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Georeli E, Stamati A, Dimitriadou M, Chainoglou A, Tsinopoulou AG, Stabouli S, Christoforidis A. Assessment of arterial stiffness in paediatric patients with type 1 diabetes mellitus. J Diabetes Complications 2024; 38:108782. [PMID: 38917602 DOI: 10.1016/j.jdiacomp.2024.108782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/12/2024] [Accepted: 05/30/2024] [Indexed: 06/27/2024]
Abstract
AIMS To investigate early indicators of cardiovascular disease (CVD) in children and adolescents with type 1 diabetes mellitus (T1DM), focusing on pulse wave velocity (PWV) and its associations with various anthropometric and glycemic parameters. PATIENTS AND METHODS A total of 124 children and adolescents with T1D (mean age 10.75 ± 3.57 years) were included in this cross-sectional study. Anthropometric data, including height, weight, body mass index (BMI), glycemic parameters, such as HbA1c and time in range (TIR) were assessed. PWV was assessed by oscillometric method using the Mobil-O-Graph PWA device. Univariate and multivariate linear regression were used to explore the association of PWV z-score with anthropometric, demographic, and glycaemic variables. RESULTS Significant negative association between PWV and age and height (β = -0.336, 95 % CI -0.44 to -0.25, p < 0.001 and β = -0.491, 95 % CI -0.62 to -0.36, p < 0.001, respectively), while gender showed a significant positive association with PWV, with females displaying higher PWV values compared to males (β = 0.366, 95 % CI 0.17 to 0.56, p < 0.001). TIR was positively associated with PWV (β = 0.092, 95 % CI 0.01 to 0.16, p = 0.017 only for patients having TIR ≤ 50 %. Finally, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were positively associated with PWV (β = 0.086, 95 % CI 0.02 to 0.14, p = 0.007 and β = 0.152, 95 % CI 0.07 to 0.23, p < 0.001, respectively). CONCLUSION Youth with T1DM who spend <50 % of time in range exhibit uniquely increased signs of arterial stiffness, indicating that poor glycemic control may contribute to early vascular damage. Differences related to age, gender and height should be considered.
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Affiliation(s)
| | - Athina Stamati
- School of Medicine, Faculty of Health Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Meropi Dimitriadou
- 1st Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, Thessaloniki, Greece
| | - Athanasia Chainoglou
- 1st Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, Thessaloniki, Greece
| | - Assimina Galli Tsinopoulou
- 2nd Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece
| | - Stella Stabouli
- 1st Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, Thessaloniki, Greece
| | - Athanasios Christoforidis
- 1st Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, Thessaloniki, Greece.
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Kavgacı A, İncedere F, Tunaoğlu S, Karabörk M, Büyükkaragöz B, Leventoğlu E, Oğuz D, Kula S, Terlemez S. Comparison of echocardiographic aortic stiffness index measurements and pulse wave velocity measurements in obese and overweight children. Cardiol Young 2024; 34:11-17. [PMID: 37340799 DOI: 10.1017/s104795112300166x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Aortic/arterial stiffness is a reliable, independent predictor and a risk factor for cardiovascular mortality. Arterial stiffness is assessed by pulse wave velocity and echocardiography. The purpose of this study is to analyse aortic/arterial stiffness in patients using echocardiographic and pulse wave velocity techniques. MATERIALS AND METHODS The participants of this study consisted of 62 patients who presented to the Gazi University Pediatric Endocrinology and Pediatric Cardiology outpatient clinics, including 21 obese, 20 overweight, and 21 normal-weight patients. Echocardiography was performed on all patients, and echocardiographic measurements were compared to pulse wave velocity measurements. RESULTS The mean (min-max) arterial strain measurements were 0.146 ± 0.0 (0.06-0.3) in the obese group and 0.106 ± 0.0 (0.05-0.18) in the overweight group. In comparison to the overweight group, the obese group had greater arterial strain measurements. The pulse wave velocity measurements in the obese and overweight groups were greater than those in the normal weight group (p > 0.05). Elastic modulus and aortic stiffness ß index values were shown to be positively correlated with pulse wave velocity measurements in the obese group (r = 0.56, r = 0.53, respectively; p = 0.008, p = 0.01, respectively). Systolic and diastolic blood pressure measurements were correlated with pulse wave velocity measurements in the obese group (r = 0.98, p = 0.0001, respectively). CONCLUSION In our study, echocardiographic aortic measurements showing the vessel wall were correlated with pulse wave velocity measurements. Echocardiographic evaluation should be included in the routine follow-up of patients because pulse wave velocity measurement devices are not available in all centres, echocardiography is available in many centres, it is easily applicable, and it facilitates the follow-up of patients.
