What does this research mean for the field?

Non-invasive vascular biomarkers, including carotid intima-media thickness and arterial stiffness markers, are significantly elevated in obese children and can effectively detect early vascular alterations and metabolic complications. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 26, 2023BiomedicinesOpen Access

Unveiling the Silent Danger of Childhood Obesity: Non-Invasive Biomarkers Such as Carotid Intima-Media Thickness, Arterial Stiffness Surrogate Markers, and Blood Pressure Are Useful in Detecting Early Vascular Alterations in Obese Children

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Why the study?

Obese children face higher cardio-metabolic risk, and measuring vascular biomarkers of arterial stiffness, subclinical atherosclerosis, and hypertension could be clinically helpful long term.

Are non-invasive vascular biomarkers such as CIMT and arterial stiffness markers elevated in obese children compared to normal-weight children?

Structured PICO

Are non-invasive vascular biomarkers such as CIMT and arterial stiffness markers elevated in obese children compared to normal-weight children?

Population

84 children aged 6 to 18 years (50 obese subjects, 34 normal weight)

Comparator

Normal weight children (n=34)

Outcome

Vascular biomarkers including carotid intima-media thickness (CIMT), pulse wave velocity (PWV), augmentation index (AIx), and peripheral/central blood pressuressurrogate

Non-invasive vascular biomarkers like CIMT and arterial stiffness markers are significantly elevated in obese children, highlighting their utility in detecting early cardio-metabolic risk and vascular damage.

Implication

May flag early vascular changes in obese youth; leaves open prospective validation before clinical use.

Abstract

Obese children present a higher cardio-metabolic risk. Measuring vascular biomarkers that assess the evolution of arterial stiffness, subclinical atherosclerosis, and hypertension in such patients could be helpful in the long term. We studied 84 children, aged from 6 to 18 years: 50 obese subjects, versus 34 of normal weight. Clinical examination involved: BMI, waist circumference, waist-to-height ratio, and detection of the presence of acanthosis nigricans and irregular menstrual cycles (the latter in adolescent girls). The carotid intima-media thickness (CIMT) was measured with the Aixplorer MACH 30 echography device. The pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures (i.e., SBP, DBP, cSBP, cDBP, and cPP) were acquired through a Mobil-O-Graph device. Obese subjects underwent body composition analysis with a Tanita BC-418. Blood tests were: HOMA-IR, lipid panel, uric acid, and 25-OH vitamin D. All vascular biomarkers presented increased values in obese subjects versus controls. The following cut-off values were significant in detecting obesity: for PWV > 4.6 m/s, cSBP > 106 mmHg for the <12-year-olds, PWV > 4.5 m/s and cSBP > 115 mmHg for the 12-15-year-olds, and PWV > 5 m/s, cSBP > 123 mmHg for the >15-year-olds. AIx is higher in obese children, regardless of their insulin resistance status. Waist circumference and waist-to-height ratio correlate to all vascular parameters. HOMA-IR is an independent predictor for all vascular parameters except CIMT. Cut-off values for PWV of >4.8 m/s, SBP > 125 mmHg, and a cSBP > 117 mmHg predicted the presence of acanthosis nigricans. Obese girls with irregular menses displayed significantly higher PWV, SBP, and DPB. Elevated levels of uric acid, LDL-c, non-LDL-c, triglycerides, and transaminases, and low levels of HDL-c and 25-OH vitamin D correlated with higher arterial stiffness and CIMT values. We conclude that CIMT and the markers of arterial stiffness are useful in the early detection of vascular damage in obese children.