Modest decrease in severity of obesity in adolescence associates with low arterial stiffness,Atherosclerosis

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Modest decrease in severity of obesity in adolescence associates with low arterial stiffness
Atherosclerosis ( IF 4.9 ) Pub Date : 2021-09-14 , DOI: 10.1016/j.atherosclerosis.2021.09.013
Christoph Saner ₁ , Tomi T Laitinen ₂ , Joel Nuotio ₃ , Sarah J Arnup ₄ , Brooke E Harcourt ₅ , Siroon Bekkering ₆ , Zoe McCallum ₇ , Kung-Ting Kao ₈ , Marco Janner ₉ , Costan G Magnussen ₁₀ , Matthew A Sabin ₈ , Markus Juonala ₁₁ , David P Burgner ₅

Affiliation

Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland; Department of Paediatric Endocrinology, Diabetology and Metabolism, University Children's Hospital Inselspital, Bern, Switzerland.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Heart Centre, Turku University Hospital and University of Turku, Turku, Finland.
Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Dept of Internal Medicine and Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Department of Paediatric Endocrinology, Diabetology and Metabolism, University Children's Hospital Inselspital, Bern, Switzerland.
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.

Background and aims

Childhood obesity is associated with cardiovascular risk factors (CVRF), subclinical cardiovascular phenotypes (carotid intima-media thickness, cIMT; pulse-wave velocity, PWV; and carotid elasticity), and adult cardiovascular disease (CVD) mortality. In youth with obesity (body mass index, BMI ≥95th centile), we investigated associations between changes in adiposity and CVRF in early adolescence and subclinical cardiovascular phenotypes in late adolescence.

Methods

Participants had adiposity measures (the severity of obesity in percentage >95th BMI-centile (%>95th BMI-centile)), waist circumference (WC), percentage total body fat (%BF) and CVRF (systolic blood pressure, SBP; glycoprotein acetyls, GlycA; and low-density lipoprotein cholesterol) assessed in early (mean age 10.2 ± 3.5y) and late (15.7 ± 3.7y) adolescence. Subclinical cardiovascular phenotypes were assessed in late adolescence. Multivariable regression analysis was performed.

Results

Decreasing the %>95th BMI-centile was associated with carotid elasticity (0.945%/10 mmHg, p = 0.002) in females, and with PWV in males (−0.75 m/s, p < 0.001). Changes in all adiposity measures (per 1-unit increase) were associated with carotid elasticity (−0.020 to −0.063%/10 mmHg, p < 0.005), and PWV (0.011–0.045 m/s, p < 0.005). Changes in GlycA (per 50 $μ$ mol-increase) were associated with elasticity (−0.162%/10 mmHg, p = 0.042), and changes in SBP (per 10 mmHg-increase) were associated with PWV (0.260 m/s, p < 0.001). Adjusted for change in BMI, the coefficient for GlycA was reduced by 46% and for SBP by 12%. Only male sex was associated with cIMT (+34 $μ$ m, p = 0.006).

Conclusions

In youth with obesity, decreasing or maintaining the severity of obesity, and decreasing the levels of SBP and GlycA from early to late adolescence was associated with low arterial stiffness.

中文翻译：

青春期肥胖严重程度的适度降低与低动脉僵硬度有关

背景和目标

儿童肥胖与心血管危险因素 (CVRF)、亚临床心血管表型（颈动脉内膜中层厚度，cIMT；脉搏波速度，PWV；和颈动脉弹性）和成人心血管疾病 (CVD) 死亡率相关。在肥胖青年（体重指数，BMI ≥ 95th 百分位）中，我们调查了青春期早期肥胖变化与 CVRF 与青春期晚期亚临床心血管表型之间的关联。

方法

参与者进行了肥胖测量（肥胖的严重程度百分比 > 95th BMI-centile (%>95th BMI-centile)）、腰围 (WC)、全身脂肪百分比 (%BF) 和 CVRF（收缩压，SBP；糖蛋白）在青春期早期（平均年龄 10.2 ± 3.5 岁）和晚期（15.7 ± 3.7 岁）进行评估。在青春期后期评估亚临床心血管表型。进行了多变量回归分析。

结果

降低 %>95th BMI 百分位数与女性的颈动脉弹性 (0.945%/10 mmHg, p = 0.002) 和男性的 PWV (-0.75 m/s, p < 0.001) 相关。所有肥胖指标的变化（每增加 1 个单位）与颈动脉弹性（-0.020 至 -0.063%/10 mmHg，p < 0.005）和 PWV（0.011-0.045 m/s，p < 0.005）相关。GlycA 的变化（每 50 $μ$ mol 增加）与弹性相关（-0.162%/10 mmHg，p = 0.042），SBP 的变化（每增加 10 mmHg）与 PWV 相关（0.260 m/s，p < 0.001）。根据 BMI 的变化调整后，GlycA 的系数降低了 46%，SBP 的系数降低了 12%。只有男性与 cIMT 相关 (+34 $μ$ 米，p = 0.006）。