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Published on: May 3, 2018
Increased ambulatory arterial stiffness index in obese children
Christoph Saner1, Giacomo D Simonetti2, Elke Wühl3
1Division of Pediatric Endocrinology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Insights
Obese children exhibit increased arterial stiffness, as indicated by a higher Ambulatory Arterial Stiffness Index (AASI). This finding highlights potential cardiovascular risks associated with childhood obesity.
Area of Science:
- Cardiovascular Health
- Pediatric Endocrinology
- Biomedical Engineering
Background:
- Altered arterial stiffness is a key risk factor for cardiovascular disease.
- Ambulatory arterial stiffness index (AASI) is an emerging, accessible marker for assessing arterial stiffness.
- Childhood obesity is a growing public health concern with potential long-term cardiovascular implications.
Purpose of the Study:
- To investigate whether AASI is elevated in obese children compared to healthy, age- and gender-matched controls.
- To identify factors influencing AASI in obese children.
Main Methods:
- AASI was calculated using 24-hour ambulatory blood pressure monitoring (ABPM) in 101 obese children and 71 healthy controls.
- Participants were matched for age and gender.
- Multivariate regression analysis was employed to determine predictors of AASI.
Main Results:
- Obese children demonstrated significantly higher AASI compared to controls (0.388 vs. 0.190, p < 0.0001), despite similar blood pressure levels.
- In obese children, 24-h systolic blood pressure SDS independently predicted AASI.
- In the combined group, BMI SDS and pulse pressure independently influenced AASI.
Conclusions:
- AASI is significantly increased in obese children, serving as a surrogate marker for heightened arterial stiffness.
- Arterial stiffness in obese children appears to be independently influenced by BMI and pulse pressure, suggesting multifactorial contributors beyond simple blood pressure elevation.
Objective:
Altered arterial stiffness is a recognized risk factor of poor cardiovascular health. Ambulatory arterial stiffness index (AASI, defined as one minus the regression slope of diastolic on systolic blood pressure values derived from a 24 h arterial blood pressure monitoring, ABPM) is an upcoming and readily available marker of arterial stiffness. Our hypothesis was that AASI is increased in obese children compared to age- and gender matched healthy subjects.
Methods:
AASI was calculated from ABPM in 101 obese children (BMI ≥ 1.88 SDS according to age- and sex-specific BMI charts), 45% girls, median BMI SDS 2.8 (interquartile range (IQR) 2.5-3.4), median age 11.5 years (9.1-13.4) and compared with an age and gender matched healthy control group of 71 subjects with median BMI SDS 0.0 (-0.8-0.5). Multivariate regression analysis was applied to identify significant independent factors explaining AASI variability in this population.
Results:
AASI was significantly higher in obese children compared to controls (0.388 (0.254-0.499) versus 0.190 (0.070-0.320), p < 0.0001), but blood pressure values were similar. In a multivariate analysis including obese children only, AASI was independently predicted by 24-h systolic blood pressure SDS (p = 0.012); in a multivariate analysis including obese children and controls BMI SDS and pulse pressure independently influenced AASI (p < 0.001).
Conclusions:
This study shows that AASI, a surrogate marker of arterial stiffness, is increased in obese children. AASI seems to be influenced by BMI and pulse pressure independently of systolic and diastolic blood pressure values, suggesting that other factors are involved in increased arterial stiffness in obese children.
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