Relationship between measures of adiposity, blood pressure and arterial stiffness in adolescents. The MACISTE study

Abstract

Objective:Children and adolescents with adiposity excess are at increased risk of future cardiovascular (CV) disease. Fat accumulation promotes the development of elevated blood pressure (BP) and arterial stiffness, two main determinants of CV risk which are strongly inter-related. We aimed at investigating whether the association between overweight and arterial stiffness, taken at different arterial segments, is mediated by increased BP or is BP-independent.Methods:Three hundred and twenty-two Italian healthy adolescents (mean age 16.9±1.4 years, 12% with overweight) attending the “G. Donatelli” High School in Terni, Italy, underwent measurement of arterial stiffness by arterial tonometry (aortic stiffness) and semiautomatical detection of pressure–volume ratio of the common carotid (carotid stiffness). The mediator effect of BP was tested for each anthropometric or biochemical measure of fat excess related to arterial stiffness.Results:Both carotid and aortic stiffness showed positive correlations with body mass index, waist, hip, and neck circumferences (NC). Only carotid stiffness, but not aortic stiffness, was associated with serum markers of fat accumulation and metabolic impairment such as insulin, homeostatic model of insulin resistance (HOMA-IR), serum gamma-glutamyl transferase (sGGT) and uric acid. The association with NC was stronger for carotid than for aortic stiffness (Fisher z-to-R 2.07, P = 0.04), and independent from BP.Conclusions:In healthy adolescents, fat accumulation is associated with arterial stiffness. The degree of this association differs by arterial segments, since carotid stiffness is more strongly associated to adipose tissue excess than aortic stiffness and shows a BP-independent association with NC whereas aortic stiffness does not.

Wall Properties of Elastic and Muscular Arteries in Children and Adolescents at Increased Cardiovascular Risk

“…Some authors have also suggested that in obese adolescents, there is an inverse correlation between cf-PWV and BMI values. On the other hand, several studies show a close relationship between insulin resistance and arterial stiffness in children and adolescents [44,[47][48][49], and this suggests that excess weight and visceral fat (related to insulin resistance) may be associated with different effects on arterial viscoelasticity, although not all authors agree on this point [50]. Our study did not show an association between cf-PWV and BMI.…”

“…There is no agreement in the literature regarding the relationship between BMI and vascular stiffness in children and adolescents. Some data suggest that there is no influence of excess weight on cf-PWV [33,44], while others go in the opposite direction [45,46]. Some authors have also suggested that in obese adolescents, there is an inverse correlation between cf-PWV and BMI values.…”

Unraveling the intricacies of adiposity and arterial stiffness in adolescents: insights from the MASCITE study

“…We applaud the efforts of Pucci et al . [1] in their research titled ‘Adiposity and Arterial Stiffness in Healthy Adolescents: Exploring Blood Pressure Mediation’. Interestingly, the findings reveal a stronger association between neck circumference and carotid stiffness than aortic stiffness, independent of blood pressure (BP).…”