Increased rate of arterial stiffening with obesity in adolescents: a five-year follow-up study

Frida Dangardt, Yun Chen, Krister Berggren, Walter Osika, Peter Friberg, Frida Dangardt, Yun Chen, Krister Berggren, Walter Osika, Peter Friberg

Abstract

Background: We prospectively and longitudinally determined the effects of childhood obesity on arterial stiffening and vascular wall changes. Changes in arterial stiffness measured as pulse wave velocity (PWV) and vascular morphology of the radial (RA) and dorsal pedal arteries (DPA) were examined in obese adolescents compared to lean subjects in a 5-year follow-up study.

Methodology/principal findings: A total of 28 obese subjects and 14 lean controls participated in both baseline (14 years old) and follow-up studies. PWV was measured by tonometer (SphygmoCor®) and recorded at RA and carotid artery, respectively. Intima thickness (IT), intima-media thickness (IMT) and RA and DPA diameters were measured using high-resolution ultrasound (Vevo 770™). Over the course of 5 years, PWV increased by 25% in the obese subjects as compared to 3% in the controls (p = 0.01). Diastolic blood pressure (DBP) increased by 23% in the obese subjects as opposed to 6% in controls (p = 0.009). BMI increased similarly in both groups, as did the IT and IMT. The change in PWV was strongly associated to the baseline BMI z -score (r = 0.51, p<0.001), as was the change in DBP (r = 0.50, p = 0.001).

Conclusions/significance: During the transition from early to late adolescence, there was a general increase in arterial stiffness, which was aggravated by childhood obesity. The increase in arterial stiffness and DBP after 5 years was closely correlated to the baseline BMI z -score, indicating that childhood obesity has an adverse impact on vascular adaptation.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Association between body mass index…
Figure 1. Association between body mass index z score at baseline and five-year change in pulse wave velocity (upper panel) and diastolic blood pressure (lower panel).

References

    1. Raitakari OT, Juonala M, Kahonen M, Taittonen L, Laitinen T, et al. (2003) Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 290: 2277–2283.
    1. Davis PH, Dawson JD, Riley WA, Lauer RM (2001) Carotid Intimal-Medial Thickness Is Related to Cardiovascular Risk Factors Measured From Childhood Through Middle Age: The Muscatine Study. Circulation 104: 2815–2819.
    1. Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, et al. (1998) Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 338: 1650–1656.
    1. Baker JL, Olsen LW, Sorensen TIA (2007) Childhood Body-Mass Index and the Risk of Coronary Heart Disease in Adulthood. N Engl J Med 357: 2329–2337.
    1. Friberg P, Allansdotter-Johnsson A, Ambring A, Ahl R, Arheden H, et al. (2004) Increased left ventricular mass in obese adolescents. Eur Heart J 25: 987–992.
    1. Messerli FH, Christie B, DeCarvalho JG, Aristimuno GG, Suarez DH, et al. (1981) Obesity and essential hypertension. Hemodynamics, intravascular volume, sodium excretion, and plasma renin activity. Arch Intern Med 141: 81–85.
    1. Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, et al. (2010) Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation 121: 505–511.
    1. Vlachopoulos C, Aznaouridis K, Stefanadis C (2010) Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 55: 1318–1327.
    1. Aatola H, Hutri-Kahonen N, Juonala M, Viikari JS, Hulkkonen J, et al. (2010) Lifetime risk factors and arterial pulse wave velocity in adulthood: the cardiovascular risk in young Finns study. Hypertension 55: 806–811.
    1. Osika W, Dangardt F, Gronros J, Lundstam U, Myredal A, et al. (2007) Increasing peripheral artery intima thickness from childhood to seniority. Arterioscler Thromb Vasc Biol 27: 671–676.
    1. Dangardt F, Osika W, Volkmann R, Gan LM, Friberg P (2008) Obese children show increased intimal wall thickness and decreased pulse wave velocity. Clin Physiol Funct Imaging 28: 287–293.
    1. Moran A, Jacobs DR, Steinberger J, Steffen LM, Pankow JS, et al. (2008) Changes in Insulin Resistance and Cardiovascular Risk During Adolescence. Circulation 117: 2361–2368.
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320: 1240
    1. Karlberg J, Luo Z, Albertsson-Wikland K (2001) Body mass index reference values (mean and SD) for Swedish children. Acta Paediatrica 90: 1427–1434.
    1. De Angelis L, Millasseau SC, Smith A, Viberti G, Jones RH, et al. (2004) Sex Differences in Age-Related Stiffening of the Aorta in Subjects With Type 2 Diabetes. Hypertension 44: 67–71.
    1. Wendelhag I, Gustavsson T, Suurkula M, Berglund G, Wikstrand J (1991) Ultrasound measurement of wall thickness in the carotid artery: fundamental principles and description of a computerized analysing system. Clin Physiol 11: 565–577.
    1. Kapiotis S, Holzer G, Schaller G, Haumer M, Widhalm H, et al. (2006) A proinflammatory state is detectable in obese children and is accompanied by functional and morphological vascular changes. Arteriosclerosis, thrombosis, and vascular biology 26: 2541–2546.
    1. Whincup PH, Gilg JA, Donald AE, Katterhorn M, Oliver C, et al. (2005) Arterial distensibility in adolescents: the influence of adiposity, the metabolic syndrome, and classic risk factors. Circulation 112: 1789–1797.
    1. Sakuragi S, Abhayaratna K, Gravenmaker KJ, O'Reilly C, Srikusalanukul W, et al. (2009) Influence of adiposity and physical activity on arterial stiffness in healthy children: the lifestyle of our kids study. Hypertension 53: 611–616.
    1. Donald AE, Charakida M, Falaschetti E, Lawlor DA, Halcox JP, et al. (2010) Determinants of vascular phenotype in a large childhood population: the Avon Longitudinal Study of Parents and Children (ALSPAC). European Heart Journal 31: 1502–1510.
    1. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, et al. (2001) Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients. Hypertension 37: 1236–1241.
    1. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, et al. (2001) Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 358: 1400–1404.
    1. Folkow B (1990) ‘Structural factor’ in primary and secondary hypertension. Hypertension 16: 89–101.

Source: PubMed

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