Abstract
Background: The relationship between childhood obesity and adverse cardiovascular outcomes during adulthood may be mediated through the promotion of impaired vascular function. Wave reflection is an index of arterial function that is determined by arterial stiffness and is predictive of adverse cardiovascular events in adults. We hypothesized that baseline and changes in adiposity during childhood have an adverse influence on future levels of wave reflection and arterial stiffness. Methods: In 514 healthy children (mean age 8.3±0.4, 50% boys); percentage body fat (%BF) was quantitated by dual-energy x-ray absorptiometry during a baseline assessment in 2005 and during a follow-up assessment in 2007. Baseline insulin resistance was evaluated using a homeostasis model assessment (HOMA-IR). Cardiorespiratory fitness (CRF) was assessed using a 20 meter shuttle run. Carotid artery wave reflection and carotid-femoral pulse wave velocity (PWV) was assessed in 2007 using applanation tonometry (SphygmoCor, Atcor Medical, Sydney, Australia). The second peak of carotid systolic blood pressure (SBP2) was obtained from the carotid arterial waveform. Results: In univariable analysis, baseline %BF was positively associated with carotid SBP2 and PWV measured in 2007. In multivariable analysis, baseline %BF and change in %BF was associated with carotid SBP2 after adjustment for age, sex, baseline blood pressure, heart rate, height, HOMA-IR, total cholesterol and CRF (Table ). Baseline %BF was also independently associated with PWV (Table ). Conclusion: Baseline adiposity was positively related to future carotid wave reflection and arterial stiffness. In addition, subsequent increase in adiposity over a 2-year period was associated a greater degree of wave reflection. Relationship between baseline and change in percent body fat and future wave reflection (carotid SBP2) and arterial stiffness (PWV) in multivariate models
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