Serum endocan as a predictive biomarker of cardiovascular risk in obese pediatric patients

Abstract

Background: Endocan is a soluble dermatan sulfate PG (50kDa), expressed and secreted by endothelial cells of the dermal microvasculature, the coronary, the pulmonary arteries and the capillaries from adipose tissue. It plays an important role in the pathogenesis of vascular disorders, inflammation, endothelium dysfunction and neoangiogenesis. The biosynthesis of endocan 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 event in obese patients is attenuated by insulin resistance. Methods: The study included 19 patients with obesity (10 males and 9 females), aged between 2-18 years, screened at the pediatric Endocrinology Clinic of our Department in Messina (Italy). Results: The results, compared with the healthy controlled group, have shown upraised endocan serum levels in children with BMI higher than normal (30,044 ±0,984), demonstrating a positive correlation trend between endocan and BMI (rho 0.356, p = 0.13). Furthermore endocan serum levels were significantly correlated to the insulin levels (rho 0.474, p = 0.047) and HOMA-IR (rho 0.434, p = 0.072). These findings confirm the correlation between endothelial damage and insulin resistance in obese children. Instead we did not found any association between Endocan and lipid serum levels, nor with the fasting blood glucose value (rho 0.024, p = 0.926). An elevated correlation was also revealed with steatosis, and with the ultrasound grade of liver steatosis (rho 0.514, p = 0.087 and rho 0.512, p = 0.088, respectively), despite not raising statistically significant results, given the small sample size, indeed only 12 children of the study underwent ultrasound. Conclusions: We can assume that endocan could be used also in children with obesity as a biomarker and that could be a valid predictor in order to stratify the future cardiovascular risk in adulthood. Retrospectively registered