title: Severe Obesity in Adolescents and Young Adults Is Associated With Subclinical Cardiac and Vascular Changes.
abstract: BACKGROUND
  Severe obesity is the fastest growing subgroup of obesity in youth.
  
  
  OBJECTIVE
  We sought to explore the association between severe obesity and subclinical measures of cardiac and vascular structure and function in adolescents and young adults.
  
  
  METHODS
  This was a cross-sectional comparison of 265 adolescents and young adults with severe obesity (defined as body mass index [BMI] ≥120% of the 95th percentile) to 182 adolescents and young adults with obesity (defined as BMI ≥100-119th of the 95th percentile) at tertiary medical center.
  
  
  RESULTS
  Noninvasive measures of cardiac and vascular structure and function were assessed.
  
  
  RESULTS
  Participants were a mean age of 17.9 years, 62% were non-Caucasian, and 68% were female. Systolic blood pressure, fasting insulin, C-reactive protein, IL-6, and frequency of type 2 diabetes were higher in participants with severe obesity (all P < .05). Arterial thickness and stiffness, cardiac structure, and diastolic function were also significantly worse in youth with severe obesity as measured by higher left ventricular mass index, worse diastolic function, higher carotid intima media thickness, and pulse wave velocity and lower brachial distensibility (all P < .05). Regression modeling showed that severe obesity (compared with obesity) was independently associated with each of the above outcomes after adjustment for age, race, sex, blood pressure, lipids, and inflammatory markers (P < .05).
  
  
  CONCLUSIONS
  Adolescents and young adults with severe obesity have a more adverse cardiovascular risk profile and worse cardiac and vascular structure and function. More importantly, severe obesity is independently associated with these subclinical cardiac and vascular changes.
authors.affiliation: Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Shah
authors.affiliation: Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
authors.affiliation: Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Khoury
authors.affiliation: Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229.
authors.forename: Zhiqan
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kimball
authors.affiliation: Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Urbina
mesh_terms: D000293:Adolescent; D000328:Adult; D058070:Asymptomatic Diseases; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness; D055815:Young Adult