Youth obesity paradox from the perspective of vascular stiffness, blood pressure and metabolic status

Abstract

Aim. To assess functional parameters of the middle and inner arterial wall layers in relation to body mass index (BMI) in young people from the perspective of their vascular aging phenotype and sex.Material and methods. A total of 264 young people (93 boys) aged from 18 to 25 years (21,4±1,3) were examined. In three groups formed according to BMI, cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI), as well as the main parameters of hemodynamic and metabolic status were determined. Angiological screening aimed at assessing vascular stiffness (VS) and blood pressure (BP) in the vascular beds was performed using a VaSera VS-1500 system ("Fukuda Denshi", Japan). The subjects were divided into tertile CAVI groups based on sex to identify carriers of early, normal and favorable vascular aging phenotypes.Results. As body weight increases in young people, a tendency towards a CAVI decrease was revealed without significant changes in the ABI. In boys, CAVI-R decreased on average by 26,4% (p=0,000) and CAVI-L — by 25,9% (p=0,000). In girls, the decrease was less pronounced. But the latter showed a significant positive relationship between BMI and systolic BP, diastolic BP, low-density lipoproteins, triglycerides, atherogenicity coefficient, as well as a significant negative relationship with high-density lipoproteins. In young men, no significant relationship was found between BMI and any hemodynamic and metabolic parameters. More than half of the overweight boys and girls were carriers of favorable vascular aging phenotype, and among them, the majority noted problems with excess weight either in middle and high school or during student years. In addition, 12,0% of overweight boys and 26,3% of the same girls were characterized by early vascular aging. The vast majority of them were distinguished by excess body weight starting from early childhood.Conclusion. In young people aged 18 to 25 years (21,4±1,3), a VS decrease was revealed against the background of BMI increase. This phenomenon is more typical for carriers of recent obesity. The identified phenomenon, caused by an adaptive mechanism, may be called the youth obesity paradox and it should be taken into account when carrying out preventive measures among young people.