10 Gaziantep Medical Journal Gaziantep Med J 2014;20(1):10-14 Research Article Received: 02.08.2013 Accepted: 01.10.2013 ISSN 2148-3132 (print) ISSN 2148-2926 (online) www.gaziantepmedicaljournal.com DOI: 10.5455/GMJ-30-2013-164 Endothelial dysfunction in children with low birth weight, born at term Normal zamanında düşük doğum ağırlığı ile doğan çocuklarda endotel disfonksiyonu Aydın Akyüz 1 , Şeref Alpsoy 1 , Dursun Çayan Akkoyun 1 , Burçin Nalbantoğlu 2 , Birol Topçu 3 , Feti Tülübaş 4 , Burcu Özdilek 2 , Mustafa Metin Donma 2 1 Namık Kemal University, Faculty of Medicine, Department of Cardiology, Tekirdağ, Turkey 2 Namık Kemal University, Faculty of Medicine, Department of Pediatrics, Tekirdağ, Turkey 3 Namık Kemal University, Faculty of Medicine, Department of Biostatistics, Tekirdağ, Turkey 4 Namık Kemal University, Faculty of Medicine, Department of Biochemistry, Tekirdağ, Turkey Abstract The aim of our study was to assess whether endothelial function of the brachial artery is normal or impaired in children born at term with low birth weight (LBW) compared with their normal birth weight (NBW) peers, because there are still few data on this subject in children born at term with LBW. We compared brachial artery flow mediated dilatation (FMD) in children with LBW (n= 55, 30 male) and NBW (n= 45, 24 male) who were born at term. Age, gender, weight, height, waist and hip circumference, body mass index, body mass Z score, fasting glucose, total cholesterol, triglycerides, low density lipoprotein-cholesterol, high density lipoprotein- cholesterol, calcium, C-reactive protein, hemoglobin, serum insulin concentration, homeostatic model assessment index, creatinine values, brachial artery baseline diameter and brachial artery post dilatation diameter were similar in both groups (all p values >0.05). Compared with the NBW group, the LBW group had lower FMD (%) (6.68 ± 2.1 vs. 7.8 ± 1.9, p = 0.004). Brachial artery FMD was negatively correlated with waist circumferences (r = - 0.521, p < 0.001). A general linear analysis model, FMD as the dependent variable revealed significant effect of waist circumference (β ± SE: - 0.07±0.02, p<0.001) and LBW controlling for age (β ± SE: -0.028±0.01, p = 0.004). LBW closely affects to FMD. Therefore, the children with LBW born at term may be potentially at risk for early atherosclerosis compared with their peers. Keywords: Atherosclerosis; birth weight; childhood; flow mediated dilatation. Özet Normal zamanında doğan düşük doğum ağırlıklı (NZDDDA) çocuklarda endoteliyal fonksiyonları ile ilgili veriler azdır. Bu çalışmamızda NZDDDA'lı çocukların brakiyal arter (BA) endoteliyal fonksiyonlarında normal doğum ağırlıklı (NDA) akranlarına göre fark olup olmadığını değerlendirmeyi amaçladık. BA’nın akım aracılı dilatasyonunu (AAD) NZDDDA’lı (30’u erkek 55 çocuk) ve NDA’lı (24 ü erkek 45 çocuk) çocuklarda karşılaştırdık. Yaş, cinsiyet, kilo, boy, bel ve kalça çevresi, vücut kile indeksi, vücut kitle Z skoru, açlık kan şekeri, total kolesterol, trigliserid, düşük yoğunluklu kolesterol, yüksek yoğunluklu kolesterol, kalsiyum, C- reaktif protein, hemoglobin, serum insulin düzeyi, hemostatik model değerlendirme indeksi, kreatinin ve BA bazal ve dilatasyon sonrası çapı her iki grupta benzerdi (tüm p değerleri >0.05). Her iki grup karşılaştırıldığında, DDA’lı grup daha düşük AAD (%) (6.68 ± 2.1’e karşı 7.8 ± 1.9, p < 0.004) sahipti. AAD bel çevresiyle ters korelasyona sahipti (r = - 0.521, p < 0.001). AAD, DDA’nın varlığı (β ± SE: -0.028±0.01, p = 0.004) ve bel çevresi (β ± SE: 0.07±0.002, p<0.001) ile ilişkili idi. DDA, AAD’yi yakın olarak etkiler, bu nedenle normal zamanında doğan DDA’lı çocuklar akranlarına kıyasla potansiyel olarak erken ateroskleroz riski altında olabilirler. Anahtar kelimeler: Ateroskleroz; doğum ağırlığı; çocukluk; akım aracılı dilatasyon. Introduction The prevalence of low birth weight (LBW) is about 10% (1). It is known that LBW <2500 g at birth is associated with the risk of developing late-onset diseases such as hypertension, chronic kidney disease, insulin resistance in adult life (2-4). Although some publications in the past demonstrated that LBW is not a cause of endothelial dysfunction (5,6), these findings have largely been buried beneath a wealth of data on the relationship between cardiovascular risk and LBW associated with preterm (7-12). The unfavorable effect of prenatal influences on endothelial function in childhood has been documented (7,13), and several clinical observations are consistent with the loss of nitric oxide bioavailability playing a central role in the pathogenesis between LBW and dysfunction of the Correspondence: Aydın Akyüz, Namık Kemal University, Faculty of Medicine, Department of Cardiology, Tekirdağ, Turkey Tel:+90 542 4116550 ayakyuzq5@gmail.com