Non-invasive assessment of endothelial function in children with obesity and lipid disorders.
BACKGROUND
Digital tonometry is designed to non-invasively screen for endothelial dysfunction by the detection of impaired flow-induced reactive hyperaemia in the fingertip. We determined whether digital reactive hyperaemia correlated with risk factors for atherosclerosis in two groups of children at increased risk for endothelial dysfunction.


METHODS
A total of 15 obese children and 23 non-obese, dyslipidaemic children, 8-21 years of age, were enrolled, and their medical histories, anthropometric measurements, carotid wall thickness by means of ultrasonography, and fasting blood samples for cardiovascular risk factors were obtained. The standard endoPAT index of digital reactive hyperaemia was modified to reflect the true peak response or the integrated response of the entire post-occlusion period. In each group, age, sex, pubertal status, carotid wall thickness, and multiple cardiovascular risk factors were tested as predictors of endothelial dysfunction.


RESULTS
In the non-obese, dyslipidaemic group, but not in the obese group, both indices strongly correlated with height (r=0.55, p=0.007, by peak response) followed by weight, waist circumference, and age. In both groups, neither index of reactive hyperaemia significantly correlated with any other cardiovascular risk factor.


CONCLUSIONS
Contrary to the known age-related increase in atherosclerosis, digital reactive hyperaemia increased with age and its correlates in non-obese, dyslipidaemic children and was not related to other cardiovascular risk factors in either group. The reason for the lack of this relationship with age in obese children is unknown. The age-dependent physiology of digital microvascular reactivity and the endothelium-independent factors controlling the peak hyperaemic response need further study in children with a wide age range.
1The Rogosin Institute,New York,United States of America.
Lisa C
LC
Hudgins
2Departments of Pediatric Cardiology,Ambulatory Pediatrics,Gastroenterology and Radiology,Weill Cornell Medical College,New York,United States of America.
Vidhya
V
Annavajjhala
2Departments of Pediatric Cardiology,Ambulatory Pediatrics,Gastroenterology and Radiology,Weill Cornell Medical College,New York,United States of America.
Arzu
A
Kovanlikaya
2Departments of Pediatric Cardiology,Ambulatory Pediatrics,Gastroenterology and Radiology,Weill Cornell Medical College,New York,United States of America.
Maura D
MD
Frank
2Departments of Pediatric Cardiology,Ambulatory Pediatrics,Gastroenterology and Radiology,Weill Cornell Medical College,New York,United States of America.
Aliza
A
Solomon
1The Rogosin Institute,New York,United States of America.
Thomas S
TS
Parker
2Departments of Pediatric Cardiology,Ambulatory Pediatrics,Gastroenterology and Radiology,Weill Cornell Medical College,New York,United States of America.
Rubin S
RS
Cooper
D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology*; D001835:Body Weight; D002648:Child; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D006949:Hyperlipidemias / Q000503:physiopathology*; D008297:Male; D063766:Pediatric Obesity / Q000503:physiopathology*; D012044:Regression Analysis; D012307:Risk Factors; D055105:Waist Circumference; D055815:Young Adult
Endothelial dysfunction; hyperlipidaemia; peripheral arterial tonometry