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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Whitfield, John B.

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Prothrombogenic factors and reduced antioxidative defense in children and adolescents with pre-metabolic and metabolic syndrome

Vesna Dimitrijevic-Sreckovic1 / Emina Colak2 / Predrag Djordjevic3 / Drasko Gostiljac4 / Branko Sreckovic5 / Srdjan Popovic6 / Fadil Canovic7 / Miroljub Ilic8 / Radmila Obrenovic9 / Vladan Vukcevic10 / Dragan Nikolic11 / Tanja Nisic12 / Gordana Milic13 / Gordana Pejcic14

1Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

2Institute of Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

3Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

4Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

5Institute of Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia

6Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

7Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

8Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

9Institute of Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

10Institute of Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia

11Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

12Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

13Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

14Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia

Corresponding author: Vesna Dimitrijevic-Sreckovic, MD, PhD, Associated Professor, Krupanjska 24, 11000 Belgrade, Serbia Phone: +381-64-2028571, Fax: +381-11-2685357,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 9, Pages 1140–1144, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: 10.1515/CCLM.2007.259, September 2007

Publication History

Received:
2006-11-01
Accepted:
2007-03-21
Published Online:
2007-09-11

Abstract

Background: The aim of this study was to examine prothrombogenic factors and antioxidative defense in obese children and adolescents with pre-metabolic and metabolic syndrome, and to analyze insulin secretion and resistance, early glycoregulation disorders and lipid status.

Methods: Insulin sensitivity was determined using the homeostasis model assessment for insulin resistance (HOMA-IR), while insulin secretion was determined using the homeostasis model assessment β (HOMA-β). Prothrombogenic factors analyzed were plasma plasminogen activator inhibitor-1 (PAI-1) and fibrinogen. Superoxide dismutase and glutathione peroxidase were measured as markers of antioxidative defense.

Results: Patients with metabolic syndrome were characterized with increased body mass index (BMI), waist circumference, and HOMA-IR and HOMA-β levels, and all had increased blood pressure and triglyceride levels, low high-density lipoprotein cholesterol levels, increased PAI-1 levels and reduced antioxidative defense levels. Patients with pre-metabolic syndrome had higher levels of basal and mean insulinemia during an oral glucose tolerance test, higher levels of HOMA-β and lower levels of antioxidative defense compared to patients with metabolic syndrome.

Conclusions: Negative correlations between antioxidative defense parameters and BMI, abdominal obesity, insulin secretion, systolic blood pressure and atherogenic lipid factors, as well as correlations between PAI-1 and insulin resistance and basal glycemia in the metabolic syndrome group contribute to accelerated atherosclerosis. Positive correlations between PAI-1 and waist circumference and BMI, and negative correlations between BMI and antioxidative defense in the pre-metabolic syndrome patients show that this early stage preceding the metabolic syndrome is also characterized by atherosclerotic complication risks and evident hyperinsulinism and insulin resistance.

Clin Chem Lab Med 2007;45:1140–4.

Keywords: antioxidative defense; children/adolescents; metabolic syndrome; plasminogen activator inhibitor-l; pre-metabolic syndrome

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