Context
Insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP)-1 have been linked to cardiovascular disease (CVD) risk and pathophysiology in adults, but there are limited data in youth.
Objective
The aim of the study was to examine the relationship between IGF and IGFBP-1 with traditional and non-traditional CVD risk factors including inflammatory markers and body composition in an obese pediatric cohort.
Design
A cross-sectional study.
Setting
The study was carried out at a university children’s hospital.
Subjects
Sixty-one obese non-diabetic adolescents.
Outcomes
Fasting IGF-I, IGFBP-1, lipoprotein profiles, high-sensitivity C-reactive protein (hsCRP), and total adiponectin as well as insulin sensitivity measures, blood pressure (BP), and anthropometrics.
Results
IGFBP-1 was negatively associated with insulin sensitivity measures, body mass index (BMI), and diastolic BP in males. IGF-I was negatively associated with hsCRP (r = −0.479, p < 0.0005), and IGFBP-1 was positively associated with adiponectin (r = 0.545, p < 0.0005). The IGF-I/CRP and IGFBP-1/adiponectin associations remained significant when controlling for both BMI and insulin sensitivity index (SI). Both IGF-I and IGFBP-1 were negatively associated with waist circumference (r = −0.327 and r = −0.275, respectively) and sagittal abdominal diameter (r = −0.333 and r = −0.371, respectively), while IGFBP-1 was negatively associated with fat mass (r = −0.347, p = 0.01) as well as neck circumference and fat-free mass in males. Controlling for BMI z-score and SI, IGFBP-1 remained negatively associated with diastolic blood pressure (r = 0.706, p = 0.001 and neck circumference (r = −0.548, p = 0.15) in males.
Conclusions
IGF-I and IGFBP-1 associate with CVD risk markers and may add to clinical assessments of cardiometabolic dysfunction in youth.
Introduction:
Interest in high fidelity aortic flow phantoms remains significant even with advancements in computational fluid dynamic methods. We present a process for creating a patient-specific, compliant aortic arch and valve (AoV) along with our corresponding validation efforts.
Methods:
A rendered aortic volume was created by threshold-based segmentation in Mimics (Materialise, Leuven, Belgium) and edited in 3-matic to create a 3D printed mold (Object Connex 5000, Stratasys, Edina, Minnesota) into which a polyurethane based resin (Smooth-on, Easton, Pennsylvania) was cast. The AoV was created in a similar manner and ultimately seated in the distal end of an inlet port designed to induce laminar flow. The arch, with fixed inlet, was then constrained to the correct anatomical conformation by a custom rapid prototyped chamber. An MRI-compatible pump programmed to match the patient’s flow profile managed flow of a 40% glycerin-aqueous solution. Both through-plane and 4D phase contrast velocity mapping MRI sequences were acquired and compared to the patient data with time-elapse flow streamlines calculated by GTFlow version 2.0.1 (GyroTools, Zurich Switzerland).
Results:
The phantom remained robust and compliant throughout the dynamic loading occurring under pulsatile flow. Registration revealed good alignment of the phantom lumen to the segmented patient aorta. 4D flow analysis showed an unusual left-handed helical flow pattern in both the in vivo patient data and derived phantom flows. Flow measurements in the ascending and descending aorta of the model agreed within 5% of the actual patient measured flow.
Conclusions:
We have demonstrated a viable method to create patient-specific flow phantoms, which closely mimic the physiological system for which they are modeled. Further studies are needed to optimize the valve anatomy and wall compliance.
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