Background: Increased inflammatory cytokines, C-reactive protein (CRP) and prothrombotic parameters are potential markers of cardiovascular risks in childhood obesity.
Objectives:We investigated whether a statin treatment can reverse these early cardiovascular risk indicators. The primary outcome was the effect of sixteen weeks of statins on the inflammatory cytokines, CRP and the pro-thrombotic state in obese adolescents.
Methods:This randomized controlled double-blind study conducted at the University Hospital of Geneva included 28 obese adolescents aged 12-16 years. Subjects received either placebo (P) or atorvastatin (A) for sixteen weeks. Levels of monocyte chemoattractant protein 1 (MCP-1), interleukin-6, interferon-γ-inducible protein, interleukin-10, interleukin-1 receptor antagonist and CRP were measured at baseline, after sixteen weeks and after one year. Coagulation parameters were evaluated by prothrombin time, activated partial thromboplastin time, fibrinogen levels and endogenous thrombin potential (ETP) at each visit.
Results:The MCP-1 level was stable in group A after sixteen weeks of treatment, while it tended to increase in group P (median evolution, 0.2 pg/mL in A vs 34.3 pg/mL in P). The ETP levels decreased in group A and increased in group P (median evolution, -7.0 mA in A vs 12.9 mA in P). These differences of the evolution were not statistically different (MCP-1 p= 0.09, ETP p= 0.07), but after adjustment for age and BMI the ETP evolution reached significance (ETP adjusted, p=0.01). The baseline fibrinogen levels were already high in both groups (median 3.6 g/L, norm < 3.0). No prolonged effects were detected after one year. Conclusions: Increased levels of fibrinogen are already observed in obese adolescents reflecting the procoagluant risk. ETP decreased significantly with atorvastatin treatment in comparison to the non-treated group. Atorvastatin did however not decrease inflammation parameters.
Abstract
Randomized Study of the Effects of Statin on Inflammatory and Prothrombotic States in Obese Adolescents