Abstract Body: Introduction: Obesity is an emerging pandemic driven by consumption of a diet rich in fat, highly refined carbohydrates and a sedentary lifestyle in both children and adults. In obesity arterial stiffness (AS) often associated with endotelial dysfunction (ED) is an independent and strong predictor of cardiovascular disease (CVD) and is a precursor to atherosclerosis, systolic hypertension, cardiac diastolic dysfunction, and impairment of coronary and cerebral flow. In obese children, AS also promotes fatty liver disease whitch eventually leads to fibrosis.
Aim of Study: In obese children (OC), central blood pressuere, arterial stiffness and endothelial dysfunction, liver steatosis/fibrosis were evaluated and compared with control group (CG), non-obese, non-hypertensive children.
Methods: Carotid-femoral pulse wave velocity (PWV) is the current non-invasive method of choice to asses AS and PWV carotid-brachial variation pre- and post-induced transient ischemia of brachial artery to evaluate ED. Fibroscan (FS) and Control Attenuation Parameter (CAP) are a non-invasive reliable examination that allows to know the degree of liver steatosis and liver stiffness (fibrosis). Carotid-femoral PWV (AS) and PWV variation of brachial artery (ED) were assessed using Complior System® (Artech-Medical France). We evaluated 31 obese children between 10 and 13 years old (BMI 28.70±3.72) and compared to CG (between 11 and 13 years old, n=16, BMI 19.89±1.75)
Results: In obese children (BMI 28.70±3.72 and Z score 2.02±0.42) vs CG (BMI 19.89±0.75 and Z core 0.57±0.24), PWV-CF (arterial stiffness) was significantly increased: 5.8±1.3 m/s vs. 3.4±0.9 m/s, p<0.01.
PWV-CB variation were paradogical (endothelial dysfunction) after transient ischemia in obese children (△+9% compared to baseline) and it was as epected in the CG (△-12.2% compared to baseline) (P<0.001). Fibroscan and CAP revealed that the degree of steatosis was significantly higher in OC but no differences were found in the degree of liver fibrosis.
Conclusions: We found a significatly increase in arterial stiffness in obese children compared to CG. Arterial stiffness in obese children often precedes the development of hypertension and liver fibrosis (even in the presence of liver steatosis) suggesting that arterial stiffness is one of the earliest biomarkers for increased cardiovascular risk. Interventions aimed at attenuating obesity in chidhood are emerging as important target to improve public health outcomes.