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Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children

Year 2014, Volume: 11 Issue: 3, 141 - 147, 01.09.2014
https://doi.org/10.15197/sabad.1.11.59

Abstract

We aimed to measure flow-mediated dilation (FMD), carotid intima-media thickness (cIMT), and to evaluate the effects of waist circumference (WC), and body mass index Z (BMI-Z) score on these parameters in obese children. This case-control cross-sectional study included 70 obese and 40 non-obese children aged 7-14 years who presented with various complaints and had no concomitant diseases. FMD and cIMT were measured in all subjects and correlated with anthropometric and biochemical factors. WC, BMI-Z score, systolic and diastolic blood pressure (BP), triglyceride (TG) and insulin concentrations, and homeostatic model assessment (HOMA) index were significantly higher, whereas high density lipoprotein (HDL) -cholesterol concentration was significantly lower in the obese than in the non-obese group. FMD values were significantly lower, whereas cIMT values were significantly higher in obese than in non-obese subjects. FMD negatively correlated with WC, BMI-Z score, serum insulin level, HOMA, systolic BP, triglyceride but positively with HDL-cholesterol. cIMT positively correlated with WC, BMI-Z score, serum insulin level, HOMA, systolic BP, triglyceride but negatively with HDL-cholesterol. Increased WC, BMI-Z score, serum insulin level, HOMA, systolic BP, triglyceride and decreased HDL-cholesterol in obese children contribute to endothelial dysfunction and early subclinical atherosclerosis compared to their normal weight peers.

References

  • Raj M. Obesity and cardiovascular risk in children and adolescents. Indian J Endocrinol Metab 2012;16: 13-9.
  • Raghuveer G. Lifetime cardiovascular risk of childhood obesity. Am J Clin Nutr 2010; 91: 1514S-9S.
  • Juonala M, Viikari JSA, Kähönen M, et al. Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study. Eur Heart J 2010; 31: 1745-51.
  • Kwiterovich PO. Clinical and laboratory assessment of cardiovascular risk in children: Guidelines for screening, evaluation, and treatment. J Clin Lipidol 2008; 2: 248-66.
  • Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr 2007; 150: 12-7.
  • Belay B, Belamarich P, Racine AD. Pediatric precursors of adult atherosclerosis. Pediatr Rev 2004; 25: 4-16.
  • Chen F, Wang Y, Shan X, et al. Association between child- hood obesity and metabolic syndrome: evidence from a large sample of Chinese children and adolescents. PLoS One 2012; 7: e47380.
  • Montero D, Walther G, Perez-Martin A, Roche E, Vinet A. Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and ef- fect of lifestyle intervention. Obes Rev 2012; 13: 441-55.
  • Urbina EM, Williams RV, Alpert BS, et al. Noninvasive as- sessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension 2009; 54: 919- 50.
  • Barton M. Obesity and aging: determinants of endothelial cell dysfunction and atherosclerosis. Pflugers Arch 2010; 460: 825-37.
  • Barlow SE; Expert Committee. Expert committee rec- ommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007; 120 Suppl 4: S164–92.
  • Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epi- demiology of obesity. Gastroenterology 2007; 132: 2087- 102.
  • Srinivasan SR, Bao W, Wattigney WA, Berenson GS. Adolescent overweight is associated with adult over- weight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996; 45: 235-40.
  • Elkiran O, Yilmaz E, Koc M, Kamanli A, Ustundag B, Ilhan N. The association between intima media thickness, central obesity and diastolic blood pressure in obese and overweight children: A cross-sectional school-based study. Int J Cardiol 2013; 165: 528-32.
  • Leite A, Santos A, Monteiro M, Gomes L, Veloso M, Costa M. Impact of overweight and obesity in carotid intima- media thickness of Portuguese adolescents. Acta Paediatr 2012; 101: e115-21.
  • Stabouli S, Kotsis V, Karagianni C, Zakopoulos N, Konstantopoulos A. Blood pressure and carotid artery intima-media thickness in children and adolescents: the role of obesity. Hellenic J Cardiol 2012; 53: 41-7.
  • Yilmazer MM, Tavli V, Carti OU, et al. Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children. Eur J Pediatr 2010; 169: 1241-8.
  • Meyer AA, Kundt G, Steiner M, Schuff-Werner P, Kienast W. Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plas- ma markers in obese children: the impact of cardiovascu- lar risk factors. Pediatrics 2006; 117: 1560-7.
  • Caserta CA, Pendino GM, Alicante S, et al. Body mass in- dex, cardiovascular risk factors, and carotid intima-me- dia thickness in a pediatric population in southern Italy. J Pediatr Gastroenterol Nutr 2010; 51: 216-20.
  • Verçoza AM, Baldisserotto M, de Los Santos CA, Poli-de- Figueiredo CE, d'Avila DO. Cardiovascular risk factors and carotid intima-media thickness in asymptomatic children. Pediatr Cardiol 2009; 30: 1055-60.
  • Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993; 362: 801-9.
  • Ciccone MM, Miniello V, Marchioli R, et al. Morphological and functional vascular changes induced by childhood obesity. Eur J Cardiovasc Prev Rehabil 2011; 18: 831-5.
  • Mori Y. Flow-mediated dilatation in obese children. Clin Pediatr Endocrinol 2003; 12: 43-8.
  • Cobble M, Bale B. Carotid intima-media thickness: knowl- edge and application to everyday practice. Postgrad Med 2010; 122: 10-8.
  • Gilardini L, Pasqualinotto L, Di Matteo S, et al. Factors associated with early atherosclerosis and arterial calci- fications in young subjects with a benign phenotype of obesity. Obesity 2011; 19:1684-9.
  • Iannuzzi A, Licenziati MR, Acampora C, et al. Increased carotid intima-media thickness and stiffness in obese children. Diabetes Care 2004; 27: 2506-8.
  • Yang XZ, Liu Y, Mi J, Tang CS, DU JB. Pre-clinical athero- sclerosis evaluated by carotid artery intima-media thick- ness and the risk factors in children. Chin Med J 2007; 120(5): 359-62.
  • DeFronzo RA. Insulin resistance, hyperinsulinemia, and coronary artery disease: a complex metabolic web. J Cardiovasc Pharmacol 1992;20 Suppl 11:S1-16.

Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children

Year 2014, Volume: 11 Issue: 3, 141 - 147, 01.09.2014
https://doi.org/10.15197/sabad.1.11.59

Abstract

Obez çocuklarda akım aracılı dilatasyonu (AAD), karotis intima-media kalınlığını (kİMK) ölçmeyi ve bel çevresi (BÇ) ile beden-kitle indeksi Z (BKİ-Z) skorunun bu parametrelere etkisini değerlendirmeyi amaçladık. Bu vaka kontrollü karşılaştırmalı kesitsel çalışma 7-14 yaşlarında, değişik şikayetlerle pediatri polikliniğine gelen ve eşlik eden hastalığı olmayan, 70 obez ve 40 obez olmayan çocuğu kapsamaktaydı. AAD ve kİMK tüm bireylerde ölçüldü ve antropometrik, biyokimyasal faktörlerle ilişkisi araştırıldı. Obez grupta yüksek dansiteli lipoprotein (YYL) kolesterol konsantrasyonu obez olmayan gruptan belirgin derecede düşük iken; BÇ, BKİ-Z skoru, sistolik ve diyastolik kan basıncı (KB), trigliserit (TG), insülin konsantrasyonları ve HOMA (homeostatic model assessment) indeksi belirgin derecede yüksekti. Obez grupta kİMK değerleri obez olmayan gruptan belirgin derecede yüksek iken, AAD değerleri belirgin derecede düşüktü. AAD değerleri; BÇ, BKİ-Z skoru, serum insulin seviyesi, HOMA, sistolik KB, TG ile negatif; HDL kolesterol ile pozitif ilişkiliydi. kİMK değerleri; BÇ, BKİ-Z skoru, serum insulin seviyesi, HOMA, sistolik KB, TG ile pozitif; HDL kolesterol ile negatif ilişkiliydi. Normal kilolu yaşıtlarıyla karşılaştırıldığında, obez çocuklarda, artmış BÇ, BKİ-Z skoru, serum insulin seviyesi, HOMA, sistolik KB, TG ve azalmış HDL kolesterol, endotel disfonksiyonu ve erken subklinik ateroskleroza katkıda bulunmaktadır

