Pathophysiological alterations and cardio-metabolic changes in childhood obesity

Aim of this dissertation is to illustrate the results of the research projects carried out during the PhD course within the main research line concerning childhood obesity, carried out at the Pediatrics Unit of the University Hospital of Messina, Department of Adult and Childhood Human Pathology “Gaetano Barresi”. Focus of our research group is childhood obesity, with particular attention to the pathophysiology and obesity-related complications in pediatric age. The main objective of our research is to find biomarkers for the early detection of children and adolescents with an increased risk of developing obesity-related cardio-metabolic (e.g. impaired glucose regulation, dyslipidemia, arterial hypertension) or to diagnose those who already have incipient cardio-metabolic alterations as a prelude to the onset of obesity-related complications. This research has been carried out both by studying the pathophysiological mechanisms underlying complications in children and adolescents, such as oxidative stress pathways and cytokines involved in impaired glucose regulation, and by evaluating the clinical, laboratory and instrumental characteristics of patients in whom it is already possible to diagnose these complications or to identify precocious, preclinical, alterations. The ultimate goal is to implement the clinical-therapeutic management of children with overweight and obesity to prevent the onset of obesity-related cardio-metabolic complications and to plan a personalized approach in obese children who already present incipient alterations. This dissertation is structured in two sections reporting the research projects realized and published in international scientific journals concerning the pathophysiological alterations and cardio-metabolic changes in childhood obesity. The first section focuses on results presentation concerning the researches in the pathophysiological field aimed to identify early biochemical biomarkers implicated in obesity-related complications; the second one focuses on the results of researches carried out to characterize the cardio-metabolic profiles of children and adolescents through innovative non-invasive methods.