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Background: Adhesion molecule (E-selectin, ICAM-1 and
VCAM-1) have a crucial role in neutrophil extravasation caused by endothelial
cell activation in viral Dengue infection. In the over nutritious state, the
serum adiponectin level tends to be lower which limit its ability to inhibit
the expression of pro-inflammatory cytokines (TNFα, IL-6 and NF-kB) and adhesion
molecules. There is also increased level of TNFα, IL-1 β, IL-6, IL-8 which
increase the expression of adhesion molecules even further.
Objective: The aim of this study is to determine the
role of sE-selectin, sICAM-1 and sVCAM-1 in pediatric Dengue Hemorrhagic Fever
(DHF) patient with overweight.
Methods: An analytic observational nested case-control
study was conducted in Pediatric Division Sanglah General Hospital, Bali,
Indonesia from January 2015 to October 2016 which DHF as a cases and Dengue
Fever (DF) as a control. Diagnosis of dengue infection was according to WHO
1997.
Results: 80 subjects were enrolled in this study with
40 subjects for each group. The baseline characteristics between case and
control showed no significant differences. This study showed that overweight increased
the risk of Dengue Shock Syndrome (DSS) with odds ratio 2.67 (95% CI
0.72-9.95). The means level of sE-selectin in DHF with overweight group vs.
normal weight was 44.39 ± 14.55 ng/mL vs. 53.76 ± 22.24 ng/mL, p=0.118; DF
group (57.18 ± 23.86 ng/mL vs. 48.95 ± 24.79 ng/mL), p=0.350; DSS group (42.44
± 9.44 ng/mL vs. 40.93 ± 14.56 ng/mL), p=0.810. Level of sICAM-1 in DHF group
(407.25 ± 137.54 ng/mL vs. 354.42 ± 87.49 ng/mL), p=0.148; DF group (363.65 ±
182.09 ng/mL vs. 359.71 ± 146.88 ng/mL), p=0.944; DSS group (367.25 ± 105.86
ng/mL vs. 313.34 ± 68.65 ng/mL), p=0.293. The means level of sVCAM-1 in DHF was
5333.86 ± 1048.18 ng/mL vs. 4703.90 ± 956.64 ng/mL), p=0.054; DF group (4666.44
± 950.74 ng/mL vs. 4549.40 ± 1027.11 ng/mL), p=0.745; DSS group (4638.64 ±
934.99 ng/mL vs. 4358.37 ± 1350.35 ng/mL) with p=0.641. Level of adiponectin in
DHF overweight group vs. normal weight was 7.44 ± 5.03 ng/mL vs. 16.82 ± 10.98
ng/mL, p=0.015; DF group (15.93 ± 10.72 ng/mL vs. 16.99 ± 8.33 ng/mL), p=0.876
and in DSS group was 5.99 ± 2.86 ng/mL vs. 8.49 ± 2.73 ng/mL with p=0.115.
Conclusion: The means level of sICAM-1 and sVCAM-1, but
not sE-Selectin, in DHF, DF, DSS and non-DSS group with overweight was found to
be consistently higher than normal weight but it was not statistically
significant.
Keywords: Dengue hemorrhagic
fever, sE-selectin, sICAM-1, sVCAM-1, Overweight children
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