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Affiliation(s)
- Akif Kavgacı
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Fatma İncedere
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sedef Tunaoğlu
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | - Bahar Büyükkaragöz
- Pediatric Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Emre Leventoğlu
- Pediatric Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Deniz Oğuz
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Serdar Kula
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Semiha Terlemez
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
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Leventoğlu E, Büyükkaragöz B, Sunar Yayla EN, Esmeray Şenol P, Bakkaloğlu SA. Arterial Stiffness and Ambulatory Blood Pressure Measurements in Children With Familial Mediterranean Fever. Clin Pediatr (Phila) 2023:99228231211705. [PMID: 37937548 DOI: 10.1177/00099228231211705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Familial Mediterranean fever (FMF) is an autoinflammatory disease which may cause endothelial dysfunction and arterial stiffness. In this study, we evaluated patients with FMF in terms of arterial stiffness indicators and investigated whether there was any difference according to colchicine response. This is a single-center, prospective, case-control study conducted on pediatric patients with FMF. Patients were categorized into 2 groups: patients on colchicine monotherapy (group 1) and patients who used anti-interleukin-1 (IL-1) plus colchicine (group 2). Patient age, mutations in the MEFV gene, overall duration of treatments, and general characteristics of symptoms were recorded. Laboratory values in an attack-free period were noted. Pulse wave velocity (PWV) was measured in all patients. Erythrocyte sedimentation rate and C-reactive protein, nocturnal hypertension, and PWV were higher in group 2. Arterial stiffness develops due to subclinical inflammation in patients with FMF. It is more pronounced in colchicine-resistant patients.
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Affiliation(s)
- Emre Leventoğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bahar Büyükkaragöz
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | | | | | - Sevcan A Bakkaloğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
- Department of Pediatric Rheumatology, Gazi University, Ankara, Turkey
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4
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Kasap Demir B, Soyaltın E, Alparslan C, Demircan T, Arslansoyu Çamlar S, Alaygut D, Mutlubaş F, Öncel EP, Yavaşcan Ö, Dündar BN, Karadeniz C. Blood pressure parameters affecting ventricular repolarization in obese children. Pediatr Nephrol 2023; 38:3359-3367. [PMID: 37140711 DOI: 10.1007/s00467-023-05971-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Ventricular repolarization (VR) increases the risk of sudden cardiac death due to ventricular arrhythmia. We aimed to evaluate the blood pressure (BP) parameters affecting VR in obese children. METHODS Obese (BMI ≥ 95p) and healthy children ≥ 120 cm between January 2017 and June 2019 were included. Demographic and laboratory data, peripheral and central BPs evaluated by a device capable of ambulatory blood pressure monitoring (ABPM), and pulse wave analysis were assessed. Electrocardiographic ventricular repolarization indices, left ventricular mass index (LVMI), and relative wall thickness (RWT) were calculated. RESULTS A total of 52 obese and 41 control patients were included. Uric acid, triglyceride, total cholesterol, LDL, and ALT values, systolic and diastolic office BPs, 24-h, daytime and nighttime systolic and mean arterial BPs, daytime diastolic BP SDS levels, daytime and nighttime systolic loads, daytime diastolic load, 24-h, daytime and nighttime central systolic and diastolic BPs, and pulse wave velocity values were significantly higher, whereas 24-h, daytime and nighttime AIx@75 were similar between the groups. fT4 levels of obese cases were significantly lower. QTcd and Tp-ed were higher in obese patients. Although RWT was higher in obese cases, LVMI values and cardiac geometry classifications were similar. The independent factors affecting VR in obese cases were younger age and higher diastolic load at night (B = - 2.83, p = 0.010; B = 0.257, p = 0.007, respectively). CONCLUSION Obese patients have higher peripheral and central BP, arterial stiffness, and higher VR indices that develop before an increase in LVMI. It would be useful to prevent obesity from an early age and follow up nighttime diastolic load to control VR associated sudden cardiac death in obese children. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Belde Kasap Demir
- Department of Pediatrics, Division of Nephrology, Izmir Katip Çelebi University, Izmir, Turkey.
