Markers of subclinical vascular damages associate with indices of adiposity and blood pressure in obese children

In this observational study, we aimed at investigating the influence of excess weight and traditional cardiovascular risk factors on vascular structure and function in a cohort of overweight/obese children. Sixty-six obese and 4 overweight children (age 11.5 +/- 2.4 years; female n: 30) underwent office and ambulatory BP measurements (ABPM); ultrasound was used to measure carotid intima-media thickness (cIMT), endothelial function by Flow-Mediated Dilation (FMD) and carotid distensibility (cDC); and digital photopletismography was used to measure stiffness index (SIDVP). Carotid IMT directly correlated with 24-h and nighttime-systolic blood pressure (SBP); while cDC had inverse correlations with BMI, waist circumference and 24-h BP. Unexpectedly, SIDVP resulted inversely related with several indices of excess weight. Most of these correlations remained significant after adjustment for age, sex, BMI, and BP. In a replication set of 40 obese children, SIDVP but not pulse wave velocity (PWV) remained inversely associated with BMI. These data suggest that arterial structure and elasticity are negatively affected by excess weight and BP levels, even in childhood. Surprisingly, SI may not be a reliable marker of vascular stiffness in obese children, because this measurement is likely confounded by other factors, including vasodilation.