Increased body fat and reduced insulin sensitivity are associated with impaired endothelial function and subendocardial viability in healthy, non‐Hispanic white adolescents

Abstract

Background Cardiovascular disease has its origins in adolescents. Endothelial dysfunction, arterial stiffness, and decreased endocardial oxygen supply: demand ratios are early functional markers of cardiovascular risk. The goal of this study was to determine the relationships of these markers to physical, inflammatory, and metabolic markers in healthy non‐Hispanic, white adolescents. Methods Thirty‐four of the 75 subjects were female. Mean age was 15.0 ± 1.7 years and mean body mass index (BMI) was 22.0 ± 5.8 kg/m2 (mean ± SD). Reactive hyperemia was measured using venous occlusion plethysmography. Arterial tonometry was used to measure the augmentation index (AIx75) and the Buckberg subendocardial viability ratio. Blood samples were taken to measure inflammatory and lipid markers and oral glucose tolerance test was used to assess insulin sensitivity. Results Reactive hyperemia decreased as body mass and fat mass increased. It also decreased with increasing neutrophil count. The Buckberg index was higher in males and was positively related to insulin sensitivity even when accounting for age, sex, and resting heart rate. AIx75 was not related to any of the other variables. Conclusions These results demonstrate that increased fat mass and decreased insulin sensitivity are related to poorer vascular function and cardiac risk in adolescents before the development of actual cardiovascular disease.

Multiple non-invasive peripheral vascular function parameters with obesity and cardiometabolic risk indicators in school-aged children

“…AIx75 value decreased) with age and adiposity, while no consistent correlation was identified in terms of lipid and glucose profiles. This was not surprising since a previous study also observed null findings of AIx with any of glucose or lipid profiles in adolescents [ 38 ]. Except for body fat mass in students with obesity, where a significantly strong correlation was found.…”

Six-Week Exercise Training With Dietary Restriction Improves Central Hemodynamics Associated With Altered Gut Microbiota in Adolescents With Obesity

“…SEVR has been investigated in individuals with obesity, and evolving evidence shows that SEVR is altered in children and adolescents with obesity, although the mechanism by which this effect is mediated has not been fully elucidated ( 16 , 37 ). Recent studies showed that SEVR was positively correlated with insulin sensitivity in both obese and lean adolescents, suggesting an important role of SEVR in early cardiovascular risk determination in children and adolescents ( 38 , 39 ). The results of the present study indicated that SEVR increased by approximately 53% in adolescents with obesity following a diet and exercise intervention program and that AIx75 was significantly decreased by approximately 22% after the intervention.…”

Role of Chemerin and Perivascular Adipose Tissue Characteristics on Cardiovascular Risk Assessment by Arterial Stiffness Markers in Patients with Morbid Obesity

“…In a recent study, Tocci et al [43,44], demonstrated that overweight adolescent patients have reduced SEVR values compared to normal-weight patients, similar to their carotid-femoral pulse wave velocity and aortic systolic blood pressure. Other recent studies conclude that SEVR values decrease with increased number of metabolic syndrome elements (p = 0.005) [44] and are correlated with both IR and IS [45,46]. So, we could hypothesize that chemerin may be a biomarker for arterial stiffness and for the risk of microvascular coronary damage.…”