Kim Sung-Ai, Park Kyung Hee, Woo Sarah, Kim Yoon Myung, Lim Hyun Jung, Park Woo-Jung
Division of Cardiology, Department of Internal Medicine, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea.
Department of Family Medicine, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea.
J Clin Med. 2022 Jun 19;11(12):3520. doi: 10.3390/jcm11123520.
Childhood obesity is linked to adverse cardiovascular outcomes in adulthood. This study aimed to assess the impact of childhood obesity on the vasculature and to investigate whether vascular alteration precedes arterial wall thickening in childhood.
A total of 295 overweight (body mass index [BMI] 85th to 95th percentile, = 30) and obese (BMI ≥ 95th percentile, = 234) children aged 7-17 years and 31 normal-weight controls with similar age and gender were prospectively recruited. We assessed anthropometric data and laboratory findings, and measured the carotid intima-media thickness (IMT), carotid artery (CA) diameter, M-mode-derived arterial stiffness indices, and velocity vector imaging parameters, including the CA area, fractional area change, circumferential strain, and circumferential strain rate (SR).
The mean ± standard deviation age of the participants was 10.8 ± 2.1 years; 172 (58%) children were male. Regarding structural properties, there was no difference in the IMT between the three groups. The CA diameter was significantly increased in obese children, whereas the CA area showed a significant increase beginning in the overweight stage. Regarding functional properties, contrary to β stiffness and Young's elastic modulus, which were not different between the three groups, the circumferential SR showed a significant decrease beginning in the overweight stage and was independently associated with BMI z-scores after adjusting for covariates.
We have demonstrated that arterial stiffening and arterial enlargement precede arterial wall thickening, and that these vascular alterations begin at the overweight stage in middle childhood or early adolescence.
儿童肥胖与成年期不良心血管结局相关。本研究旨在评估儿童肥胖对血管系统的影响，并调查儿童期血管改变是否先于动脉壁增厚。
前瞻性招募了295名7至17岁的超重（体重指数[BMI]处于第85至95百分位，n = 30）和肥胖（BMI≥第95百分位，n = 234）儿童以及31名年龄和性别相似的正常体重对照儿童。我们评估了人体测量数据和实验室检查结果，并测量了颈动脉内膜中层厚度（IMT）、颈动脉（CA）直径、M型衍生的动脉僵硬度指数以及速度向量成像参数，包括CA面积、面积变化分数、圆周应变和圆周应变率（SR）。
参与者的平均年龄±标准差为10.8±2.1岁；172名（58%）儿童为男性。关于结构特性，三组之间的IMT没有差异。肥胖儿童的CA直径显著增加，而CA面积从超重阶段开始就显著增加。关于功能特性，与三组之间无差异的β僵硬度和杨氏弹性模量相反，圆周SR从超重阶段开始就显著降低，并且在调整协变量后与BMI z评分独立相关。
我们已经证明动脉僵硬度增加和动脉扩大先于动脉壁增厚，并且这些血管改变始于童年中期或青春期早期的超重阶段。
