Numerous studies have evaluated the effects of exercise training on obese children and adolescents. However, the impact of aerobic and/or resistance exercise alone, without any other interventions, on vascular markers and C-reactive protein (CRP) in obese children and adolescents is still not clear. We performed a literature search in Ovid Medline, PubMed, and SCOPUS databases to identify articles on the effects of exercise on vascular markers and CRP among obese children and adolescents, published between January 2009 and May 2019. Only full-text articles in English that reported on the effect of aerobic and/or resistance exercise on the vascular markers pulse wave velocity (PWV), carotid intima-media thickness (CIMT), flow-mediated dilatation (FMD), augmentation index (AIx) or CRP in obese children and adolescents (5–19 years old) were included. The literature search identified 36 relevant articles; 9 articles that fulfilled all the inclusion criteria were selected by two independent reviewers. Aerobic exercise or a combination of aerobic and resistance exercise training significantly improved CIMT and PWV in obese children and adolescents in all studies in which they were measured (2 studies for PWV and 4 studies for CIMT). However, the effects of exercise on FMD and CRP levels were inconclusive, as only half of the studies demonstrated significant improvements (1/2 studies for FMD and 4/8 studies for CRP). The results of our review support the ability of exercise to improve vascular markers such as PWV and CIMT in obese children and adolescents. This finding is important as obesity is a modifiable risk factor of CVD, and exercise may help in reducing the future occurrence of CVD in this population.
The use of photoplethysmography (PPG) as one of cardiovascular disease (CVD) marker has got more attention due to its simplicity, noninvasive and portable characteristics. Two new markers had been developed from PPG namely PPG fitness index (PPGF) and vascular risk prediction index (VPRI). The aim of the present study was to compare PPGF level between young women with and without CVD risk factors, to investigate the relationship between PPGF with other CVD markers and to assess the sensitivity of VRPI in classifying young women that have CVD risk factors. A total of 148 young women aged 20-40 years old with and without CVD risk factors were involved in this study. CVD risk factors comprised of abdominal obesity, hypertension, dyslipidemia, smoking and family history of premature CVD. Subjects were categorized into healthy or having CVD risk factor. Measurements taken were anthropometric data, blood pressure, lipid profile, pulse wave velocity (PWV), augmentation index (AIx), high sensitivity C-Reactive Protein (hs-CRP), PPGF and VRPI. SPSS version 20 was used for data analysis with p<0.05 as significant value. The mean subjects' age was 29.97±5.27 years old. There was no difference in PPGF level between groups (p>0.05). PPGF was independently determined by PWV (β=-0.31, p<0.001) and height (β=0.16, p=0.04). VRPI had 77.9% sensitivity in identifying subjects with CVD risk factor. In conclusion, PPGF correlates with PWV and has potential to be an indicator of aortic stiffness while VRPI is sensitive to classify those with CVD risk factor.
Data pertaining to carotid intima-media thickness (CIMT), carotid-femoral pulse wave velocity (PWVcf), augmentation index (AI), and C-reactive protein (CRP) are less studied among young Asian women. The objectives of this study were to determine the associations between these vascular markers with other cardiovascular (CVD) risk factors and future CVD risks; and secondly, to determine the associations between the markers themselves among young women. One hundred and forty-eight young women who were healthy, or having any CVD risk factor, were recruited. They were divided into a healthy group (HG, n=71) and a risk group (RG, n=77). The parameters measured included body anthropometry, blood pressure (BP), CIMT, PWVcf, AI, CRP, blood sugar, and lipid profiles. The future CVD risk was expressed in short and long term Framingham Risk Scores (FRS). The data was analysed via SPSS and p-value <0.05 was accepted as significant. The RG had significantly higher PWVcf, AI, and hs-CRP when compared to HG. All of the markers were associated with CVD risk factors and the long-term FRS. The independent variable for CIMT was age (R 2 =0.11), while PWVcf was determined by diastolic BP and age (R 2 =0.29). AI was independently determined by age, heart rate, and LDL (R 2 =0.28), while for CRP, it was weight and HDL (R 2 =0.30). In conclusion, among the young women with CVD risk factor, CIMT, PWVcf, AI, and hs-CRP can be used to assess their risk of future CVD. No associations were observed between the markers themselves, which suggests that every marker reflects a different entity. They should be measured independently for a complete vascular assessment. ABSTRAKMaklumat berkaitan ketebalan intima media arteri karotid (CIMT), halaju gelombang nadi arteri karotid femor (PWVcf), indeks augmentasi (AI) dan protein C-Reaktif (CRP) kurang dikaji dalam kalangan belia wanita Asia. Objektif kajian ini adalah menentukan hubungan antara penanda saluran darah tersebut dengan faktor-faktor risiko CVD yang lain serta risiko CVD pada masa depan, dan kedua adalah untuk menentukan hubungan penanda saluran darah tersebut sesama sendiri dalam kalangan wanita muda. Seramai seratus empat puluh lapan wanita muda yang sihat atau mempunyai faktor risiko CVD direkrut. Mereka dibahagikan kepada kumpulan sihat (HG, n=71) dan kumpulan berisiko (RG, n=77). Parameter yang diukur meliputi antropometri badan, tekanan darah (BP), CIMT, PWVcf, AI, CRP, glukosa darah dan profil lipid. Risiko CVD pada masa depan dibentangkan dalam bentuk Skor Risiko Framingham (FRS) jangka masa panjang dan pendek. Data dianalisis menggunakan SPSS dan nilai p<0.05 diterima sebagai signifikan. Kumpulan RG mempunyai PWVcf, AI dan Hs-CRP yang lebih tinggi apabila dibandingkan dengan HG. Kesemua penanda saluran darah ini mempunyai hubungan dengan faktor risiko CVD dan FRS jangka masa panjang. Variabel tidak bersandar bagi CIMT adalah umur (R 2 =0.11) sementara PWVcf ditentukan oleh BP diastolik dan umur (R 2 =0.29). AI ditentukan secara bebas oleh umur, kadar nadi dan LDL (R 2 =0.30) manak...
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