References

  • Raj M. Obesity and cardiovascular risk in children and adolescents. Indian J Endocrinol Metab 2012;16: 13-9.
  • Raghuveer G. Lifetime cardiovascular risk of childhood obesity. Am J Clin Nutr 2010; 91: 1514S-9S.
  • Juonala M, Viikari JSA, Kähönen M, et al. Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study. Eur Heart J 2010; 31: 1745-51.
  • Kwiterovich PO. Clinical and laboratory assessment of cardiovascular risk in children: Guidelines for screening, evaluation, and treatment. J Clin Lipidol 2008; 2: 248-66.
  • Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr 2007; 150: 12-7.
  • Belay B, Belamarich P, Racine AD. Pediatric precursors of adult atherosclerosis. Pediatr Rev 2004; 25: 4-16.
  • Chen F, Wang Y, Shan X, et al. Association between child- hood obesity and metabolic syndrome: evidence from a large sample of Chinese children and adolescents. PLoS One 2012; 7: e47380.
  • Montero D, Walther G, Perez-Martin A, Roche E, Vinet A. Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and ef- fect of lifestyle intervention. Obes Rev 2012; 13: 441-55.
  • Urbina EM, Williams RV, Alpert BS, et al. Noninvasive as- sessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension 2009; 54: 919- 50.
  • Barton M. Obesity and aging: determinants of endothelial cell dysfunction and atherosclerosis. Pflugers Arch 2010; 460: 825-37.
  • Barlow SE; Expert Committee. Expert committee rec- ommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007; 120 Suppl 4: S164–92.
  • Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epi- demiology of obesity. Gastroenterology 2007; 132: 2087- 102.
  • Srinivasan SR, Bao W, Wattigney WA, Berenson GS. Adolescent overweight is associated with adult over- weight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996; 45: 235-40.
  • Elkiran O, Yilmaz E, Koc M, Kamanli A, Ustundag B, Ilhan N. The association between intima media thickness, central obesity and diastolic blood pressure in obese and overweight children: A cross-sectional school-based study. Int J Cardiol 2013; 165: 528-32.
  • Leite A, Santos A, Monteiro M, Gomes L, Veloso M, Costa M. Impact of overweight and obesity in carotid intima- media thickness of Portuguese adolescents. Acta Paediatr 2012; 101: e115-21.
  • Stabouli S, Kotsis V, Karagianni C, Zakopoulos N, Konstantopoulos A. Blood pressure and carotid artery intima-media thickness in children and adolescents: the role of obesity. Hellenic J Cardiol 2012; 53: 41-7.
  • Yilmazer MM, Tavli V, Carti OU, et al. Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children. Eur J Pediatr 2010; 169: 1241-8.
  • Meyer AA, Kundt G, Steiner M, Schuff-Werner P, Kienast W. Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plas- ma markers in obese children: the impact of cardiovascu- lar risk factors. Pediatrics 2006; 117: 1560-7.
  • Caserta CA, Pendino GM, Alicante S, et al. Body mass in- dex, cardiovascular risk factors, and carotid intima-me- dia thickness in a pediatric population in southern Italy. J Pediatr Gastroenterol Nutr 2010; 51: 216-20.
  • Verçoza AM, Baldisserotto M, de Los Santos CA, Poli-de- Figueiredo CE, d'Avila DO. Cardiovascular risk factors and carotid intima-media thickness in asymptomatic children. Pediatr Cardiol 2009; 30: 1055-60.
  • Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993; 362: 801-9.
  • Ciccone MM, Miniello V, Marchioli R, et al. Morphological and functional vascular changes induced by childhood obesity. Eur J Cardiovasc Prev Rehabil 2011; 18: 831-5.
  • Mori Y. Flow-mediated dilatation in obese children. Clin Pediatr Endocrinol 2003; 12: 43-8.
  • Cobble M, Bale B. Carotid intima-media thickness: knowl- edge and application to everyday practice. Postgrad Med 2010; 122: 10-8.
  • Gilardini L, Pasqualinotto L, Di Matteo S, et al. Factors associated with early atherosclerosis and arterial calci- fications in young subjects with a benign phenotype of obesity. Obesity 2011; 19:1684-9.
  • Iannuzzi A, Licenziati MR, Acampora C, et al. Increased carotid intima-media thickness and stiffness in obese children. Diabetes Care 2004; 27: 2506-8.
  • Yang XZ, Liu Y, Mi J, Tang CS, DU JB. Pre-clinical athero- sclerosis evaluated by carotid artery intima-media thick- ness and the risk factors in children. Chin Med J 2007; 120(5): 359-62.
  • DeFronzo RA. Insulin resistance, hyperinsulinemia, and coronary artery disease: a complex metabolic web. J Cardiovasc Pharmacol 1992;20 Suppl 11:S1-16.
There are 28 citations in total.

Details

Primary Language English
Journal Section Original Articles
Authors

Seref Alpsoy This is me

Aydın Akyüz This is me

Dursun Cayan Akkoyun This is me

Burcin Nalbantoglu This is me

Birol Topcu This is me

Mustafa Metin Donma This is me

Publication Date September 1, 2014
Published in Issue Year 2014 Volume: 11 Issue: 3

Cite

APA Alpsoy, S., Akyüz, A., Akkoyun, D. C., Nalbantoglu, B., et al. (2014). Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children. European Journal of General Medicine, 11(3), 141-147. https://doi.org/10.15197/sabad.1.11.59
AMA Alpsoy S, Akyüz A, Akkoyun DC, Nalbantoglu B, Topcu B, Donma MM. Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children. European Journal of General Medicine. September 2014;11(3):141-147. doi:10.15197/sabad.1.11.59
Chicago Alpsoy, Seref, Aydın Akyüz, Dursun Cayan Akkoyun, Burcin Nalbantoglu, Birol Topcu, and Mustafa Metin Donma. “Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children”. European Journal of General Medicine 11, no. 3 (September 2014): 141-47. https://doi.org/10.15197/sabad.1.11.59.
EndNote Alpsoy S, Akyüz A, Akkoyun DC, Nalbantoglu B, Topcu B, Donma MM (September 1, 2014) Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children. European Journal of General Medicine 11 3 141–147.
IEEE S. Alpsoy, A. Akyüz, D. C. Akkoyun, B. Nalbantoglu, B. Topcu, and M. M. Donma, “Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children”, European Journal of General Medicine, vol. 11, no. 3, pp. 141–147, 2014, doi: 10.15197/sabad.1.11.59.
ISNAD Alpsoy, Seref et al. “Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children”. European Journal of General Medicine 11/3 (September 2014), 141-147. https://doi.org/10.15197/sabad.1.11.59.
JAMA Alpsoy S, Akyüz A, Akkoyun DC, Nalbantoglu B, Topcu B, Donma MM. Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children. European Journal of General Medicine. 2014;11:141–147.
MLA Alpsoy, Seref et al. “Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children”. European Journal of General Medicine, vol. 11, no. 3, 2014, pp. 141-7, doi:10.15197/sabad.1.11.59.
Vancouver Alpsoy S, Akyüz A, Akkoyun DC, Nalbantoglu B, Topcu B, Donma MM. Effect of Obesity on Endothelial Function and Subclinical Atherosclerosis in Children. European Journal of General Medicine. 2014;11(3):141-7.