Endothelial Function as Measured by Peripheral Arterial Tonometry Increases during Pubertal Advancement

Abstract

Background/Aims:Sex steroids, such as estrogens, are known to influence endothelial function by their vasodilator action. The aim of this study was to study the relation of puberty and sex steroids with endothelial function using peripheral arterial tonometry (PAT). Methods: In 89 healthy school boys and girls, we determined height, weight, waist circumference, percent body fat, BMI, BMI z-score, blood pressure (BP), BP percentiles, lipid profile, insulin, and glucose levels after overnight fast. Estrone (E₁), estradiol (E₂), DHEAS and E₁-sulfate were measured using ultrasensitive assays. Participants were divided into 3 pubertal groups on the basis of their estrogen levels: group 1 (Tanner stage I), group 2 (Tanner stages II–III), and group 3 (Tanner stages IV–V). Endothelial function was measured by Endo-PAT 2000® and expressed as PAT index. A higher PAT index represents a higher reactive hyperemia response. Results: The PAT index was lowest at 1.42 ± 0.44 (mean ± SD) in group 1 and significantly increased in group 2 at 1.71 ± 0.35 (p = 0.02) and group 3 at 1.92 ± 0.38 (p < 0.001). The PAT index correlated positively with E₂, DHEAS and age. Conclusion: Enhancement of the PAT index was associated with an increment in Tanner stages. The changes in E₂ and DHEAS levels may contribute to increasing endothelial response to shear stress or arterial blood flow.

Cardiovascular effects of 3 months of football training in overweight children examined by comprehensive echocardiography: a pilot study

“…A reason for this negative finding may be that arterial function in these children was too good to be significantly improved by any intervention, as also suggested by the negative mean AI values at baseline that were considerably lower than values (determined by other techniques) reported in children with severe hypercholesterolaemia or diabetes (Palombo et al, 2011;Riggio et al, 2010). However, endothelial function and arterial elasticity appear to increase with age from childhood to young adulthood and recent data indicate that Cardiovascular effects of football in overweight children 1437 arterial stiffness is actually decreased in obese compared to non-obese children, apparently reflecting accelerated growth and maturation (Bhangoo et al, 2011;Gardner & Parker, 2010;Tryggestad et al, 2012). Furthermore, in adults an inverse relationship exists between AI and RHR, and it is possible that favourable effects on arterial stiffness of football training in our study were masked by a decrease of RHR (Wilkinson et al, 2000).…”

“…We selected participants of similar age for the two study groups since age is an important confounder for paediatric echocardiographic and PAT variables (Bu'Lock, Mott, & Martin, 1995;Bhangoo, Sinha, Rosenbaum, Shelov, & Ten, 2011;Gardner & Parker, 2010). All participants were healthy, did not receive medical treatment and had not participated in structured weight loss or exercise programmes for at least one year prior to commencement of the study.…”

Childhood obesity–related endothelial dysfunction: an update on pathophysiological mechanisms and diagnostic advancements

“…The Endo-PAT algorithm might not correctly account for physiological adaptations in childhood and puberty (62,63). Therefore, if RHI is used in children, the true peak dilation could be missed.…”

Younger age is associated with lower reactive hyperemic index but not lower flow-mediated dilation among children and adolescents

“…14 Recently, a number of pediatric studies have utilized this technique using the EndoPAT device (EndoPAT 2000, Itamar Medical, Caesarea, Israel). 15–19 …”