Circulating markers of inflammation and endothelial dysfunction in Arab adolescent subjects: Reference ranges and associations with age, gender, body mass and insulin sensitivity

Introduction: Important biochemical markers for the low-grade vascular inflammation and endothelial dysfunction that characterize the earliest events in the pathogenesis of atherosclerosis are CRP and the adhesion molecules ICAM-1 and VCAM-1. This study aims to evaluate, in healthy Arab adolescent subjects aged 10-19 yr, the reference ranges for these markers and their associations with such determinants as age, gender, body mass and insulin sensitivity. Methods: There were 774 Kuwaiti subjects (316 boys and 456 girls) aged mean (SD) 14.5 (2.2) yr. All had detailed clinical examination, anthropometry (to derive BMI) and assessment of fasting serum levels of CRP, ICAM-1, VCAM-1 and insulin (and HOMA-IR) to derive their reference values. Associations with putative determinants were explored by logistic regression analyses. Results and discussion: The reference ranges (mean (SD)) were: CRP 0.28 (0.49) mg/dl; ICAM-1, 286 (119) ng/ml; VCAM-1, 1148 (352) ng/ml; HOMA-IR, 4.57 (5.05). These parameters were significantly higher in boys than in girls, and in the overweight/obese and those aged <= 14 yr. BMI was significantly and independently related to CRP and ICAM-1 even after adjusting for age, gender, socio-demographic factors, diet and exercise. Levels of these markers were significantly influenced by age and gender. Conclusion: BMI, age and gender are significant predictors of serum levels of circulating inflammatory biomarkers, particularly ICAM-1, CRP and HOMA-IR. These atherogenic processes therefore probably cluster together in early life in individuals at increased later heart disease risk. Preventive public health measures should therefore commence in early childhood. (C) 2009 Elsevier Ireland Ltd. All rights reserved.