Arterial Stiffness, Obesity and Metabolic Syndrome in Children and Adolescents

Abstract

Atherosclerotic cardiovascular disease (CVD) is the leading cause of death in Western Societies. The pathological processes and risk factors associated with its development begin in childhood, long before clinical consequences emerge. Cardiovascular risk factors have been shown to cluster together in adults and children, particularly in the presence of obesity. Exposure to these risk factors in the first decade of life has been shown to cause vascular endothelial dysfunction and autopsy documented atherosclerosis. Childhood overweight and obesity is increasing in worldwide, Western populations and is strongly associated with vascular dysfunction and arterial stiffness. The aim of this research program was to collect anthropometrical, haematological and physiological data from a large number of apparently healthy Welsh children and adolescents with the purpose of examining central and peripheral haemodynamic indices of arterial stiffness and their association with CVD risk factors. In addition it sought to examine the prevalence of overweight and obesity, the prevalence of metabolic syndrome and examine relationships with emerging risk factors. This study has shown that the prevalence of overweight and obesity in children and adolescents is high yet varies greatly dependent on the measurement methods and cut-off criteria applied. Prevalence estimates for metabolic syndrome ranged from 0% to 3.5%. All measures of adiposity showed significant associations with insulin resistance and with 2 or more components of the metabolic syndrome. Aortic pulse wave velocity increased with increasing BMI status. A negative association was found between arterial stiffness and aerobic fitness. The overall prevalence of hypertension was 9.8% with 4.4% of individuals identified with isolated systolic hypertension. The mechanisms underlying isolated systolic hypertension could not be confirmed through this study. Elevations in alanine aminotransferase were highly prevalent and strongly associated with insulin resistance, fasting insulin, body composition, clustering of metabolic risk factors and inversely related to aerobic fitness.

Date of Award	Jan 2012
Original language	English
Supervisor	Simon Williams (Supervisor)