Intima-media thickness in obese children before and after weight loss
Rainer Wunsch1, Gideon de Sousa, André Michael Toschke
1Department of Pediatrics, University of Witten/Herdecke, Datteln, Germany.
Insights
Childhood obesity is linked to early vascular changes. Weight loss in obese children significantly reduced intima-media thickness, indicating reversibility of these atherosclerotic changes.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Childhood obesity is associated with increased intima-media thickness (IMT), a marker of early atherosclerosis.
- Obesity negatively impacts cardiovascular risk factors, including blood pressure, lipids, and insulin resistance.
Purpose of the Study:
- To investigate the changes in intima-media thickness (IMT) in obese children following a weight loss intervention.
- To assess the impact of weight loss on cardiovascular risk factors in prepubertal obese children.
Main Methods:
- A 1-year outpatient intervention program was conducted on 56 prepubertal obese children.
- Carotid intima-media thickness (cIMT) was measured using B-mode ultrasound.
- Cardiovascular risk factors including blood pressure, lipids, glucose, insulin, and insulin resistance were analyzed.
Main Results:
- Obese children exhibited significantly higher IMT and poorer cardiovascular risk profiles compared to non-obese controls.
- Obese children who achieved substantial weight loss showed significant reductions in IMT, blood pressure, triglycerides, insulin, and insulin resistance.
- High-density lipoprotein cholesterol levels increased significantly in obese children with substantial weight loss.
Conclusions:
- Vascular changes, evidenced by increased IMT, occur early in childhood obesity.
- Weight loss interventions can lead to the reversal of early atherosclerotic changes in obese children.
- Improving cardiovascular risk factors through weight management is crucial for pediatric health.
Objective:
Obesity in childhood is related to increased intima-media thickness, a noninvasive marker for early atherosclerotic changes. The objective of this study was to analyze the changes of intima-media thickness in obese children with weight loss.
Methods:
We analyzed the changes of intima-media thickness and, as markers of cardiovascular risk factor profile, systolic and diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, glucose, insulin, and insulin resistance index (homeostasis model analysis) in 56 prepubertal obese children (median: 9 years old) before and after a 1-year outpatient intervention program. The control group consisted of 10 nonobese children of the same age and gender. We determined the carotid intima-media thickness by B-mode ultrasound with a 14-MHz linear transducer. Substantial weight loss was defined by a reduction of overweight of at least 0.5 standard deviation scores in BMI.
Results:
Obese children demonstrated a significantly thicker intima-media compared with the control group. Furthermore, blood pressure, triglycerides, insulin, and insulin resistance index were significantly higher in obese children, whereas high-density lipoprotein cholesterol was significantly lower. In the 24 obese children with substantial weight loss, intima-media thickness, blood pressure, triglycerides, insulin, and insulin resistance index decreased significantly, whereas high-density lipoprotein cholesterol increased significantly. In the 32 obese children without substantial weight loss, there were no significant changes apart from an increase of insulin and insulin resistance index.
Conclusions:
Because obese children demonstrated a thicker intima-media, vascular changes seemed to occur already in childhood obesity. Paralleling the improvement of the cardiovascular risk factor profile, intima-media thickness decreased in obese children with substantial weight loss, suggesting the reversibility of early atherosclerotic changes.
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