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Eren Soyaltın
- Department of Pediatrics, Division of Nephrology, Izmir Katip Çelebi University, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Caner Alparslan
- Department of Pediatrics, Division of Nephrology, Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
| | - Tülay Demircan
- Department of Pediatrics, Division of Cardiology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Seçil Arslansoyu Çamlar
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Medical Faculty, Izmir, Turkey
| | - Demet Alaygut
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Medical Faculty, Izmir, Turkey
| | - Fatma Mutlubaş
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology, University of Health Sciences Izmir Medical Faculty, Izmir, Turkey
| | - Elif Perihan Öncel
- Department of Pediatrics, Division of Neurology, Başkent University, Ankara, Turkey
| | - Önder Yavaşcan
- Department of Pediatrics, Division of Nephrology, Istanbul Medipol University, Istanbul, Turkey
| | - Bumin Nuri Dündar
- Department of Pediatrics, Division of Endocrinology, İzmir Katip Çelebi University, İzmir, Turkey
- Department of Pediatrics, Division of Endocrinology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Cem Karadeniz
- Department of Pediatrics, Division of Cardiology, University of Health Sciences Izmir Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatrics, Division of Cardiology, Izmir Katip Çelebi University, İzmir, Turkey
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Kraav J, Zagura M, Remmel L, Mäestu E, Jürimäe J, Tillmann V. Rapid trabecular bone growth in puberty associated with stiffer arteries in adulthood - longitudinal study on healthy young males. Arch Osteoporos 2023; 18:62. [PMID: 37133622 DOI: 10.1007/s11657-023-01257-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/22/2023] [Indexed: 05/04/2023]
Abstract
Longitudinal bone content data from puberty to adulthood was assessed in 102 healthy males and associations with arterial health in adulthood was analysed. Bone growth in puberty was related to arterial stiffening and final bone mineral content to decreased arterial stiffness. Relationships with arterial stiffness were dependent on the studied bone regions. INTRODUCTION Our aim was to assess the relationships between arterial parameters in adulthood and bone parameters in several locations longitudinally from puberty to 18-years and cross-sectionally at 18-years. METHODS 102 healthy male data from a 7-year follow-up study was used to analyse total body (TB), femoral neck (FN) and lumbar spine (LS) mineral content and density by DXA, carotid intima-media thickness (cIMT) by ultrasound, carotid-femoral pulse wave velocity (cfPWV) and heart rate adjusted augmentation index (AIxHR75) by applanation tonometry. RESULTS Linear regression analysis revealed negative associations between LS bone mineral density (BMD) and cfPWV [ß=-1.861, CI -3.589, -0.132, p=0.035] which remained significant [ß=-2.679, CI -4.837, -0.522, p=0.016] after adjustment to smoking, lean mass, weight category, pubertal stage, physical fitness, and activity. For AIxHR75 similar results were present [ß=-0.286, CI -0.553, -0.020, p=0.035], but were dependent on confounders. Analysis on pubertal bone growth speed showed independent positive associations to AIxHR75 between Δ FN bone mineral apparent density (BMAD) [ß=672.50, CI 348.07, 996.93, p<0.001] and Δ LS BMAD [ß=700.40, CI 57.384, 1343.423, p=0.033]. Further analysis combining pubertal bone growth and adulthood BMC revealed that the relationships of AIxHR75 with LS BMC and ΔFN BMAD were independent of each other. CONCLUSION Trabecular bone regions like lumbar spine and femoral neck, showed stronger relationships with arterial stiffness. Rapid bone growth in puberty is related to arterial stiffening, while final bone mineral content relates to decreased arterial stiffness. These results could indicate that bone metabolism is independently associated with arterial stiffness rather than bone and arteries just having common traits of growth and maturation.
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Affiliation(s)
- Juta Kraav
- Institute of Clinical Medicine, University of Tartu, 50406, Tartu, Estonia.
| | - Maksim Zagura
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Liina Remmel
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Evelin Mäestu
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Vallo Tillmann
- Children's Clinic, Tartu University Hospital, 50406, Tartu, Estonia
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Lan YS, Khong TK, Yusof A. Effect of Exercise on Arterial Stiffness in Healthy Young, Middle-Aged and Older Women: A Systematic Review. Nutrients 2023; 15:nu15020308. [PMID: 36678179 PMCID: PMC9867069 DOI: 10.3390/nu15020308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/25/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Arterial stiffness, an age-dependent phenomenon, is improved with exercise, which in turn may prevent cardiovascular diseases in women. However, there is a lack of consolidated information on the impact of exercise on arterial stiffness among healthy women. The aim of this review was to (i) analyse the effect of exercise on arterial stiffness in healthy young, middle-aged, and older women, and (ii) recommend types, intensity, and frequency for each age group. Database searches on PubMed, ScienceDirect, Web of Science, and Scopus were conducted using PRISMA guidelines until September 2022. The keywords were: exercise, women/female, and arterial stiffness. The inclusion criteria were: healthy women, supervised exercise, and arterial stiffness measures. Study quality and bias were assessed using the PEDro scale. Fifty-one papers were classified into young (n = 15), middle-aged (n = 14), and older (n = 22) women. Improvements in arterial stiffness were observed among: young women (Pulse Wave Velocity, PWV: 4.9-6.6 m/s), following an 8-week high-intensity aerobic (3 days/week) or hypoxic high-intensity interval training; middle-aged women (PWV: 5.1-7.9 m/s), aerobic exercise with moderate intensity or stretching exercise at "moderate to heavy" (Borg Scale), 20-30 s per site, 10 s of rest interval for 30 min; and for older women (PWV: 7.9-15.6 m/s), resistance training at light intensity, aerobic exercise at any intensity, or a combination of the two exercises. This review shows that arterial stiffness increases with age in healthy women and has an inverse relationship with exercise intensity. Therefore, when prescribing exercise to improve arterial stiffness, age and arterial stiffness measures should be accounted for.
