title: Determinants of carotid-femoral pulse wave velocity in prepubertal children.
abstract: BACKGROUND
  Pulse wave velocity (PWV) is a noninvasive technique to evaluate arterial stiffness, a dynamic property of the vessels, reflecting their structure and function. Childhood obesity is associated with several cardiovascular comorbidities and to the progression of atherosclerosis. We aimed to compare carotid-femoral PWV between normal weight and overweight/obese prepubertal children and to quantify its association with other cardiovascular risk factors.
  
  
  METHODS
  Cross-sectional study of 315 children aged 8-9years. Anthropometrics, 24-h ambulatory blood pressure (BP) and carotid-femoral PWV were measured. Classification of obesity was according to World Health Organization (WHO) body mass index (BMI)-for-age reference values.
  
  
  RESULTS
  Compared to normal weight children, overweight and obese children presented significantly higher levels of PWV (4.95 (P25-P75: 4.61-5.23), 5.00 (4.71-5.33), 5.10 (4.82-5.50) m/s, respectively; ptrend<0.001). Significant positive correlations were found between PWV and total cholesterol, LDL cholesterol, triglycerides, fasting insulin and insulin resistance levels (HOMA-IR) and with high-sensitivity C-reactive protein (hs-CRP). In a multivariate linear regression model adjusted for sex, age, height and 24-h systolic blood pressure z-score, the independent determinants of PWV were BMI, HOMA-IR and the absence of dipping.
  
  
  CONCLUSIONS
  The association between PWV and the loss of dipping and insulin resistance levels, independently of the BMI, reinforces the contribution of these comorbidities to vascular injury in early life.
authors.affiliation: Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal; Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Correia-Costa
authors.affiliation: Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal; EPIUnit - Institute of Public Health, University of Porto, Portugal; Division of Pediatric Nephrology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal. Electronic address: liane@med.up.pt.
authors.forename: Liane
authors.initials: L
authors.lastname: Correia-Costa
authors.affiliation: Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal; EPIUnit - Institute of Public Health, University of Porto, Portugal; Division of Pediatric Nephrology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal.
authors.forename: Alberto
authors.initials: A
authors.lastname: Caldas Afonso
authors.affiliation: Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Germany.
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.affiliation: Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal; Division of Pediatric Nutrition, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Guerra
authors.affiliation: Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal; Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Moura
authors.affiliation: Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Mota
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine of University of Porto, Portugal.
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.affiliation: Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal; Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Areias
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine of University of Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002339:Carotid Arteries / Q000502:physiology*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005263:Femoral Artery / Q000502:physiology*; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000503:physiopathology; D063177:Pulse Wave Analysis / Q000379:methods*; D059289:Vascular Stiffness / Q000502:physiology*
keywords: Arterial stiffness; Blood pressure; Childhood obesity; Hyperlipidemia; Insulin resistance; Pulse wave velocity