Impaired endothelial function and subendocardial viability in teenagers

Pediatr Diabetes. 2019 Nov;20(7):842-848.
Increased body fat and reduced insulin sensitivity are associated with impaired endothelial function and subendocardial viability in healthy, non-Hispanic white adolescents.
Hoffman RP1, Copenhaver MM2, Zhou D3, Yu CY3.
Author information
1 Division of Endocrinology, Nationwide Children’s Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
2 Division of Emergency Medicine, Nationwide Children’s Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
3 Center for Microbial Pathogenesis, The Research Institute at Nationwide Children’s Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
Abstract
BACKGROUND:
Cardiovascular disease has its origins in adolescents. Endothelial dysfunction, arterial stiffness, and decreased endocardial oxygen supply: demand ratios are early functional markers of cardiovascular risk. The goal of this study was to determine the relationships of these markers to physical, inflammatory, and metabolic markers in healthy non-Hispanic, white adolescents.
METHODS:
Thirty-four of the 75 subjects were female. Mean age was 15.0 ± 1.7 years and mean body mass index (BMI) was 22.0 ± 5.8 kg/m2 (mean ± SD). Reactive hyperemia was measured using venous occlusion plethysmography. Arterial tonometry was used to measure the augmentation index (AIx75 ) and the Buckberg subendocardial viability ratio. Blood samples were taken to measure inflammatory and lipid markers and oral glucose tolerance test was used to assess insulin sensitivity.
RESULTS:
Reactive hyperemia decreased as body mass and fat mass increased. It also decreased with increasing neutrophil count. The Buckberg index was higher in males and was positively related to insulin sensitivity even when accounting for age, sex, and resting heart rate. AIx75 was not related to any of the other variables.
CONCLUSIONS:
These results demonstrate that increased fat mass and decreased insulin sensitivity are related to poorer vascular function and cardiac risk in adolescents before the development of actual cardiovascular disease.
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
KEYWORDS:
adolescents; arterial stiffness; inflammation; insulin sensitivity; reactive hyperemia
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