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Affiliation(s)
- Yong Sheng Lan
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- School of Physical Education, Changchun Normal University, Changchun 130032, China
| | - Teng Keen Khong
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Ashril Yusof
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence:
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Evaluation of Arterial Stiffness and Carotid Intima-Media Thickness in Children with Primary and Renal Hypertension. Pediatr Cardiol 2023; 44:54-66. [PMID: 36169696 DOI: 10.1007/s00246-022-03012-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023]
Abstract
Hypertension is an increasing disease in children and the risk of endothelial damage and target organ damage increases in the presence of additional risk factors such as obesity. In our study, the effect of hypertension on early atherosclerotic changes and target organ damage in children was investigated. Twenty four-hour ambulatory pulse wave analysis was performed by oscillometric method in 71 children aged 8-18 years, 17 of whom were diagnosed with primary hypertension without obesity, 18 had both primary hypertension and obesity, and 16 had renal hypertension. Twenty healthy normotensive children were included as the control group. Carotid intima-media thickness (CIMT) and Left Ventricular Mass Index were measured. Central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in the primary hypertension group compared to controls (p = 0.001, p = 0.005, p = 0.001, p = 0.009, respectively), cSBP was higher in the renal hypertension group than the control group (p = 0.018). There was no difference between the groups in terms of pulse wave analysis parameters, CIMT, or left ventricular mass index (p > 0.05). Pulse wave velocity was positively correlated with SBP, DBP, cSBP, cDBP (p < 0.001). Augmentation index was positively correlated with DBP and cDBP (p = 0.01, p = 0.002, respectively). Our findings show that high blood pressure is associated with arterial stiffness and target organ damage beginning in childhood. The detection of early atherosclerotic vascular changes using pulse wave analysis allows to take necessary precautions such as lifestyle changes to prevent target organ damage in hypertensive children.
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Schipper HS, de Ferranti S. Cardiovascular Risk Assessment and Management for Pediatricians. Pediatrics 2022; 150:189891. [PMID: 36321395 DOI: 10.1542/peds.2022-057957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 12/05/2022] Open
Abstract
Childhood and adolescence provide a unique window of opportunity to prevent atherosclerotic cardiovascular disease later in life, especially for pediatric groups at risk. The growing list of pediatric groups at risk includes individuals with chronic inflammatory disorders, organ transplants, familial hypercholesterolemia, endocrine disorders, childhood cancer, chronic kidney diseases, congenital heart diseases, and premature birth, as well as increasing numbers of children and adolescents with traditional risk factors such as obesity, hypertension, hyperlipidemia, and hyperglycemia. Here, we focus on recent advances in cardiovascular risk assessment and management and their implications for pediatric practice. First, hyperlipidemia and hyperglycemia are highly prevalent in the young, with hyperlipidemia occurring in 14.6% and hyperglycemia in 16.4% of children and adolescents with a normal weight. Implementation of nonfasting lipid and glycated hemoglobin screening in youth at risk is emerging as a promising avenue to improve testing compliance and lipid and glucose management. Second, blood pressure, lipid, and glucose management in youth at risk are reviewed in depth. Third, multisite and multimodal assessment of early atherosclerosis is discussed as a way to capture the complexity of atherosclerosis as a systemic disease. In addition to conventional carotid intima-media thickness measurements, the measurement of aortic pulse wave velocity and peripheral arterial tonometry can advance the assessment of early atherosclerosis in pediatrics. Finally, we make a plea for lifetime atherosclerotic cardiovascular disease risk stratification that integrates disease-associated risk factors and traditional risk factors and could facilitate tailored cardiovascular risk management in growing numbers of children and adolescents at risk.
