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Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plasma markers in obese children: the impact of cardiovascular risk factors.
Pediatrics. 2006 May; 117(5):1560-7.Ped

Abstract

OBJECTIVES

Childhood obesity contributes to the development of adult obesity and subsequent cardiovascular disease. The present study aimed to assess vascular status (flow-mediated vasodilation [FMD], intima-media thickness [IMT]) and to analyze plasma surrogate endothelial markers (von Willebrand factor [vWf], E-selectin, and thrombomodulin) in obese children as compared with controls. Associations between early morphologic and functional vascular changes, surrogate soluble markers of early atherosclerosis, and the cardiovascular risk profile were determined.

METHODS

We examined 32 obese children versus 20 control subjects. All of the children underwent identical screening, comprehensive risk factor assessment, and measurements of E-selectin, vWf, thrombomodulin, FMD, and IMT.

RESULTS

Compared with controls, obese children demonstrated significantly impaired FMD and increased IMT. Concentrations of soluble E-selectin and thrombomodulin were significantly elevated in obese children, whereas vWf showed no significant differences between obese children and controls. FMD, IMT, E-selectin, and thrombomodulin were significantly associated with various risk factors, including the extent of obesity, arterial hypertension, fibrinogen, C-reactive protein, and low physical fitness.

CONCLUSIONS

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.

Authors+Show Affiliations

Division of Pediatric Cardiology, Childrens Hospital, University of Rostock, Rostock, Germany. andreas-alexander.meyer@medizin.uni-rostock.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16651309

Citation

Meyer, Andreas Alexander, et al. "Impaired Flow-mediated Vasodilation, Carotid Artery Intima-media Thickening, and Elevated Endothelial Plasma Markers in Obese Children: the Impact of Cardiovascular Risk Factors." Pediatrics, vol. 117, no. 5, 2006, pp. 1560-7.
Meyer AA, Kundt G, Steiner M, et al. Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plasma markers in obese children: the impact of cardiovascular risk factors. Pediatrics. 2006;117(5):1560-7.
Meyer, A. A., Kundt, G., Steiner, M., Schuff-Werner, P., & Kienast, W. (2006). Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plasma markers in obese children: the impact of cardiovascular risk factors. Pediatrics, 117(5), 1560-7.
Meyer AA, et al. Impaired Flow-mediated Vasodilation, Carotid Artery Intima-media Thickening, and Elevated Endothelial Plasma Markers in Obese Children: the Impact of Cardiovascular Risk Factors. Pediatrics. 2006;117(5):1560-7. PubMed PMID: 16651309.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plasma markers in obese children: the impact of cardiovascular risk factors. AU - Meyer,Andreas Alexander, AU - Kundt,Günther, AU - Steiner,Michael, AU - Schuff-Werner,Peter, AU - Kienast,Wolfgang, PY - 2006/5/3/pubmed PY - 2006/5/24/medline PY - 2006/5/3/entrez SP - 1560 EP - 7 JF - Pediatrics JO - Pediatrics VL - 117 IS - 5 N2 - OBJECTIVES: Childhood obesity contributes to the development of adult obesity and subsequent cardiovascular disease. The present study aimed to assess vascular status (flow-mediated vasodilation [FMD], intima-media thickness [IMT]) and to analyze plasma surrogate endothelial markers (von Willebrand factor [vWf], E-selectin, and thrombomodulin) in obese children as compared with controls. Associations between early morphologic and functional vascular changes, surrogate soluble markers of early atherosclerosis, and the cardiovascular risk profile were determined. METHODS: We examined 32 obese children versus 20 control subjects. All of the children underwent identical screening, comprehensive risk factor assessment, and measurements of E-selectin, vWf, thrombomodulin, FMD, and IMT. RESULTS: Compared with controls, obese children demonstrated significantly impaired FMD and increased IMT. Concentrations of soluble E-selectin and thrombomodulin were significantly elevated in obese children, whereas vWf showed no significant differences between obese children and controls. FMD, IMT, E-selectin, and thrombomodulin were significantly associated with various risk factors, including the extent of obesity, arterial hypertension, fibrinogen, C-reactive protein, and low physical fitness. CONCLUSIONS: 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. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/16651309/Impaired_flow_mediated_vasodilation_carotid_artery_intima_media_thickening_and_elevated_endothelial_plasma_markers_in_obese_children:_the_impact_of_cardiovascular_risk_factors_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=16651309 DB - PRIME DP - Unbound Medicine ER -