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Impaired microvascular function in normal children: effects of adiposity and poor glucose handling
Faisel Khan1, Fiona C Green, J Stewart Forsyth
1Vascular Diseases Research Unit, Department of Medicine, Ninewells Hospital and Medical School, University of Dundee, Scotland, UK. f.khan@dundee.ac.uk
Insights
Cardiovascular risk factors cluster in healthy children, impacting microvascular function and indicating early signs of atherosclerosis. Higher body fat and glucose levels are linked to impaired blood vessel responses in adolescents.
Area of Science:
- Pediatrics
- Cardiovascular Science
- Metabolic Health
Background:
- Cardiovascular risk factors often cluster early in life.
- The endothelium plays a crucial role in regulating microvascular function.
- Early identification of cardiovascular risk in children is essential for long-term health.
Purpose of the Study:
- To investigate the relationship between microvascular endothelial function and cardiovascular risk factors in healthy children.
- To determine if cardiovascular risk factors cluster in normal children and associate with impaired microvascular function.
Main Methods:
- Studied 145 healthy children aged 11-14 years.
- Assessed skin microvascular responses using laser Doppler imaging after iontophoresis of acetylcholine and sodium nitroprusside.
- Measured percentage body fat, waist-to-hip ratio, fasting glucose, insulin, insulin resistance index, triglycerides, and cholesterol.
Main Results:
- Microvascular responses were negatively correlated with percentage body fat.
- Children with higher 2-hour post-feeding glucose levels exhibited significantly lower vasodilatation.
- A subgroup showed clustering of high glucose, impaired microvascular function, increased insulin resistance, and central adiposity.
Conclusions:
- Microvascular function is negatively associated with adiposity in normal children.
- Cardiovascular risk factors begin to cluster in childhood, potentially leading to atherosclerosis later in life.
- These findings highlight the importance of early detection and intervention for cardiovascular health in pediatric populations.
Abstract:
Clustering of cardiovascular risk factors is thought to occur early in life. The endothelium is an important regulator of microvascular function. We investigated the relationship between microvascular function and cardiovascular risk factors in 145 normal, healthy children aged 11-14 years. Skin microvascular responses, measured using laser Doppler imaging, to iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP), were negatively correlated with percentage body fat (r = -0.20, P < 0.05 and r = -0.18, P < 0.05, respectively). Subjects were stratified into quintiles based on 2-h, post-feeding glucose levels. Subjects in the upper glucose quintile (range 7.4-11.4 mmol l-1) showed significantly lower vasodilatation to both ACh (P < 0.005) and SNP (P < 0.02) than those in the lower quintile (range 3.9-4.9 mmol l-1). Waist-to-hip ratio and the fasting insulin resistance index were significantly greater in subjects in the upper quintile than those in the lower quintile (P < 0.001 and P < 0.05, respectively). Additionally, in subjects in the upper glucose quintile, fasting triglyceride correlated with fasting insulin (r = 0.59, P < 0.001) and with the fasting insulin resistance index (r = 0.49, P < 0.009), and plasma levels of cholesterol and 2-h glucose were also correlated (r = 0.40, P < 0.05). In a cross-section of normal children, microvascular function was negatively associated with adiposity. Additionally, in a subgroup of subjects, there was a clustering of high post-feeding glucose, impaired microvascular function, increased insulin resistance and higher central fat distribution. These findings suggest that risk factors for adult cardiovascular disease begin to cluster in normal children, which might have important consequences for development of atherosclerosis later in life.