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Affiliation(s)
- Henk S Schipper
- Department of Pediatric Cardiology, Wilhelmina Children's Hospital and University Medical Center Utrecht, The Netherlands.,Center for Translational Immunology, University Medical Center Utrecht, The Netherlands
| | - Sarah de Ferranti
- Department of Cardiology, Boston Children's Hospital, and Harvard University Medical School, Boston, Massachusetts
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9
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Christoforidis A, Georeli I, Dimitriadou M, Galli-Tsinopoulou A, Stabouli S. Arterial stiffness indices in children and adolescents with type 1 diabetes mellitus: A meta-analysis. Diabetes Metab Res Rev 2022; 38:e3555. [PMID: 35675380 DOI: 10.1002/dmrr.3555] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/16/2022] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
AIMS Cardiovascular disease (CVD) represents the most frequent cause of morbidity and mortality among patients with type 1 diabetes mellitus (T1DM). Our aim was to review the evidence and conduct a meta-analysis assessing measures of arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx) in children and adolescents with T1DM compared to healthy controls. METHODS PubMed and the Cochrane Library were searched for relevant studies published up to 10 May 2021. RESULTS Twenty-one studies were finally included in the meta-analysis. The T1DM group had significantly higher carotid to femoral PWV levels than that of the control group (mean difference [d]: 0.53 CI: 0.35-0.71, P < 0.00001) but with a fair heterogeneity (I 2:73%). By omitting one study with marked heterogeneity, mean difference in cfPWV remained significantly increased in the T1DM group compared to the control group (mean difference [d]: 0.37 CI: 0.27-0.48, P < 0.00001) but with improved heterogeneity (I2 = 26%). Regarding Aix, the T1DM group had a significantly higher AI@75 index than that of the control group (mean difference [d]: 0.28 CI: 0.17-0.39, P < 0.00001) and with no heterogeneity (I 2 = 8%). CONCLUSIONS Youths with T1DM show increased arterial stiffness, either as increased carotid-femoral pulse wave velocity or increased augmentation index, early in their course of life compared to healthy controls. PROSPERO REGISTRATION NUMBER CRD42021253236.
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Affiliation(s)
| | - Irene Georeli
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
| | - Meropi Dimitriadou
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
| | | | - Stella Stabouli
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
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10
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Mellin J, Le Prevost M, Kenny J, Sturgeon K, Thompson LC, Foster C, Kessler HH, Goswami N, Klein N, Judd A, Castro H. Arterial Stiffness in a Cohort of Young People Living With Perinatal HIV and HIV Negative Young People in England. Front Cardiovasc Med 2022; 9:821568. [PMID: 35299977 PMCID: PMC8921599 DOI: 10.3389/fcvm.2022.821568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/07/2022] [Indexed: 12/19/2022] Open
Abstract
Background Antiretroviral therapy (ART) has increased life expectancy and consequently the risk of cardiovascular disease (CVD) in adults living with HIV. We investigated the levels and predictors of arterial stiffness in young people (YP) living with perinatal HIV (PHIV) and HIV negative YP in the Adolescents and Adults Living with Perinatal HIV (AALPHI) study. Methods AALPHI was a prospective study evaluating the impact of HIV infection and exposure to ART on YP living with PHIV (aged 13–21 years) who had known their HIV status for at least 6 months, and HIV negative YP (aged 13–23 years) who either had a sibling, friend or parent living with HIV. Participants were enrolled from HIV clinics and community services in England. Two hundred and thirteen PHIV and 65 HIV negative YP (42% siblings of PHIV) had pulse wave velocity (PWV) measurements taken (Vicorder software) from the supra-sternal notch to the middle of the thigh cuff, at their second interview in the study between 2015 and 2017. Average PWV was calculated from the three closest readings (≥3 and ≤ 12 m/s) within 0.6 m/s of each other. Linear regression examined predictors of higher (worse) PWV, including age, sex, HIV status and height as a priori, ethnicity, born outside UK/Ireland, alcohol/nicotine/drug use, weight, waist-to-hip-ratio, mean arterial pressure (MAP), caffeine 2 h before PWV and nicotine on day of PWV. A separate PHIV model included CD4, viral load, years taking ART and ART regimen. Findings One hundred and twenty eight (60%) PHIV and 45 (69%) HIV negative YP were female (p = 0.18), with median (IQR) age 18 (16, 20) and 18 (16, 21) years (p = 0.48) respectively. Most PHIV were taking a combination of three ART drugs from two classes. There was a trend toward higher (worse) mean PWV in the PHIV group than the HIV negative group [unvariable analysis 6.15 (SD 0.83) m/s vs. 5.93 (0.70) m/s, respectively, unadjusted p = 0.058], which was statistically significant in the multivariable analysis [adjusted p (ap) = 0.020]. In multivariable analysis being male (ap = 0.002), older age (ap < 0.001), higher MAP (ap < 0.001) and nicotine use on day of measurement (ap = 0.001) were also predictors of higher PWV. The predictors were the same in the PHIV model. Interpretation By late adolescence PHIV had worse PWV in comparison to HIV negative peers, and traditional risk factors for CVD (higher arterial pressure, being male and older age) were associated with higher PWV values. Regular detailed monitoring of cardiovascular risk factors should become standard of care for every young person with PHIV worldwide.
