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Published on: February 23, 2020
Preclinical changes in the mechanical properties of abdominal aorta in obese children
Arcangelo Iannuzzi1, Maria Rosaria Licenziati, Ciro Acampora
1Divisione di Medicina Interna, Ospedale S. Maria dell'Olmo e Costa d'Amalfi, Cava de' Tirreni, Italy.
Insights
Childhood obesity is linked to early cardiovascular issues. Obese children show preclinical changes in aortic stiffness, particularly those with insulin resistance, indicating a need for early intervention.
Area of Science:
- Cardiovascular Science
- Pediatric Endocrinology
- Medical Imaging
Background:
- Childhood obesity is a growing concern linked to early cardiovascular abnormalities.
- Preclinical detection of vascular changes in obese children is crucial for timely intervention.
Purpose of the Study:
- To investigate preclinical functional changes in the abdominal aorta of obese children.
- To assess aortic mechanical properties and their correlation with metabolic factors.
Main Methods:
- Utilized B-mode ultrasound to assess pulsatile wall-motion of the abdominal aorta in 100 obese children and 50 controls.
- Measured lumen diameters, relative aortic strain, elastic modulus, and stiffness.
- Assessed blood pressure, lipid profiles, C-reactive protein, and insulin resistance (HOMA score).
Main Results:
- Obese children exhibited higher blood pressure, total cholesterol, triglycerides, insulin, and C-reactive protein compared to controls.
- Significantly increased aortic stiffness and elastic modulus were observed in obese children.
- Obese girls with high insulin resistance showed increased aortic stiffness, even after adjusting for cardiovascular risk factors.
Conclusions:
- Preclinical alterations in aortic elastic properties are detectable in obese children.
- Insulin resistance appears to be a significant factor contributing to increased aortic wall rigidity in obese girls.
- These findings highlight the importance of monitoring cardiovascular health in obese children.
Abstract:
Obesity in childhood has been associated with the development of early cardiovascular abnormalities. The aim of the present study was to investigate whether preclinical functional changes are detectable in the abdominal aorta of obese children. One hundred consecutively seen obese children and 50 healthy controls were studied. The groups were matched in terms of age and gender. The pulsatile wall-motion of the abdominal aorta was determined using a B-mode ultrasound technique. The following mechanical property parameters were measured or computed: lumen diastolic and systolic diameters, relative aortic strain, elastic modulus, and stiffness. Compared to controls, obese children had higher blood pressure values and higher concentrations of total cholesterol, triglycerides, insulin, and C-reactive protein. Homeostasis model assessment (HOMA) score, a parameter of insulin resistance, was significantly higher in obese children than in controls (3.2 +/- 1.9 v 1.4 +/- 0.5, P <.001). Aortic mechanical parameters were significantly different in obese children as compared to controls: stiffness was higher (3.00 +/- 1.45 v 2.22 +/- 0.87, P <.001) as was elastic modulus (0.38 +/- 0.18 v 0.24 +/- 0.10 N/m(2), P <.001). Obese girls with insulin resistance (ie, in the highest tertile of HOMA, >3.7) had increased aortic stiffness (3.79 +/- 2.25) compared to obese girls in the lowest tertiles of HOMA (2.67 +/- 1.09, P =.045), even after adjustment for traditional cardiovascular risk factors (P =.031). The present findings suggest that preclinical changes in the aortic elastic properties are detectable in obese children. Insulin resistance seems to play an important role in the increased rigidity of the aortic wall in obese girls.
