Determinants of carotid-femoral pulse wave velocity in prepubertal children

Int J Cardiol. 2016 Sep 1:218:37-42. doi: 10.1016/j.ijcard.2016.05.060. Epub 2016 May 14.

Abstract

Background: Pulse wave velocity (PWV) is a noninvasive technique to evaluate arterial stiffness, a dynamic property of the vessels, reflecting their structure and function. Childhood obesity is associated with several cardiovascular comorbidities and to the progression of atherosclerosis. We aimed to compare carotid-femoral PWV between normal weight and overweight/obese prepubertal children and to quantify its association with other cardiovascular risk factors.

Methods: Cross-sectional study of 315 children aged 8-9years. Anthropometrics, 24-h ambulatory blood pressure (BP) and carotid-femoral PWV were measured. Classification of obesity was according to World Health Organization (WHO) body mass index (BMI)-for-age reference values.

Results: Compared to normal weight children, overweight and obese children presented significantly higher levels of PWV (4.95 (P25-P75: 4.61-5.23), 5.00 (4.71-5.33), 5.10 (4.82-5.50) m/s, respectively; ptrend<0.001). Significant positive correlations were found between PWV and total cholesterol, LDL cholesterol, triglycerides, fasting insulin and insulin resistance levels (HOMA-IR) and with high-sensitivity C-reactive protein (hs-CRP). In a multivariate linear regression model adjusted for sex, age, height and 24-h systolic blood pressure z-score, the independent determinants of PWV were BMI, HOMA-IR and the absence of dipping.

Conclusions: The association between PWV and the loss of dipping and insulin resistance levels, independently of the BMI, reinforces the contribution of these comorbidities to vascular injury in early life.

Keywords: Arterial stiffness; Blood pressure; Childhood obesity; Hyperlipidemia; Insulin resistance; Pulse wave velocity.

MeSH terms

  • Blood Pressure Monitoring, Ambulatory / methods*
  • Carotid Arteries / physiology*
  • Child
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Femoral Artery / physiology*
  • Humans
  • Male
  • Obesity / diagnosis*
  • Obesity / physiopathology
  • Pulse Wave Analysis / methods*
  • Vascular Stiffness / physiology*