Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study

被引:605
作者
Tounian, P
Aggoun, Y
Dubern, B
Varille, V
Guy-Grand, B
Sidi, D
Girardet, JP
Bonnet, D
机构
[1] Necker Enfants Malad Teaching Hosp, Dept Paediat Cardiol, F-75015 Paris, France
[2] Armand Trousseau Teaching Hosp, Dept Paediat Gastroenterol & Nutr, Paris, France
[3] Hotel Dieu Teaching Hosp, Dept Nutr, Paris, France
关键词
D O I
10.1016/S0140-6736(01)06525-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Epidemiological studies suggest that obesity-induced atherosclerosis may start in childhood, but this process has never been demonstrated. We looked for arterial changes and investigated their relation to cardiovascular risk factors in obese children. Methods Non-invasive ultrasonographic measurements were made in 48 severely obese children and 27 controls to investigate arterial mechanics and endothelial function. Plasma lipid concentrations, indices of insulin resistance, and body composition were assessed in the obese children. Findings The obese children had significantly lower arterial compliance than the healthy controls (median 0.132 [0.022-0.273], vs 0.143 [0.112-0.237] mm(2).mm Hg; p=0.02) and lower distensibility (0.60 [0.10-1.00] vs 0.70 [0.50-1.10] mm Hg-1.10(-2); p=0.0001). Conversely, the obese children had higher values than the controls for wall stress (3.36 [2.00-5.01] vs 2.65 [2.13-3.54] mm Hg.10(2); p=0.0001) and incremental elastic modulus (1.68 [0.72-10.8] vs 0.96 [0.64-1.47]; p=0.0001). Endothelium-dependent and independent function were also lower in the obese than in the control children. An android fat distribution was positively correlated with indices of insulin resistance and plasma triglyceride concentrations and was negatively correlated with plasma HDL-cholesterol concentration and arterial compliance. Endothelial dysfunction was correlated with low plasma apolipoprotein A-1 and with insulin resistance indices. Interpretation Severe obesity in children is associated with arterial wall stiffness and endothelial dysfunction. Low plasma apolipoprotein A-1, insulin resistance, and android fat distribution may be the main risk factors for these arterial changes, which are of considerable concern as possible early events in the genesis of atheroma.
引用
收藏
页码:1400 / 1404
页数:5
相关论文
共 30 条
[1]   Mechanical properties of the common carotid artery in Williams syndrome [J].
Aggoun, Y ;
Sidi, D ;
Levy, BI ;
Lyonnet, S ;
Kachaner, J ;
Bonnet, D .
HEART, 2000, 84 (03) :290-293
[2]  
Aggoun Y, 2000, ARTERIOSCL THROM VAS, V20, P2070
[3]   Body fat distribution predicts the degree of endothelial dysfunction in uncomplicated obesity [J].
Arcaro, G ;
Zamboni, M ;
Rossi, L ;
Turcato, E ;
Covi, G ;
Armellini, F ;
Bosello, O ;
Lechi, A .
INTERNATIONAL JOURNAL OF OBESITY, 1999, 23 (09) :936-942
[4]  
Bachorik PS, 1997, CLIN CHEM, V43, P2364
[5]   INSULIN-MEDIATED SKELETAL-MUSCLE VASODILATION CONTRIBUTES TO BOTH INSULIN SENSITIVITY AND RESPONSIVENESS IN LEAN HUMANS [J].
BARON, AD ;
STEINBERG, HO ;
CHAKER, H ;
LEAMING, R ;
JOHNSON, A ;
BRECHTEL, G .
JOURNAL OF CLINICAL INVESTIGATION, 1995, 96 (02) :786-792
[6]   Role of tissue-specific blood flow and tissue recruitment in insulin-mediated glucose uptake of human skeletal muscle [J].
Bonadonna, RC ;
Saccomani, MP ;
Del Prato, S ;
Bonora, E ;
DeFronzo, RA ;
Cobelli, C .
CIRCULATION, 1998, 98 (03) :234-241
[7]   Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes [J].
Caballero, AE ;
Arora, S ;
Saouaf, R ;
Lim, SC ;
Smakowski, P ;
Park, JY ;
King, GL ;
LoGerfo, FW ;
Horton, ES ;
Veves, A .
DIABETES, 1999, 48 (09) :1856-1862
[8]   NONINVASIVE DETECTION OF ENDOTHELIAL DYSFUNCTION IN CHILDREN AND ADULTS AT RISK OF ATHEROSCLEROSIS [J].
CELERMAJER, DS ;
SORENSEN, KE ;
GOOCH, VM ;
SPIEGELHALTER, DJ ;
MILLER, OI ;
SULLIVAN, ID ;
LLOYD, JK ;
DEANFIELD, JE .
LANCET, 1992, 340 (8828) :1111-1115
[9]   Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults [J].
Clarkson, P ;
Adams, MR ;
Powe, AJ ;
Donald, AE ;
McCredie, R ;
Robinson, J ;
McCarthy, SN ;
Keech, A ;
Celermajer, DS ;
Deanfield, JE .
JOURNAL OF CLINICAL INVESTIGATION, 1996, 97 (08) :1989-1994
[10]   Association of body fat distribution and cardiovascular risk factors in children and adolescents [J].
Daniels, SR ;
Morrison, JA ;
Sprecher, DL ;
Khoury, P ;
Kimball, TR .
CIRCULATION, 1999, 99 (04) :541-545