CRP Marker Adds a Risk Factor for Lebanese Obese Children and Adolescents

Abstract

Bassem Abou Merhi, Zainab Ali, Fouad Ziade, Layla Dimashkieh, Noura Tayyara, Mariam Rajab

Objectives: Obesity in children and adolescents is increasingly recognized as a major health concern. It is actually a pandemic disease by itself. Several cytokines and inflammatory mediators are induced in obesity and they may trigger atherosclerosis, coronary disease and heart failure. It is reported that increased high sensitivity C-reactive protein (CRP) was an independent predictor of cardiovascular events in adults and this relation is less clear in pediatrics age group. 1) To Measure the high sensitivity CRP level in children and adolescents who are obese or normal weight (control group) with no known history of associated co morbidities and to define the abnormality in CRP level among obese children and adolescent in Lebanese population. 2) To prove that the increase in CRP among obese children could be as early as 2 years of age. 3) Follow up the obese children and adolescents who had positive CRP with scheduled diet regimen by help of the nutritionist and seek the effect of diet on CRP level. Method: This is a prospective case control study, collecting children and adolescents between 2 and 15 years of age and determining the obese group according to definition of obesity which refers to BMI that vary with age and sex. Obese group selected if BMI > 95th percentile and normal weight (control group) selected if BMI < 85th percentile for age and sex respectively. This was achieved by using document analysis, paper based questionnaire, interviews, complete physical examination, direct measurement of weight and height. Then after justification for the inclusion criteria, CRP level was drawn and tested in Makassed General Hospital laboratory. Results: CRP level was significantly different between obese and control group (normal weight). All subjects of control group had negative CRP value with mean result of 0.08, while 33 subjects (57.9%) of obese group had positive CRP value with a mean of 0.83 that has statistically significant P value of 0.003. This relation was observed among obese children as young as 2 years of age. For All members who had weight reduction the CRP decreased, while only one subject who lost the dietary control had elevation in CRP level. Conclusions: We conclude that obesity in children and adolescents with no comorbidities is strongly associated with elevated CRP level (a high sensitivity inflammatory marker) which may reflect a future increase in the risk of developing atherosclerosis process. This relation was observed among obese children as young as 2 years of age. Changing life style according to diet regimen lowered CRP level in direct correlation to the weight reduction