Obesidade na infância e adolescência: evidência da associação entre o fator de inibição da ativação do plasminogênio-1 e adiposidade visceral

Abstract

Introduction: Fat mass excess is associated to a systemic low-grade inflammatory state and dysfunction of endothelial and fibrinolytic systems. However, there is a lack of data as to whether interactions of plasminogen activator inhibitor-1 (PAI-1), metabolic and clinical variables and adipokines are present in childhood obesity. Objective: To study selected factors associated to the circulating levels of PAI-1 in obesechildren and adolescents. Study design: This is a cross-sectional study of 86 children and adolescents with mean age of 10.7 ± 2.8 years, 42 male (49%), divided in two groups, according to body mass index (BMI):obese (n=61) and controls (n=25). Subjects were also allocated into three pubertal status groups: pre-pubertal (n=22), early-puberty (n=39) and late-puberty (n=25). Besides anthropometric data, blood samples were collected for measurement of PAI-1, leptin and biochemical markers of metabolic syndrome. Results: Obese group presented significant higher BMI z-score, abdominal circumference (AC)/height, blood pressure, insulin levels, HOMA-IR, triglycerides, leptin and PAI-1 incomparison to control group (p<0.05 for all comparisons). In the univariate analysis, PAI-1 categories presented significant differences between obese and control groups (p=0.035) and for the variables BMI z-score, AC/height, leptin, glucose, HOMA-IR, pubertal progressionand triglycerides (p<0.05 for all). However, multivariate regression analysis showed that only puberty progression (p=0.005) and AC/height index (p=0.002) remained as independent predictors of PAI-1 levels.Conclusion(s): In childhood and adolescence, PAI-1 levels are associated with fat mass accumulation (mainly visceral fat) and with puberty progression.