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Affiliation(s)
- J Mellin
- Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - M Le Prevost
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - J Kenny
- Guy's and St. Thomas' National Heath Service Foundation Trust, Evelina London Children's Hospital, St. Thomas' Hospital, London, United Kingdom
| | - K Sturgeon
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - L C Thompson
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - C Foster
- Imperial College Healthcare National Heath Service Trust, St. Mary's Hospital, London, United Kingdom
| | - H H Kessler
- Diagnostic and Research Institute of Hygiene, Microbiology, and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Nandu Goswami
- Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria.,Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - N Klein
- Department of Infection, Immunity and Inflammation, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - A Judd
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - H Castro
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
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11
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Charlton PH, Paliakaitė B, Pilt K, Bachler M, Zanelli S, Kulin D, Allen J, Hallab M, Bianchini E, Mayer CC, Terentes-Printzios D, Dittrich V, Hametner B, Veerasingam D, Žikić D, Marozas V. Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: A review from VascAgeNet. Am J Physiol Heart Circ Physiol 2021; 322:H493-H522. [PMID: 34951543 PMCID: PMC8917928 DOI: 10.1152/ajpheart.00392.2021] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
The photoplethysmogram (PPG) signal is widely measured by clinical and consumer devices, and it is emerging as a potential tool for assessing vascular age. The shape and timing of the PPG pulse wave are both influenced by normal vascular aging, changes in arterial stiffness and blood pressure, and atherosclerosis. This review summarizes research into assessing vascular age from the PPG. Three categories of approaches are described: 1) those which use a single PPG signal (based on pulse wave analysis), 2) those which use multiple PPG signals (such as pulse transit time measurement), and 3) those which use PPG and other signals (such as pulse arrival time measurement). Evidence is then presented on the performance, repeatability and reproducibility, and clinical utility of PPG-derived parameters of vascular age. Finally, the review outlines key directions for future research to realize the full potential of photoplethysmography for assessing vascular age.
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Affiliation(s)
- Peter H Charlton
- Department of Public Health and Primary Care, University of Cambridge, United Kingdom.,Research Centre for Biomedical Engineering, City, University of London, London, United Kingdom
| | - Birutė Paliakaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Kristjan Pilt
- Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Martin Bachler
- Biomedical Systems, Center for Health and Bioresources, AIT Austrian Institute of Technology, Vienna, Austria
| | - Serena Zanelli
- Laboratoire Analyse, Géométrie et Applications (LAGA), University Sorbonne Paris Nord, Paris, France.,Axelife, 44460 Saint Nicolas de Redon, France
| | - Daniel Kulin
- Institute of Translational Medicine, Semmelweis University, Budapest, Hungary.,E-Med4All Europe Ltd., Budapest, Hungary
| | - John Allen
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom.,Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Magid Hallab
- Axelife, 44460 Saint Nicolas de Redon, France.,Centre de recherche et d'Innovation, Clinique Bizet, Paris, France
| | | | - Christopher C Mayer
- Biomedical Systems, Center for Health and Bioresources, AIT Austrian Institute of Technology, Vienna, Austria
| | - Dimitrios Terentes-Printzios
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Bernhard Hametner
- Biomedical Systems, Center for Health and Bioresources, AIT Austrian Institute of Technology, Vienna, Austria
| | - Dave Veerasingam
- Department of Cardiothoracic Surgery, Galway University Hospitals, Ireland
| | - Dejan Žikić
- Institute of Biophysics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vaidotas Marozas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
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12
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Beltran-Valls MR, Santos R, Mota J, Moreira C, Lopes L, Agostinis-Sobrinho C. The mediating role of adiposity in the longitudinal association between cardiorespiratory fitness and blood pressure in adolescents: LabMed cohort study. Eur J Clin Invest 2021; 51:e13430. [PMID: 33047322 DOI: 10.1111/eci.13430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this prospective cohort study was to examine whether the association between the cardiorespiratory fitness (CRF) at baseline and blood pressure (BP) at follow-up is mediated by adiposity in adolescents. MATERIALS AND METHODS The sample comprised 734 adolescents (349 girls) aged 12-18 years from the LabMed Physical Activity Cohort Study. The variables of interest were measured in 2011 (baseline) and in 2013 (2-year follow-up). CRF was assessed by the 20-m shuttle run test. Body mass index, waist circumference, body fat percentage, pubertal status and resting BP were assessed according to standard procedures. Boot-strapped mediation procedures were performed, and indirect effects (IE) with confidence intervals (CI) not including zero were considered statistically significant. RESULTS After adjusting for potential confounders, body mass index acted as a mediator of the relationship between CRF and systolic BP (IE = -0. 023; CI = -0.039; -0.009), pulse pressure (IE = -0.023; CI = -0.034; -0.012) and rate product pressure (IE = -2.839; CI = -5.329; -0.340). Similar results were obtained for waist circumference as mediator for systolic BP (IE = -0.019; CI = -0.033; -0.005), pulse pressure (IE = -0.017; CI = -0.028; -0.007) and rate product pressure (IE = -3.793; CI = -6.097; -1.689). Likewise, body fat percentage mediated the association for: systolic BP (IE = -0.029; CI = -0.048; -0.010), pulse pressure (IE = -0.027; CI = -0.041; -0.013) and rate product pressure (IE = -4.280; CI = -7.488; -1.264). CONCLUSIONS Adiposity mediated the association between CRF and BP in adolescents. Therefore, both optimal CRF and adiposity levels are important to maintain normal BP ranges throughout adolescence.
