Impaired Flow-Mediated Vasodilation, Carotid Artery Intima-Media Thickening, and Elevated Endothelial Plasma Markers in Obese Children: The Impact of Cardiovascular Risk Factors

Abstract

The present study documented increased IMT, impaired endothelial function, and elevated plasma markers of endothelial activation and injury in obese children. Morbid obesity, arterial hypertension, subclinical inflammation, and low physical fitness formed a risk profile associated with the risk of early atherosclerosis in these children. Sonographic assessment of vascular status and the estimation of soluble endothelial plasma markers, combined with comprehensive risk factor screening, may form a rationale to identify high-risk children susceptible to early atherosclerotic disease and to monitor vascular changes during follow-up studies and therapeutic measures.

Endothelial and Metabolic Function Interactions in Overweight/Obese Children:

“…D-dimers, fibrinogen, and vWFAg levels did not reach a significant correlation with vascular parameters. These results were in contrast with some previous literature studies, 11,[49][50][51][52] which reported the influence of such parameters on endothelial function and on vascular wall morphological structure. In fact, OrenesPiñero et al 53) pointed out the correlation between BMI and coagulation parameters, observing an increased prothrombotic status in adult subjects suffering from increased body weight.…”

Associations of low-grade inflammation with physical activity, fitness and fatness in prepubertal children; the European Youth Heart Study

“…In youths, plasma lipid profile is negatively associated with CVF in both overweight and non-overweight adolescents, 44 as well as total body fat, 10,11 abdominal adiposity, 8 features of the metabolic syndrome, 9,45 arterial compliance 46 and morphologic parameters reflecting early stage vascular changes, such as flow-mediated vasodilation and intima-media thickness. 47 However, others have failed to find associations between features of metabolic syndrome and CVF in overweight Latino youths aged 8-14 years with a positive family history of type 2 diabetes. 48 To our knowledge, there is no data examining the association of fibrinogen, C3 and C4 with CVF and fatness in prepubertal children.…”

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

“…Carotid intima media thickness and distensibility, associated with age, anthropometry and BP are elevated in at-risk children with familial hypercholesterolaemia (115,116), overweight (117,118), HTN (119,120), and type 1 diabetes (121).…”