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Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children

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Abstract

Obesity is associated with a number of risk factors, such as hyperlipidemia, hyperinsulinemia, hypertension, and early atherosclerosis. Evidence indicates that atherosclerosis begins in childhood and progresses over decades. In this work, we examined the relationship between cardiovascular risk factors and ultrasonographic signs of subclinical atherosclerosis in 77 obese children and adolescents compared to 40 non-obese healthy peers. Carotis intima media thickness (cIMT), carotid artery compliance (CAC), brachial artery flow-mediated dilatation (FMD), and established cardiovascular risk factors were studied. In the obese patients, cIMT was significantly increased (0.57 mm vs 0.45 mm, p < 0.001) whereas CAC (1.84% vs 3.29%, p < 0.001) and FMD (9.67 % vs 14.81%, p < 0.001) were significantly decreased. In multiple linear regression analysis, a relation was observed between cIMT, CAC, brachial FMD on one hand, and body mass index (BMI) on the other. Among the lipid anomalies, only hypertriglyceridemia was found to be positively correlated with cIMT. Additionally, we found a significant association between waist circumference (WC) and FMD. These findings indicate that obesity in children is associated with arterial wall alterations and endothelial dysfunction. In hyperlipidemic situations, only hypertriglyceridemia was found to be positively correlated with cIMT. This finding has consistently indicated TG to be a risk factor for the development of atherosclerosis. To our knowledge this is the first study to determine the relation between FMD and WC, which is used as a parameter of obesity in childhood.

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Acknowledgments

We greatly thank Özgül Vupa and Ali Rıza Firuzan (Department of Statistics, Faculty of Science and Letters, Dokuz Eylul University) for their help with statistical analysis and Savaş Demirpençe (Department of Pediatric Cardiology, Izmir Dr.Behçet Uz Children’s Hospital) for his technical support.

Conflict of interest

The authors did not have any financial support during the research.

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children’s Hospital, 35210-Alsancak, Izmir, Turkey

    Murat Muhtar Yilmazer, Vedide Tavli, Timur Mese & Barış Güven

  2. Department of Pediatrics, Izmir Dr.Behcet Uz Children’s Hospital, Izmir, Turkey

    Özgür Umaç Carti & Ilker Devrim

  3. Istanbul Medical Faculty, Department of Pediatric Endocrinology, Istanbul University, Istanbul, Turkey

    Banu Aydın

  4. Medical Faculty, Department of Cardiology, Celal Bayar University, Manisa, Turkey

    Talat Tavlı

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  1. Murat Muhtar Yilmazer
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Correspondence to Murat Muhtar Yilmazer.

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Yilmazer, M.M., Tavli, V., Carti, Ö.U. et al. Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children. Eur J Pediatr 169, 1241–1248 (2010). https://doi.org/10.1007/s00431-010-1216-5

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