Abstract 3219: Influence of Adiposity on Arterial Stiffness in Healthy Children

Childhood obesity is increasingly prevalent in the community and is related to adverse cardiovascular outcomes during adulthood. Identification of intermediary markers of preclinical cardiovascular disease may identify high-risk children who would benefit greatest from primary prevention measures. In this study, we evaluated the relationship between adiposity on arterial stiffness in healthy children. In 596 healthy children (mean age 10.1 +/− 0.3 years; 51% boys), we measured body mass index (BMI) and waist circumference (WC). Percentage body fat (%BF) was quantitated by dual-energy x-ray absorptiometry (DEXA). Insulin resistance was assessed by a fasting insulin level and homeostasis model assessment as an index of insulin (HOMA-IR). Carotid-femoral pulse wave velocity (PWV), an index of aortic stiffness, was estimated by applanation tonometry. Compared to girls, boys were older (10.1 vs 10.0 years, p=0.01); and had higher WC (61 vs. 60 cm, p=0.02), lower %BF (24% vs. 29 %, p<0.001), similar BMI (18.0 vs. 18.5, p=0.05) and lower PWV (4.4 vs 4.5 m/sec, p<0.001). In univariate analysis, BMI (ρ=0.26 and ρ=0.31), WC (ρ=0.32 and ρ=0.26) and %BF (ρ=0.23 and ρ=0.30) were correlated positively with PWV in boys and girls, respectively (all p<0.001). After adjustment for age, systolic blood pressure, mean arterial pressure and heart rate, BMI, WC and %BF were significantly associated with PWV (p<0.01) (Table ). HOMA-IR and fasting insulin level were not predictors of PWV (p>0.07 for both). Increased adiposity is related to arterial stiffness in healthy children, independently of blood pressure and heart rate. Further studies are required to evaluate whether public health efforts to promote healthy lifestyles and weight loss in children will reduce arterial stiffness, attenuate the progression of subclinical cardiovascular disease, and prevent the development of subsequent cardiovascular events in the community. Table: Separate Multivariable Models relating Predictor Variable to PWV