Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening

OBJECTIVE: We sought to study arterial endothelial function and carotid intima-media thickness (IMT), both early markers of atherosclerosis, in overweight compared to normal children. DESIGN: Case - control comparison. SUBJECTS: A total of 36 asymptomatic overweight children (body mass index (BMI) >23; mean 25+/-3) aged 9 - 12 y and 36 age- and gender-matched nonobese healthy children (BMI<21) from a school community. MEASUREMENTS: The key parameters were: BMI, arterial endothelial function (ultrasound-derived endothelium- dependent dilation) and carotid artery IMT. The secondary parameters measured included body fat content, waist - hip ratio (WHR), blood pressures, blood lipids, insulin and glucose. RESULTS: The two groups were well matched for blood pressures, cholesterol and glucose levels, but BMI ( P<0.0001), body fat ( P = 0.001), WHR ( P<0.05), fasting blood insulin ( P 0.001) and triglyceride levels ( P<0.05) were higher in obese children. Overweight was associated with impaired arterial endothelial function (6.6 +/- 2.3 vs 9.7 +/- 3.0%, P<0.0001) and increased carotid IMT (0.49 +/- 0.04 mm vs 0.45 +/- 0.04 mm, P = 0.006). The degree of endothelial dysfunction correlated with BMI ( P<0.003) on multivariate analysis. CONCLUSION: Obesity, even of mild-to-moderate degree, is independently associated with abnormal arterial function and structure in otherwise healthy young children.