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Affiliation(s)
- Maria Reyes Beltran-Valls
- LIFE Research Group, University Jaume I, Castellon, Spain.,Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.,National Physical Activity Promotion Program, Directorate-General of Health, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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13
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Kasap-Demir B, Soyaltın E, Arslansoyu-Çamlar S, Alparslan C, Alaygut D, Yavaşcan Ö, Demircan T, Mutlubaş F, Karadeniz C. Cardiovascular risk assessment in children and adolescents with congenital solitary kidneys. J Clin Hypertens (Greenwich) 2021; 23:245-252. [PMID: 33387392 PMCID: PMC8030084 DOI: 10.1111/jch.14159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 11/30/2022]
Abstract
Patients with solitary kidneys (SKs) are at risk of hypertension (HT) and associated end-organ damage. The authors aimed to evaluate whether children with congenital SKs (CSKs) have higher office, ambulatory, or central blood pressure (BP), increased arterial stiffness or left ventricular mass index, or any risk for arrhythmia. With this purpose, patients with CSK and healthy controls being followed up between January 2018 and June 2019 were enrolled in the study. Demographic, biochemical, and office blood pressure (BP) data were recorded. Then, ambulatory blood pressure monitoring (ABPM) and measurements of central BP (cBP), pulse wave velocity (PWV), and augmentation index (AIx@75) were obtained. Ventricular repolarization parameters were acquired by 12-lead electrocardiography. Left ventricular mass index (LVMI) and abdominal aortic stiffness parameters including strain, pressure strain elastic modulus (Ep), and normalized Ep (Ep*) were calculated with echocardiographic measurements. Finally, 36 children with CSK and 36 healthy controls were included. Serum creatinine, uric acid, total cholesterol levels, ABPM parameters, cBP levels, and PWV values were significantly higher, and eGFR levels were significantly lower in the CSK group. VR parameters, abdominal aortic stiffness indices, and LVMI were similar between the groups. CSK increased the risk of HT in ABPM (HTABPM ) by 6 times. PWV was significantly correlated with Ep and Ep* in cases with CSK. Determination of cBP and PWV along with 24-hour ABPM would be a useful tool in children with CSK.
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Affiliation(s)
- Belde Kasap-Demir
- Department of Pediatric Nephrology, İzmir Katip Çelebi University, İzmir, Türkiye.,Department of Pediatric Nephrology, University Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Eren Soyaltın
- Department of Pediatric Nephrology, University Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Seçil Arslansoyu-Çamlar
- Department of Pediatric Nephrology, University Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Caner Alparslan
- Department of Pediatric Nephrology, University Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Demet Alaygut
- Department of Pediatric Nephrology, University Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Önder Yavaşcan
- Department of Pediatric Nephrology, University Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Tülay Demircan
- Department of Pediatric Cardiology, University of Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Fatma Mutlubaş
- Department of Pediatric Nephrology, University Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Cem Karadeniz
- Department of Pediatric Cardiology, University of Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Türkiye.,Department of Pediatric Cardiology, İzmir Katip Çelebi University, İzmir, Türkiye
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14
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Torigoe T, Dallaire F, Slorach C, Cardinal MP, Hui W, Bradley TJ, Sarkola T, Mertens L, Jaeggi E. New Comprehensive Reference Values for Arterial Vascular Parameters in Children. J Am Soc Echocardiogr 2020; 33:1014-1022.e4. [DOI: 10.1016/j.echo.2020.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/28/2020] [Accepted: 03/01/2020] [Indexed: 11/15/2022]
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15
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Kollios K, Nika T, Kotsis V, Chrysaidou K, Antza C, Stabouli S. Arterial stiffness in children and adolescents with masked and sustained hypertension. J Hum Hypertens 2020; 35:85-93. [PMID: 32099080 DOI: 10.1038/s41371-020-0318-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 11/09/2022]
Abstract
