title: Endothelial Function in Children and Adolescents Is Mainly Influenced by Age, Sex and Physical Activity　- An Analysis of Reactive Hyperemic Peripheral Artery Tonometry.
abstract: As adolescents rarely experience cardiovascular events, surrogate markers of atherosclerosis are useful to justify and monitor effects of primary prevention and therapy of risk factors. Endothelial function assessed by reactive hyperemic peripheral arterial tonometry (RH-PAT) resulting in a reactive hyperemic index (RHI) is a noninvasive method with limited data for use in children and adolescents.
  
  
  
  We performed a total of 931 RHI measurements in 445 high-school students, aged 10-17 years, over a time period of 5 years. Students were randomized by class to 60 min physical exercise (PE) at school daily (intervention group), or 2 units of 45-min PE weekly (control group). To characterize the factors influencing the RHI, anthropometry, cardiopulmonary exercise testing, blood cholesterol and quality of life were assessed and used to build mixed linear models. Main influential factors were age, with an increase of RHI from 1.53±0.42 in the youngest to 1.96±0.59 in the oldest students, sex, with higher values in girls, and physical activity. This increase adjusted by age and sex was estimated as 0.11 [0.08, 0.14] per year. RHI was higher in the intervention group by 0.09 [-0.05, 0.23] in comparison with the control group.
  
  
  
  If RH-PAT is used in research or as a clinical tool in adolescents, the shown age- and sex-dependence of RHI have to be taken in account.
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.
authors.forename: Ulrike M
authors.initials: UM
authors.lastname: Mueller
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.|Department of Cardiology, Kerckhoff Heart Center.
authors.forename: Claudia
authors.initials: C
authors.lastname: Walther
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Adam
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.
authors.forename: Kati
authors.initials: K
authors.lastname: Fikenzer
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.
authors.forename: Sandra
authors.initials: S
authors.lastname: Erbs
authors.affiliation: Clinical Trial Center, University Leipzig.
authors.forename: Meinhard
authors.initials: M
authors.lastname: Mende
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.
authors.forename: Volker
authors.initials: V
authors.lastname: Adams
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
authors.affiliation: Department of Internal Medicine/Cardiology, University Leipzig - Heart Center.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001158:Arteries / Q000503:physiopathology*; D050197:Atherosclerosis / Q000517:prevention & control; D002648:Child; D002784:Cholesterol / Q000097:blood; D004730:Endothelium, Vascular / Q000502:physiology*; D015444:Exercise; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D008297:Male; D008365:Manometry / Q000379:methods*; D011788:Quality of Life; D012737:Sex Factors
chemical_list: D002784:Cholesterol
keywords: Adolescents; Endothelial function; Physical exercise; Primary prevention; Reactive hyperemic index