coronary, pulmonary arteries, and capillaries from adipose tissue. It plays an important role in the pathogenesis of vascular disorders, inflammation, and neoangiogenesis. Endocan biosynthesis is upregulated by inflammatory cytokines like TNF-α,IL-1, TGF-β1, and by proangiogenic and growth factors like VEGF, EGF, and FGF-2; conversely, it is downregulated by INF-γ and insulin level, but this effect in obese patients is attenuated by insulin resistance. Recent studies have already reported that endocan is a valid marker of endothelial cell damage in different conditions like cancers, systemic inflammation, obesity, and cardiovascular diseases, and that could be linked to the severity and outcomes of these disorders.

Objectives: The aims of our study are the following: a) to evaluate the use of endocan serum levels as an indicator of endothelial damage in children and adolescents with high BMI; b) to identify its possible correlation with other metabolic indices.

Methods and results: The study included 19 patients with obesity (10 males, 9 females), aged between 2-18 years (mean age11.94±0.52), screened at the Pediatric Endocrinology Unit of Messina (Italy) from October 2018 to May 2020. We assessed weight, height, and BMI, and measured levels of endocan, total cholesterol, HDL-C, LDL-C, triglycerides, blood glucose, and insulin. The results, compared to a healthy controlled group, have shown upraised endocan serum levels in children with high BMI (2.03±1.55 vs 0.82±0.34 ng/ml, P <0.001); demonstrating also a positive correlation trend between endocan and BMI (P = 0.13). Furthermore, endocan serum levels were significantly correlated to insulin levels (P = 0.047) (HOMA-IR: P = 0.072). These findings confirm the link between endothelial damage and insulin resistance in obese children. However, we did not find any association between endocan and lipid profile, or with fasting blood glucose value (P = 0.926). We also performed abdomen ultrasound in 12 children, revealing a correlation with steatosis, and with its grade (P = 0.087, P = 0.088, respectively), despite not raising statistically significant results, given the small sample size.

Conclusions: We can assume that endocan could be used, as a biomarker, also in children with obesity and that could be a valid predictor, in order to stratify the future cardiovascular risk in adulthood.