Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children
Murat Muhtar Yilmazer1, Vedide Tavli, Ozgür Umaç Carti
1Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey. drmuratmuhtar@hotmail.com
Insights
Childhood obesity is linked to early signs of atherosclerosis, including increased carotid intima-media thickness and reduced arterial compliance and flow-mediated dilation. Hypertriglyceridemia and waist circumference are key indicators of these arterial changes in obese youth.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Public Health Nutrition
Background:
- Obesity is a growing global health concern in children and adolescents.
- It is associated with numerous cardiovascular risk factors, including hyperlipidemia, hypertension, and hyperinsulinemia.
- Atherosclerosis, a disease of the arteries, begins in childhood and progresses over time.
Purpose of the Study:
- To investigate the relationship between cardiovascular risk factors and subclinical atherosclerosis in obese children and adolescents.
- To compare ultrasonographic markers of atherosclerosis in obese versus non-obese youth.
- To identify specific lipid anomalies and obesity parameters associated with arterial changes.
Main Methods:
- Compared 77 obese children/adolescents with 40 non-obese healthy peers.
- Measured carotid intima-media thickness (cIMT), carotid artery compliance (CAC), and brachial artery flow-mediated dilation (FMD) using ultrasonography.
- Analyzed associations between cIMT, CAC, FMD, body mass index (BMI), waist circumference (WC), and lipid profiles.
Main Results:
- Obese youth showed significantly increased cIMT (0.57 mm vs 0.45 mm) and decreased CAC (1.84% vs 3.29%) and FMD (9.67% vs 14.81%) compared to controls.
- BMI was significantly related to cIMT, CAC, and FMD.
- Hypertriglyceridemia was positively correlated with cIMT, and WC was significantly associated with FMD.
Conclusions:
- Childhood obesity is associated with arterial wall alterations and endothelial dysfunction.
- Hypertriglyceridemia is a significant risk factor for atherosclerosis development in obese children.
- This study highlights the novel association between flow-mediated dilation and waist circumference in pediatric obesity.
Abstract:
Obesity is associated with a number of risk factors, such as hyperlipidemia, hyperinsulinemia, hypertension, and early atherosclerosis. Evidence indicates that atherosclerosis begins in childhood and progresses over decades. In this work, we examined the relationship between cardiovascular risk factors and ultrasonographic signs of subclinical atherosclerosis in 77 obese children and adolescents compared to 40 non-obese healthy peers. Carotis intima media thickness (cIMT), carotid artery compliance (CAC), brachial artery flow-mediated dilatation (FMD), and established cardiovascular risk factors were studied. In the obese patients, cIMT was significantly increased (0.57 mm vs 0.45 mm, p < 0.001) whereas CAC (1.84% vs 3.29%, p < 0.001) and FMD (9.67 % vs 14.81%, p < 0.001) were significantly decreased. In multiple linear regression analysis, a relation was observed between cIMT, CAC, brachial FMD on one hand, and body mass index (BMI) on the other. Among the lipid anomalies, only hypertriglyceridemia was found to be positively correlated with cIMT. Additionally, we found a significant association between waist circumference (WC) and FMD. These findings indicate that obesity in children is associated with arterial wall alterations and endothelial dysfunction. In hyperlipidemic situations, only hypertriglyceridemia was found to be positively correlated with cIMT. This finding has consistently indicated TG to be a risk factor for the development of atherosclerosis. To our knowledge this is the first study to determine the relation between FMD and WC, which is used as a parameter of obesity in childhood.
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