title: Vascular endothelial and smooth muscle function relates to body mass index and glucose in obese and nonobese children.
abstract: BACKGROUND
  Endothelial and smooth muscle dysfunction are critical precursors of atherosclerosis. These can be detected in children at risk of cardiovascular disease.
  
  
  OBJECTIVE
  The objective of this study is to evaluate endothelial and smooth muscle function and their determinants using flow-mediated dilatation (FMD) and glyceryl trinitrate-mediated dilatation (GTN) in obese, nonobese, and type 1 diabetes mellitus (T1DM) children.
  
  
  METHODS
  This is a cross-sectional study.
  
  
  METHODS
  The study subjects were 270 children [140 males, mean age 13.7 (2.8) yr] including 58 obese, 53 nonobese, and 159 T1DM children.
  
  
  METHODS
  Vascular function (FMD and GTN), body mass index (BMI) z-score, blood pressure, glucose, glycosylated hemoglobin, lipids, folate, homocysteine, and high sensitive C-reactive protein were measured.
  
  
  RESULTS
  FMD and GTN were significantly lower in obese and T1DM compared with nonobese subjects (P < 0.001, P < 0.001). FMD and GTN were similarly reduced in obese and T1DM subjects (P = 0.22, P = 0.28). In all nondiabetic subjects (n = 111), both FMD and GTN were significantly and independently related to BMI z-score (r = -0.28, P = 0.003, beta = -0.36, P < 0.001) and weight z-score (beta = -0.31, P = 0.002; r = -0.52, P < 0.001). FMD related independently to total cholesterol (beta = -0.22, P = 0.02). GTN related independently to vessel diameter (beta = -0.49, P < 0.001). GTN related to glucose within the normal range (r = -0.34, P = 0.001).
  
  
  CONCLUSIONS
  Children with obesity and T1DM have a similar degree of vascular dysfunction. BMI and weight adjusted for age and sex relate to endothelial and smooth muscle function in nonobese and obese children. Glucose relates to smooth muscle function in nonobese nondiabetic children. This suggests a continuum effect of BMI and glucose within the normal range on vascular function in childhood.
authors.affiliation: Department of Endocrinology, University of Adelaide, Women's and Children's Hospital, North Adelaide, SA 5006, Australia. alexia.pena@adelaide.edu.au
authors.forename: Alexia Sophie
authors.initials: AS
authors.lastname: Peña
authors.forename: Esko
authors.initials: E
authors.lastname: Wiltshire
authors.forename: Karen
authors.initials: K
authors.lastname: MacKenzie
authors.forename: Roger
authors.initials: R
authors.lastname: Gent
authors.forename: Lino
authors.initials: L
authors.lastname: Piotto
authors.forename: Craig
authors.initials: C
authors.lastname: Hirte
authors.forename: Jennifer
authors.initials: J
authors.lastname: Couper
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D001808:Blood Vessels / Q000033:anatomy & histology / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006706:Homeostasis; D006801:Humans; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000502:physiology*; D009765:Obesity / Q000097:blood*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose