title: Arterial function and anatomy in obese children with cardiovascular risk factors.
abstract: BACKGROUND
  Limited data are available related to the effects of cardiovascular risk factors on abdominal arterial stiffness using carotid and brachial artery indices. Therefore, we aimed to determine arterial changes in obese children and investigate any relation with cardiovascular risk factors.
  
  
  METHODS
  Thirty-eight obese children (mean body mass index: 28.35 ± 4.65 kg/m(2) ) and 34 age- and sex-matched healthy subjects underwent ultrasound measurements of abdominal, carotid and brachial arteries. Aortic strain, pressure strain elastic modulus (Ep), pressure strain normalized by diastolic blood pressure (Ep*), carotid intima-media thickness, carotid artery compliance, brachial artery flow-mediated dilatation, and well-known cardiovascular risk factors were assessed in the obese children.
  
  
  RESULTS
  Obese children had significantly higher Ep and Ep* parameters than the healthy controls (mean: 242.6 [107.1-666.6], 164.2 [110.6-231.5]; P < 0.001, and mean: 3.39 [1.76-7.5], 2.64 [1.46-4.2]; P < 0.001, respectively). Ep and Ep* were significantly correlated with the homeostasis model assessment of insulin resistance (r = 0.587, P = 0.001; r = 0.467, P = 0.004, respectively). Receiver-operator curve analysis of Ep for identification of children with cardiovascular risk factors showed that the area under the curve for hyperinsulinemia was 0.80 (P < 0.001) and for hypertriglyceridemia was 0.62 (P < 0.01).
  
  
  CONCLUSIONS
  Abdominal arterial stiffness parameters as well as carotid intima-media thickness and brachial arterial flow-mediated dilatation assessment were similarly useful in identifying obese children with cardiovascular risk factors. Insulin resistance is related with the augmented rigidity of the aortic wall in obese children.
authors.affiliation: Department of Pediatric Cardiology, Izmir Dr Behcet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Guven
authors.forename: Savas
authors.initials: S
authors.lastname: Demirpence
authors.forename: Murat Muhtar
authors.initials: MM
authors.lastname: Yilmazer
authors.forename: Ozgur Umac
authors.initials: OU
authors.lastname: Carti
authors.forename: Vedide
authors.initials: V
authors.lastname: Tavli
authors.forename: Timur
authors.initials: T
authors.lastname: Mese
authors.forename: Taliha
authors.initials: T
authors.lastname: Oner
mesh_terms: D000293:Adolescent; D001916:Brachial Artery / Q000473:pathology* / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002339:Carotid Arteries / Q000473:pathology* / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D059289:Vascular Stiffness
keywords: carotid intima-media thickness; hyperinsulinemia; obesity; vascular stiffness