Original article Platelet function in obese children and adolescents J. Lohse 1 ; J. Schweigel 1 ; A. Naeke 1 ; MA. Lee-Kirsch 1 ; G. Siegert 2 ; S. Bergmann 2 ; E. Kuhlisch 3 ; M. Suttorp 1 ; R. Knöfler 1 1 Department of Paediatric, University Hospital Carl Gustav Carus, Technical University of Dresden, Germany; 2 Department of Laboratory Medicine, University Hospital Carl Gustav Carus, Technical University of Dresden; 3 Depart- ment of Medical Biometry and Bioinformatics, University Hospital Carl Gustav Carus, Technical University of Dresden Keywords Platelet aggregation, obesity, whole blood, children Summary Platelet hyperaggregability contributes to thromboembolic events of obesity in adult- hood. In obese children hyperaggregability was described in platelet rich plasma. We in- vestigated platelet aggregation in children with obesity and lipometabolic disorders in whole blood. Patients, material, methods: Specimens from patients with overweight (n = 35), hypercholesterolaemia and normal weight (n = 5), overweight plus combined li- pometabolic disorder (n = 5) and healthy con- trols (n = 20) were investigated. Aggregation and ATP release were induced by ADP (20 μmol/l), collagen (1 μg/ml) and thrombin (0.5 U/ml) using a lumiaggregometer. Results: Overweight children and normal weight pa- tients with hypercholesterolaemia exhibited Correspondence to: Judith Lohse, M.D. Department of Paediatric Hematology and Oncology University Hospital Carl Gustav Carus, Technical University of Dresden Fetscherstr. 74, D-01307 Dresden, Germany Tel. +49/(0)351/458 35 22, Fax +49/(0)351/458 58 64 E-mail: judith.lohse@uniklinikum-dresden.de no significant differences in platelet aggre- gation compared to controls. Contrastingly, in patients with obesity plus lipometabolic dis- order the aggregation rate was significantly higher (p < 0.05) suggesting a hyperaggreg- able state. Conclusion: Obviously in obese children a hypercoagulable state exists and the slight hyperaggregability observed in whole blood in this cohort might contribute to that. Any effort should be undertaken to avoid obes- ity in children especially in those countries where the prevalence of obesity in childhood is continuously increasing. Schlüsselwörter Plättchenaggregation, Adipositas, Vollblut, Kin- der Zusammenfassung Hyperaggregabilität trägt zur Entstehung thromboembolischer Ereignisse bei Adipositas Thrombozytenfunktion bei adipösen Kindern und Jugendlichen. Hämostaseologie 2010; 30 (Suppl 1): S126–S131 im Erwachsenenalter bei. Bei adipösen Kin- dern wurde eine Hyperaggregabilität im plätt- chenreichen Plasma bereits beschrieben. Wir haben die Plättchenaggregation bei Kindern mit Adipositas und Fettstoffwechselstörung im Vollblut untersucht. Patienten, Material, Methoden: Proben von Patienten mit Überge- wicht (n = 35), Hypercholesterolämie und Normalgewicht (n = 5), Übergewicht und gemischter Fettstoffwechselstörung (n = 5) sowie gesunden Kontrollen (n = 20) wurden untersucht. Mittels Lumiaggregometrie er- folgte die Messung der ADP (20 μmol/l), Kolla- gen (1 μg/ml) und Thrombin (0,5 U/ml) indu- zierten Aggregation und ATP-Freisetzung. Er- gebnisse: Übergewichtige Kinder und Nor- malgewichtige mit Hypercholesterolämie zeigten keine signifikanten Unterschiede in der Thrombozytenaggregation verglichen mit der Kontrollgruppe. Dagegen konnte bei Pa- tienten mit Adipositas und gemischter Fett- stoffwechselstörung eine signifikant höhere Aggregationsrate (p < 0,05) beobachtet wer- den, welche eine Hyperaggregabilität vermu- ten lässt. Schlussfolgerung: Offensichtlich existiert bei adipösen Kindern eine Hyper- koagulabilität, zu der die milde Hyperaggre- gabiliät im Vollblut beitragen könnte. Die Ver- meidung von Übergewicht im Kindesalter, vor allem in Ländern mit steigender Prävalenz der Adipositas im Kindesalter, sollte angestrebt werden. Obesity which is defined as body mass index (BMI) above the 97 th age- and gender-related percentile is a well known risk factor for cardiovascular morbidity and mortality in adulthood and presently shows an alarming increased prevalence also in childhood and adolescence. In Ger- many the prevalence of overweight defined as BMI above the 90 th age- and gender-re- lated percentile in 3 to 17 years old children and adolescents is about 15% and of obes- ity about 6% (1). The metabolic complications of obesity, such as elevated blood pressure, dyslipid- aemia and insulin resistance may already become relevant in childhood and adoles- cence (2–4). For instance one third of all obese children have mild hypertension and elevated triglyceride (TG) and total choles- terol (TC) levels are present in about 25% of these children (5–7). It is well known that in adults the com- bination of obesity and lipometabolic dis- order leads to an increased risk of venous thromboembolism (8–10). In contrast, the incidence of thrombosis in obese children is not elevated compared to children with a Hämostaseologie 4a/2010 S126 © Schattauer 2010 Pädiatrie For personal or educational use only. No other uses without permission. All rights reserved. Downloaded from www.haemostaseologie-online.com on 2017-10-11 | IP: 54.70.40.11