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Change of early atherosclerotic markers in obese children

Korean Journal of Pediatrics 2006;49(4):368-374.
Published online April 15, 2006.
Change of early atherosclerotic markers in obese children
Eui Jung Roh, Jung Min Yoon, Jae Woo Lim, Eun Jung Cheon, Kyoung Og Ko
Department of Pediatrics, College of Medicine, Konyang University, Daejeon, Korea
비만아에서 조기 동맥경화증 지표들의 변화
노의정, 윤정민, 임재우, 천은정, 고경옥
건양대학교 의과대학 소아과학교실
Correspondence: 
Eun Jung Cheon, Email: kcm1000@kyuh.co.kr
Abstract
Purpose
: The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction.
Methods
: Thirty-eight obese children(14-16 years old of age, male, body mass index 29.40¡¾3.18 kg/m2) and forty-five age and sex-matched healthy control children(body mass index 18.43¡¾1.01 kg/ m2) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flow- mediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors.
Results
: The obese children had significantly increased IMT(0.52¡¾0.09 mm vs 0.40¡¾0.07 mm, P< 0.001) and markedly impaired FMD(7.35¡¾7.78 percent vs 20.34¡¾16.81 percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P< 0.001) and reduced FMD(r=-0.414, P<0.001).
Conclusion
: We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.
Key Words: Intima-media thickness , Flow mediated dilation , Atherosclerosis , Obesity


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