Correlation Between Obesity And CD40-CD40L System In Children And Adolescents

Background:With the rapid economic development and lifestyle modification,the incidence of obesity in children and adolescents is growing rapidly.Obesity has become a global public health problem in the 21st century.In recent years,At present,many reports show that CD40 and its ligand CD40L system are closely related to adult cardiovascular and cerebrovascular diseases,diabetes and its various risk factors,which play an important role in their development,prognosis evaluation.Objective:To explore the correlation between obesity and CD40-CD40L system in children and adolescents,and to provide new ideas for the diagnosis and treatment of obese children and adolescents.Methods:From August 2016 to November 2016,76 obese children with initial diagnosis in Department of Endocrinology,affiliated to the Children's Hospital of Zhejiang University School of Medicine,were obese,including 54 males and 22 females,aged 11.04±1.85 years.Meanwhile,74 healthy BMI children who were admitted to the hospital during the same period were selected as control group.Among them,there were 16 males and 58 females,aged 8.35± 1.37 years.By measuring the morphological and biochemical indexes of obese children,combined with the determination of CD40 and CD40L,univariate and multivariate analyses were performed.Results:Single factor analysis showed that the waist circumference/height,BMI,systolic pressure,diastolic pressure,alanine aminotransferase,glutamic pyruvic transaminase,uric acid,triglyceride,CD40L,mean carotid artery middle layer thickness(IMT)were higher than those of the control group,and HDL and apolipoprotein A1 were all lower than the control group,and the difference was statistically significant,p<0.05.Taking age and sex as the control factors,CD40-CD40L was correlated with weight,BMI,waist circumference,waist circumference/height,systolic pressure,diastolic pressure,alanine aminotransferase,glutamic acid,uric acid,triglyceride,total cholesterol,low density lipoprotein,apolipoprotein B and glycosylated hemoglobin.It was negatively correlated with high density lipoprotein and apolipoprotein Al.Multiple linear regression analysis showed that body weight,BMI,waist circumference,systolic blood pressure and ALT were the major risk factors for CD40(R2=0.465).TC,HDL,BMI,ALT and bile acid were the major risk factors for CD40L(R2=0.598).Conclusions:CD40 and CD40L are highly correlated with obesity and hyperlipidemia.CD40-CD40L system is closely related to obesity and obesity related dyslipidemia and hypertension,which may provide new indicators for early warning of metabolic syndrome and provide new ideas for the prevention and treatment of related chronic diseases.