title: Increased ambulatory arterial stiffness index in obese children.
abstract: OBJECTIVE
  Altered arterial stiffness is a recognized risk factor of poor cardiovascular health. Ambulatory arterial stiffness index (AASI, defined as one minus the regression slope of diastolic on systolic blood pressure values derived from a 24 h arterial blood pressure monitoring, ABPM) is an upcoming and readily available marker of arterial stiffness. Our hypothesis was that AASI is increased in obese children compared to age- and gender matched healthy subjects.
  
  
  METHODS
  AASI was calculated from ABPM in 101 obese children (BMI ≥ 1.88 SDS according to age- and sex-specific BMI charts), 45% girls, median BMI SDS 2.8 (interquartile range (IQR) 2.5-3.4), median age 11.5 years (9.1-13.4) and compared with an age and gender matched healthy control group of 71 subjects with median BMI SDS 0.0 (-0.8-0.5). Multivariate regression analysis was applied to identify significant independent factors explaining AASI variability in this population.
  
  
  RESULTS
  AASI was significantly higher in obese children compared to controls (0.388 (0.254-0.499) versus 0.190 (0.070-0.320), p < 0.0001), but blood pressure values were similar. In a multivariate analysis including obese children only, AASI was independently predicted by 24-h systolic blood pressure SDS (p = 0.012); in a multivariate analysis including obese children and controls BMI SDS and pulse pressure independently influenced AASI (p < 0.001).
  
  
  CONCLUSIONS
  This study shows that AASI, a surrogate marker of arterial stiffness, is increased in obese children. AASI seems to be influenced by BMI and pulse pressure independently of systolic and diastolic blood pressure values, suggesting that other factors are involved in increased arterial stiffness in obese children.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Saner
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland; Pediatric Department of Southern Switzerland, University of Bern, Bellinzona, Switzerland. Electronic address: giacomo.simonetti@insel.ch.
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
authors.affiliation: Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Wühl
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Primus E
authors.initials: PE
authors.lastname: Mullis
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Janner
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D063766:Pediatric Obesity / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D059289:Vascular Stiffness
keywords: Ambulatory arterial stiffness index; Arterial stiffness; Blood pressure; Body mass index; Cardiovascular risk; Children; Obesity