Endothelial Function in Children and Adolescents Is Mainly Influenced by Age, Sex and Physical Activity　― An Analysis of Reactive Hyperemic Peripheral Artery Tonometry ―

Abstract

emic index (RHI)) of endothelial function in a 15-min test. 9 In adults, an RHI <1.35 indicates impaired endothelial function. 7 Data providing normal values for RHI in children and adolescents are limited. However, the method is used frequently for study purposes, usually to compare endothelial function in children with cardiovascular risk factors against healthy subjects. 2,3 Additionally, interventional studies investigating the effect of physical exercise (PE) on RHI in adolescents are lacking.Thus, using RH-PAT in a large cohort of healthy school children, we aimed to explore the factors influencing the RHI under particular consideration of PE at school. A

HIV-positive youth who are perinatally infected have impaired endothelial function

“…Children in these studies were younger and the majority were Caucasians. A recent larger longitudinal study performed in healthy German children had a mean baseline RHI of 1.53[18]. Interestingly, in this same cohort, there was an interaction between RHI, age and sex; with RHI increasing with age and being consistently higher in females in all age groups.…”

“…In our cohort, the control group had twice more males than the perinatally-infected group, however the differences in RHI between the groups are unlikely due to gender imbalances alone. Several larger studies in HIV-uninfected adolescents and adults have found that men have lower hyperemic responses than women as measured by endoPAT [18, 27]. If our findings were due to gender differences alone, we would expect them to have a conservative effect on our main outcome,…”

“…In multiple longitudinal studies, a lower RHI detected by endoPAT was independently associated with a higher risk of cardiac adverse events (cardiac death, myocardial infarction)[16]. In addition, endoPAT is painless and is proven to be feasible and reproducible in adolescents[17, 18]. …”

Outstanding Effect of Physical Exercise on Endothelial Function Even in Children and Adolescents

“…8 Among them, the clinical importance of PE in healthy children and adolescents is a key message, which is actually similar to the importance of PE in adults and patients with cardiovascular diseases. This novel finding suggests the clinical effect of PE which could reduce future mortality and morbidity not only in adults but also in children.…”

“…8 In fact, several types of intervention to improve endothelial function have been reported to date (Table). 10 Of them, this study focused on the relationship of endothelial function with physical exercise (PE) at school.…”