Childhood Obesity and Vascular Phenotypes A Population Study

Objectives This study sought to assess the associations of childhood adiposity with vascular phenotype in pre-pubertal children.

Background The early-life metabolic consequences have consistently been demonstrated in obese children, but the time course and development of any vascular changes remain largely unexplored.

Methods A total of 6,576 children age 10 to 11 years from the ALSPAC (Avon Longitudinal Study of Parents and Children) were studied. Childhood overweight and obesity were based on body mass index contemporary to vascular measures and supported by other adiposity measures, including fat mass and waist circumference on dual-energy x-ray absorptiometry. Heart rate, blood pressure, flow-mediated dilation in the brachial artery, and carotid to radial pulse wave velocity were measured in all children.

Results Overweight and obese children had higher heart rates (mean 72.4 +/- 11 beats/min and 74.6 +/- 12.2 beats/min vs. 71.7 +/- 11 beats/min) and systolic blood pressures (mean 106.3 +/- 9.1 mm Hg and 108 +/- 10.2 mm Hg vs. 103.6 +/- 9 mm Hg) compared with normal-weight peers. However, obese children had greater brachial diameters and resting and hyperemic blood flow, marginally increased endothelial function (higher flow-mediated dilation: mean 8.2 +/- 3.2% vs. 8.1 +/- 3.3%), and lower arterial stiffness (pulse wave velocity: mean 6.99 +/- 1.0 m/s vs. 7.05 +/- 1.23 m/s) compared with normal-weight children. These findings were not explained by metabolic differences.

Conclusions Greater childhood adiposity is associated with adverse cardiometabolic risk factors, but with no evidence of vascular damage at age 9 to 11 years. This could represent physiological adaptation to the hyperemic state of adiposity in childhood. (J Am Coll Cardiol 2012;60:2643-50) (C) 2012 by the American College of Cardiology Foundation