Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children

Abstract

Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject’s medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients’ vascular health and should be considered a reliable tool in the management of obese children.

Connections between serum Trimethylamine N-Oxide (TMAO), a gut-derived metabolite, and vascular biomarkers evaluating arterial stiffness and subclinical atherosclerosis in children with obesity

“…Obesity is a promoter of an earlier progression of atherosclerosis and arterial stiffness ( 16 , 17 , 46 – 51 , 53 ). Using non-invasive biomarkers like the carotid intima-media thickness and pulse wave velocity to detect early functional and structural modifications of the arterial walls could be useful long-term in these children ( 16 , 50 , 73 ). Showing a connection to a marker like TMAO, which has received much attention in the last decades concerning its role in numerous pathologies ( 74 ), is important.…”

“…Post-pubertal girls were asked whether they had regular or irregular menses. Irregular menses were considered the menstrual cycles <21 or >35 days, or missing ≥ 3 menses in a row, in girls who had their menarche at least 2 years before ( 50 ).…”

“…This device can be used in children older than three years old, according to the manufacturer. Details of the methodology and specifics of the device have been presented in our previous work ( 50 , 73 ).…”

“…The elasticity of large arteries is described by the PWV. It essentially reconstructs the aortic pulse wave and provides an estimate of the pulse velocity through the arterial tree ( 50 , 51 ). Due to its elevated values being associated with myocardial remodeling, PWV is a trustworthy predictor of cardiovascular events ( 53 ).…”

Unveiling the Silent Danger of Childhood Obesity: Non-Invasive Biomarkers Such as Carotid Intima-Media Thickness, Arterial Stiffness Surrogate Markers, and Blood Pressure Are Useful in Detecting Early Vascular Alterations in Obese Children

“…Detecting visible signs of vascular disruptions is crucial for effective management of childhood obesity and its long-term vascular consequences. Our previous research has linked intima-media thickness [9], pulse wave velocity, and blood pressure to childhood obesity [10]. This study focuses on providing additional data on subclinical atherosclerosis and arterial stiffness in the same type of individuals.…”