Moderated Poster Session II: Epidemiology and public health

P22 C-reactive protein in prepubertal children with abdominal obesity as a marker of cardiovascular and metabolic risk S Galcheva, Y Yotov, V Iotova Medical University, Varna, Bulgaria Topic: Risk factors and risk prediction High sensitivity C-reactive protein (hsCRP) is a marker of inflammation and is found to be a significant predictor of cardiovascular diseases (CVD). Metabolic syndrome and abdominal obesity are associated with earlier and more severe presentation of atherosclerosis. Aim: To evaluate the level of hsCRP in children aged below 10 years according to overweight/ obesity status and in relation to cardiovascular parameters and other risk factors. Participants and methods:We evaluated 168 healthy children (78 boys and 90 girls) at the mean age 8.1 1.2 years divided in three groups normal (NW, 31.5%), overweight (OW, 27.4%) or obese (OB, 41.1%) according to bodymass index (BMI) international reference (Cole, 2000) and waist circumference (WC). Their blood pressure (BP) and heart rate (HR) were measured and blood tests for fasting blood glucose (BG), immunoreactive insulin (IRI), lipids, liver enzymes, hsCRP, and other proinflammatory and hormonal markers were drawn. HOMA-IR was calculated according to the standard formula. Log transformation of data for the hsCRP, BMI and other variables was performed where appropriate because of skewed distribution. Results: The hsCRP was significantly higher in the OB 7.53 0.91 (mean SE) compared with the OW 4.11 0.9 (p1⁄40.029) and NW 3.17 0.88 mg/l (p1⁄40.001) children, without important gender differences. The inflammation marker displayed significant linear increase with both BMI andWC. The hsCRP was positively correlated with IRI (r1⁄40.237, p1⁄4 0.004), with HOMAIR (r1⁄40.279, p1⁄40.001), with systolic BP (r1⁄40.396, p<0.0001) and diastolic BP (r1⁄40.299, p <0.0001), and negatively with HDL-cholesterol (r1⁄4-0.202, p1⁄40.013). In multivariable linear regression model, the hsCRP increased with 1.84 mg/l (95%CI1⁄41.50-2.26, p<0.0001) per WC quartile after adjustment for age, gender, BMI, birth weight, BG, HOMA-IR. For BMI, the significance of the relation with hsCRP which was present in the univariate analysis disappeared after adjusting for WC in the multivariate model. Conclusions: The hsCRP is elevated in healthy overweight and obese children already in prepuberty. It correlates with higher BP and other important risk factors for CVD. At this age, waist circumference is a better predictor of the hsCRP levels than is BMI. The prevention of CVD through weight control has to start early in life.