Vascular compliance in lean, obese, and diabetic children and adolescents: a cross-sectional study in a minority population.
BACKGROUND
In adults, both obesity and type 2 diabetes mellitus (T2DM) are positively correlated with cardiovascular disease mortality and arterial stiffness. Several studies of adults have shown that both obesity and T2DM are independently associated with increased arterial stiffness. However, little is known about the relationship between arterial compliance and cardiovascular disease risk in children. We assessed whether large and small arterial compliance is impaired in obese and diabetic pubertal children.


METHODS
One hundred children of African-Caribbean ethnicity, aged 14-16 years, including 21 lean children (between the 25th and 75th percentile), 40 obese children (>95th percentile), and 39 children with T2DM diagnosed by American Diabetes Association criteria were studied. Arterial compliance of the large (C1) and small (C2) vessels was measured using radial arterial diastolic pulse wave contour analysis.


RESULTS
C1 did not differ significantly between lean, obese, and T2DM subjects. C2 was significantly greater in obese and T2DM subjects (10.9 ± 1 and 10.4 ± 0.7 ml/mm Hg × 100 ml, respectively) compared to lean subjects (7.8 ± 0.8 ml/mm Hg × 100 ml; p < 0.05). C2 was also significantly greater in T2DM subjects receiving antihypertensive drug therapy than in diabetic subjects not on antihypertensive treatment.


CONCLUSIONS
Increased compliance in diabetic and obese children compared to lean subjects could be secondary to premature maturation of the vascular system; whether this early maturation can translate into a subsequent rise in the incidence of cardiovascular events related to diabetes and obesity can only be determined by long-term follow-up of these patients.
Division of Endocrinology, Department of Internal Medicine, Downstate Medical Center, Brooklyn, N.Y., USA.
Deep
D
Shikha
Division of Nephrology, Department of Internal Medicine, Metropolitan Hospital Center, New York, N.Y., USA.
Montish
M
Singla
Division of Endocrinology, Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
Rachna
R
Walia
Division of Endocrinology, Department of Internal Medicine, Downstate Medical Center, Brooklyn, N.Y., USA.
Natia
N
Potter
Division of Endocrinology, Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, N.Y., USA.
Arlene
A
Mercado
Division of Endocrinology, Department of Internal Medicine, Downstate Medical Center, Brooklyn, N.Y., USA.
Nathaniel
N
Winer
Children; HOMA-IR; Insulin levels; Obesity; Type 2 diabetes mellitus; Vascular compliance