ESPE Abstracts

Background and Objectives: N-terminal-pro hormone Brain Natriuretic Peptide (NT-proBNP) and hs-Troponin T (hs-TnT) are commonly used cardiac biomarkers despite lacking a deeper understanding about influencing parameters especially in the healthy pediatric population. We previously found associations between NT-proBNP and hs-TnT and a child´s age, sex, pubertal status, Body Mass Index (BMI) and serum lipid levels. Subsequently, we explored associations with growth hormone status represented by Insuline-like Growth Factor-1 (IGF1) and IGF1-Binding Proetin-3 (IGF-BP3), glucose metabolism (HbA1c) and Cystatin C (CysC).

Material and Methods: Serum values, medical history and anthropometric data provided by 2522 children aged 0.25-18 years, who participated in the prospective longitudinal population-based cohort study, “LIFE child” in Leipzig, Germany, were collected and analyzed as per study protocol.

Results: NT-proBNP values decreased throughout childhood and dropped rapidly with advancing pubertal stage. Furthermore, the negative associations seen between lower NT-proBNP values and higher BMI and higher values for serum lipids, IGF1 and IGF-BP3, was also found for HbA1c with a greater effect in children above 11 years of age and no difference between the sexes. For IGF-BP3 levels, this interaction was found to be modulated by both, sex and age. There was no general correlation between NT-proBNP and CysC, we could only demonstrate a negative association between these values for children 5 to 11 years. HsTnT levels showed positive associations with higher BMI and IGF-BP3 levels, as well as with higher CysC levels. The latter effect was stronger in girls, an interaction with age was only seen in boys. The association between hsTnT and HbA1c levels was significantly negative and did not show an interaction with sex but with age, resulting in a substantially stronger effect in children older than 11 years. We could not find any significant interaction between hsTnT and IGF1.

Conclusion: We have identified important associations between cardiac markers and certain metabolic parameters to increase the understanding of their influence in the development of healthy children.