Elsevier

Metabolism

Volume 53, Issue 9, September 2004, Pages 1243-1246
Metabolism

Preclinical changes in the mechanical properties of abdominal aorta in obese children

https://doi.org/10.1016/j.metabol.2004.03.023Get rights and content

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/m2, 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.

Section snippets

Materials and methods

The study population consisted of 100 obese children (60% males; mean age, 10.0 ± 2.6 years) consecutively recruited from subjects attending the Outpatient Center for Pediatric Obesity and Endocrinology of Cardarelli Hospital in Naples, Italy.

Obesity was defined as BMI greater tham the 95th percentile of the reference values stated in the Centers for Disease Control growth chart.18

The control group consisted of 50 children, who were relatives or friends of the obese children studied. The groups

Results

The clinical characteristics of the study groups are presented in Table 1. Years of education of children parents were similar in the 2 groups (mean ± SD, 8.9 ± 3.0 in obese v 8.5 ± 3.2 years in the control group, P = .45). Compared to controls, obese children had higher blood pressure values and higher concentrations of total cholesterol, triglycerides, insulin, and C-reactive protein. HOMA, a parameter of insulin resistance, was significantly higher in obese children than in controls.

Elastic

Discussion

Epidemiological studies have shown that obesity in childhood predicts not only obesity in adulthood,21 but also an increased risk of cardiovascular morbidity and mortality.22, 23 Furthermore, postmortem studies suggested that obese children were at increased atherosclerotic risk.7, 8, 24

In recent years, the development of noninvasive methods has allowed the detection of in vivo abnormalities in arterial structure and function in childhood and adolescence.15, 16, 25, 26, 27

In the present study,

References (31)

  • R.V. Luepker et al.

    Secular trends of blood pressure and body size in a multiethnic adolescent population1986 to 1996

    J Pediatr

    (1996)
  • D.S. Ludwig et al.

    Type 2 diabetes mellitus in childrenPrimary care and public health considerations

    JAMA

    (2001)
  • G.S. Berenson et al.

    Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study

    N Engl J Med

    (1998)
  • M.L. Kortelainen

    Adiposity, cardiac size and precursors of coronary atherosclerosis in 5- to 15-year old childrenA retrospective study of 210 violent deaths

    Int J Obesity

    (1997)
  • M.L. Bots et al.

    Carotid intima-media thickness, arterial stiffness and risk of cardiovascular diseaseCurrent evidence

    J Hypertens

    (2002)
  • Cited by (0)

    View full text