Relationship of circulating endothelial cells with obesity and cardiometabolic risk factors in children and adolescents

Erica G. Soltero, Anna N. Solovey, Robert P. Hebbel, Elise F. Palzer, Justin R. Ryder, Gabriel Q. Shaibi, Micah Olson, Claudia K. Fox, Kyle D. Rudser, Donald R. Dengel, Nicholas G. Evanoff, Aaron S. Kelly

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


BACKGROUND: Circulating endothelial cells (CECs) reflect early changes in endothelial health; however, the degree to which CEC number and activation is related to adiposity and cardiovascular risk factors in youth is not well described. METHODS AND RESULTS: Youth in this study (N=271; aged 8-20 years) were classified into normal weight (body mass index [BMI] percentage <85th; n=114), obesity (BMI percentage ≥95th to <120% of the 95th; n=63), and severe obesity (BMI percentage ≥120% of the 95th; n=94) catagories. CEC enumeration was determined using immunohistochemical examination of buffy coat smears and activated CEC (percentage of vascular cell adhesion molecule-1 expression) was assessed using immunofluorescent staining. Cardiovascular risk factors included measures of body composition, blood pressure, glucose, insulin, lipid profile, C-reactive protein, leptin, adiponectin, oxidized low-density lipoprotein cholesterol, carotid artery intima-media thickness, and pulse wave velocity. Linear regression models examined associations between CEC number and activation with BMI and cardiovascular risk factors. CEC number did not differ among BMI classes (P>0.05). Youth with severe obesity had a higher degree of CEC activation compared with normal weight youth (8.3%; 95% CI, 1.1-15.6 [P=0.024]). Higher CEC number was associated with greater body fat percentage (0.02 per percentage; 95% CI, 0.00-0.03 [P=0.020]) and systolic blood pressure percentile (0.01 per percentage; 95% CI, 0.00-0.01 [P=0.035]). Higher degree of CEC activation was associated with greater visceral adipose tissue (5.7% per kg; 95% CI, 0.4-10.9 [P=0.034]) and non-high-density lipoprotein cholesterol (0.11% per mg/dL; 95% CI, 0.01-0.21 [P=0.039]). CONCLUSIONS: Methods of CEC quantification are associated with adiposity and cardiometabolic risk factors and may potentially reflect accelerated atherosclerosis as early as childhood.

Original languageEnglish (US)
Article numbere018092
Pages (from-to)1-8
Number of pages8
JournalJournal of the American Heart Association
Issue number1
StatePublished - Jan 5 2021

Bibliographical note

Funding Information:
This work was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) R01 HL110957 (principal investigator: Kelly). This work was also supported in part by the National Institutes of Diabetes and Digestive and Kidney Diseases of the NIH R01 DK10757901 (principal investigator: Shaibi) and a postdoctoral fellowship awarded by the American Heart Association 18POST33990036 (principal investigator: Soltero). Dr Soltero is also supported by a US Department of Agriculture/Agricultural Research Service (USDA/ARS) cooperative agreement #58-3092-5-001.

Publisher Copyright:
© 2020 The Authors.


  • Adolescents
  • Cardiovascular risk
  • Children
  • Endothelial health
  • Novel biomarkers
  • Obesity


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