This study recruited 85 healthy children and adolescents, aged 6-18 years, from a school-based blood pressure (BP) screening study and performed office BP measurements, 24-h ambulatory blood pressure monitoring (24-h ABPM) and 24-h pulse wave analysis. Prevalence of BP phenotypes was assessed, factors that may predict hypertension (HTN) in ABPM were examined and the effect of BP phenotypes, as well as school, office, and ambulatory BP parameters on pulse wave velocity (PWV), was investigated. Forty-five (54.9%) of the children were normotensives, 8 (9.7%) were white coat hypertensives (WCH), 19 (23.2%) had masked hypertension (MH), and 10 (12.2%) had sustained HTN. Estimated adjusted marginal means for 24-h PWV were 4.79 m/s (95% CI 4.65-4.94) for sustained hypertensives, 4.72 m/s (95% CI 4.62-4.82) for MH, 4.38 m/s (95% CI 4.23-4.54) for WCH, and 4.33 m/s (95% CI 4.26-4.40) for normotensives (sustained hypertensives versus normotensives and WCH, p < 0.001, MH versus normotensives and WCH, p < 0.005). Neither body mass index (BMI) z-score nor school systolic BP (SBP) z-score could predict HTN by ABPM. Office SBP z-score was associated with 1.74 times increased odds ratio to have HTN in ABPM. Sustained HTN and MH were independent predictors of 24-h PWV after adjustment for age, sex, and BMI z-score. In conclusion, arterial stiffness in children and adolescents was assessed by 24-h PWV associates with mean ambulatory BP. Both school and office BP measurements could not predict HTN in ABPM or increasing PWV. HTN in ABPM was independently associated with the risk of higher PWV compared with normotensive and WCH phenotype.
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Affiliation(s)
- Konstantinos Kollios
- 3rd Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece
| | - Thomaitsa Nika
- 3rd Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece.
| | - Vasilios Kotsis
- 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Hypertension-24h ABPM Center, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Katerina Chrysaidou
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece
| | - Christina Antza
- 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Hypertension-24h ABPM Center, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Stella Stabouli
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece
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16
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Wong R, Al‐Omary M, Baker D, Spratt N, Boyle A, Baker N, Howe P, Collins N. Cognitive dysfunction is associated with abnormal responses in cerebral blood flow in patients with single ventricular physiology: Novel insights from transcranial Doppler ultrasound. CONGENIT HEART DIS 2019; 14:638-644. [PMID: 30908884 DOI: 10.1111/chd.12763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/29/2019] [Accepted: 02/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Rachel Wong
- School of Biomedical Sciences and Pharmacy, University of Newcastle Callaghan Australia
| | | | - David Baker
- Department of Medicine, John Hunter Hospital New Lambton Australia
| | - Neil Spratt
- School of Biomedical Sciences and Pharmacy, University of Newcastle Callaghan Australia
- Department of Medicine, John Hunter Hospital New Lambton Australia
| | - Andrew Boyle
- School of Biomedical Sciences and Pharmacy, University of Newcastle Callaghan Australia
- Department of Medicine, John Hunter Hospital New Lambton Australia
| | - Natasha Baker
- School of Biomedical Sciences and Pharmacy, University of Newcastle Callaghan Australia
| | - Peter Howe
- School of Biomedical Sciences and Pharmacy, University of Newcastle Callaghan Australia
| | - Nicholas Collins
- Department of Medicine, John Hunter Hospital New Lambton Australia
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17
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Lentferink YE, Kromwijk LAJ, van der Aa MP, Knibbe CAJ, van der Vorst MMJ. Increased Arterial Stiffness in Adolescents With Obesity. Glob Pediatr Health 2019; 6:2333794X19831297. [PMID: 30828593 PMCID: PMC6390226 DOI: 10.1177/2333794x19831297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/08/2018] [Accepted: 12/14/2018] [Indexed: 01/09/2023] Open
Abstract
Increased arterial stiffness (AS) is an early sign of cardiovascular disease.
Influence of weight, puberty, and insulin resistance (IR) on AS in adolescents
is unclear. Therefore, this study compared AS, assessed with pulse wave velocity
(PWV) and augmentation index (AIx), of adolescents with and without obesity and
evaluated the influence of puberty and IR on AS. Sixty-two lean and 61
adolescents with obesity were included. Significantly higher PWV was observed in
adolescents with obesity (4.1 ms−1 [2.4 to 5.6 ms−1] vs
3.6 ms−1 [0.4 to 6.1 ms−1]; P = .01),
while AIx was not significant different. However, significantly higher AIx was
observed in adolescents with obesity and IR (3.0 [−17.5% to 28.5%] vs −3.0
[−19.0% to 13.0%]; P = .01). For Tanner stages, no differences
were observed. The higher PWV in adolescents with obesity and higher AIx in
adolescents with obesity and IR both indicate an increased AS. Consequently,
measurement of AS should be considered in adolescents with obesity and IR as
part of cardiovascular risk assessment.
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