AWARD WINNING REPORT
011 Correspondence Panagiota Markopoulou Efkalipton 17, Marousi 15126, Athens-Greece Τ. +306970984583 e-mail: panmarkopoulou@ hotmail.com
Endothelial dysfunction and cardiovascular risk in prepubertal children born prematurely. The role of endothelial microparticles and endothelial progenitor cells Panagiota Markopoulou, Paraskevi Galina, Sofia Loukopoulou, Eleni Papanikolaou, Tania Siahanidou
Summary
Background: Endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs) are reliable, early markers of endothelial damage, they have not been studied, so far, in prepubertal children born prematurely. The aim of our study was the measurement of EMPs and EPCs in prepubertal children born prematurely and the assessment of their correlation with cardiovascular risk factors. Methods: The study population consisted of 106 children, 8-13 years old (52 preterm and 54 full term, as controls). Anthropometric measurements (body mass index-BMI, waist/hip circumference-WHR), arterial blood pressure and biochemical markers (glucose, insulin, serum lipids) were assessed. In addition, echocardiogram and ultrasonographic measurements of common carotid (cIMT) and abdominal aorta (aIMT) intima-media thickness were performed. Circulating EMPs [CD62e(+) and CD144(+)] and EPCs [CD34(+)/VEGFR2(+) and CD34(+)/ VEGFR2(+)/CD45(-)] were quantified by flow cytometry. For statistical analysis, Student’s ttest, Mann-Whitney U-test, and correlation/multiple regression analysis were performed. Results: Children born prematurely presented with higher BMI, WHR, systolic and diastolic arterial blood pressure, cIMT and aIMT, compared with controls. Circulating CD62e(+) (16.29±6.76% vs. 13.1±4.08%, p=0.01) and CD144(+) (5.94±3.02% vs. 4.28±1.63%, p=0.005), as well as CD34(+)/VEGFR2(+) [0.53(0.27-2.11)% vs. 0.31(0.22-0.71)%, p=0.02] and CD34(+)/VEGFR2(+)/CD45(-) cells [0.6(0.23-2.56)% vs. 0.37(0.07-0.8)%, p=0.05] were significantly higher in children born prematurely compared to children born full-term. Significant correlations of circulating CD62e(+) EMPs and CD34(+)/VEGFR2(+) EPCs with cIMT, aIMT, the left ventricular dimensions were also observed. Conclusions: Prepubertal children born prematurely demonstrate increased expression of endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs) compared to full term born children, which is indicative of impaired endothelial dysfunction/vascular damage. Panagiota Markopoulou Paraskevi Galina Sofia Loukopoulou Eleni Papanikolaou Tania Siahanidou
Key words: prematurity, cardiovascular risk, endothelial microparticles, endothelial progenitor cells, endothelial dysfunction
Εισαγωγή
Υπολογίζεται ότι, περίπου 10% των ζώντων νεογνών παγκοσμίως έχει γεννηθεί πρόωρα (<37 εβδομάδες κύησης) (1). Σύμφωνα με την υπόθεση Barker, το χαμηλό βάρος γέννησης αποτελεί παράγοντα κινδύνου για τη μετέπειτα εμφάνιση καρδιαγγειακής νόσου και μη ινσουλινοεξαρτώμενου σακχαρώδους διαβήτη (2). Ωστόσο, αποτελεί, έως σήμερα, αμφιλεγόμενο θέμα εάν η προωρότητα αποτελεί ανεξάρτητο παράγοντα κινδύνου για τη μετέπειτα εμφάνιση καρδιαγγειακών νοσημάτων και μεταβολικού συνδρόμου.