Abstract
ASTRACTObjective: To evaluate whether the obesity alters ultrasonographical markers of metabolic and cardiovascular disease risk in children.Methods: A cross-sectional study evaluated 80 children aged between 6 and 10 years, comparing 40 obese with 40 normal children. The following parameters were assessed: weight; height; body mass index; arterial blood pressure; body fat; basal metabolic rate; HDL-cholesterol, LDL-cholesterol and total cholesterol; fasting insulin and glucose; quantitative insulin sensitivity check index (QUICKI); homeostasis model of assessment - insulin resistance (HOMA-IR); basal diameter of the brachial artery; brachial artery flow mediated dilation (FMD) and of pulsatility index change (PI-C).Results: Significant differences were observed between obese vs. non-obese children: systolic blood pressure (97.7±8.4 vs. 89.0±5.8 mmHg; p<0.01), diastolic blood pressure (64.3±7.9 vs. 52.9±5.1 mmHg; p<0.01), proportion of body fat (45.1±5.9 vs. 21.3±6.0%; p<0.01), basal metabolic rate (1216.1±102.1 vs. 1072.9±66.4 Kcal; p<0.01), total cholesterol (164.7±25.2 vs. 153.4±15.8 mg/dL; p=0.03), fasting insulin (7.1±5.2 vs. 2.8±1.8 pIU/mL; p<0.01), HOMA-IR (1.5±1.1 vs. 0.6±0.4; p<0.01), basal diameter of the brachial artery (2.5±0.3 vs. 2.1±0.3 mm; p<0.01); PI-C (-15.5±27.2 vs. -31.9±15.5%; p<0.01), decreased QUICKI (0.4±0.05 vs. 0.4±0.03; p<0.01), and FMD (6.6±3.2 vs. 15.6±7.3%; p<0.01).Conclusions: Obesity worsens ultrasonographical and laboratorial markers of metabolic and cardiovascular disease risk in children.
Highlights
Significant differences were observed between obese vs. nonobese children: systolic blood pressure (97.7±8.4 vs. 89.0±5.8 mmHg; p
The present study aimed to improve the evaluation of the endothelial dysfunction in obese children through a noninvasive method, compared to already acknowledged clinical, laboratory and metabolic markers of cardiovascular risks.[19,20]
It is an opportunity to introduce the study of the pulsatility index (PI)-C of the brachial artery, method with good reliability and greater technical facility at sonographic analysis of endothelial dysfunction when compared to FMD.[21]
Summary
Obesity in childhood is an important risk factor to cardiovascular disease (CVD), dyslipidemia, impaired glucose tolerance, hypertension, adult obesity and premature mortality.[1,2] In the last decades, the prevalence of obesity has markedly increased: about 10% of school-aged children worldwide are overweight; inwestern countries, approximately 35% are overweight, and about one fourth of those children are obese.[3,4] excess weight in children represents a public health issue, and is associated with endothelial damage and metabolic abnormalities.[1,5,6]The injured endothelium plays an important role in the development of many cardiovascular diseases,[7] such as atherosclerosis and coronary heart disease.[7]. Endothelial dysfunction is the major event in the development of atherosclerosis, and it may be observed a long time before the appearance of structural atherosclerotic disease.[9]
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