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. 2023 Mar;182(3):1403-1415.
doi: 10.1007/s00431-023-04807-6. Epub 2023 Jan 21.

Arterial stiffness indices, pulse wave velocity and central systolic blood pressure, are able to discriminate between obese and non-obese children

Juliana Cabral Bittencourt  1 , Giovanna Hermont Abbes Scheinbein  2 , Walmer Cardoso de Oliveira Junior  3 , Roberta Leão Bassi  3 , Luiza Bretas Moura  3 , Ana Luisa Drumond Correa  3 , Raquel Gil de Lima Bernardes  3 , Leticia Silveira Freitas  3 , Julia Correa Lemos  3 , Gleisy Kelly Neves Gonçalves  2 , Maria da Glória Rodrigues-Machado  4
Affiliations

Arterial stiffness indices, pulse wave velocity and central systolic blood pressure, are able to discriminate between obese and non-obese children

Juliana Cabral Bittencourt et al. Eur J Pediatr. 2023 Mar.

Abstract

The objectives of this study were to verify, first, if arterial stiffness indices can discriminate between obese and healthy children. Second, to evaluate arterial stiffness index predictors and hemodynamic parameters in obese children. Arterial stiffness indices evaluated were pulse wave velocity (PWV), central systolic blood pressure (SBPc), and central pulse pressure (PPc). A cross-sectional, descriptive, comparative study design was used. The sample consisted of 78 normal-weight children (8.1 ± 1.96 years) and 58 obese children (9.0 ± 1.87 years). PWV, PPc, and SBPc were significantly higher in the group of obese children than in the control group. The ROC curve analysis showed that maximum PWV and SBPc sensitivity and specificity in differentiating obese from non-obese children occurred at 4.09 m/s and 86.17 mmHg, respectively. PPc did not exhibit a discriminatory capacity between the two groups. Peripheral systolic blood pressure (SBPp), peripheral pulse pressure (PPp), and PPc (R2 = 0.98) were predictors of increased PWV. Augmentation pressure, PPp, and reflection coefficient (R2 = 0.873) were predictors of PPc. Age, augmentation index, total vascular resistance, cardiac index, and mean fat percentage (R2 = 0.801) were predictors of SBPc.

Conclusion: This study shows for the first time that PWV > 4.09 m/s and SBPc > 86.17 mmHg are cut-off points associated with a higher risk of obesity. These results indicate that the simple, rapid, and noninvasive measurement of arterial stiffness adds prognostic information regarding cardiovascular risk, in addition to increased body mass index.

What is known: • Overweight and obesity are strongly associated with comorbidities que contribute to the development of cardiovascular diseases.

What is new: • This is the first study to show that PWV and SBPc can discriminate obese from non-obese children. These results show that, in addition to an increased BMI, a simple, rapid, and noninvasive measurement of arterial stiffness adds prognostic information on cardiovascular risk.

Keywords: Overweight; Pediatric obesity; Pulse wave velocity; Systemic arterial hypertension; Vascular stiffness.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
ROC curve of pulse wave velocity (PWV) and central systolic blood pressure (cSBP)
Fig. 2
Fig. 2
Association between anthropometric characteristics, cardiovascular parameters, and other arterial stiffness indices with pulse wave velocity (PWV) in obese children. BMI, body mass index; SBPp and SBPc, peripheral and central systolic blood pressure; PPp and PPc, peripheral and central pulse pressure; AIx@75, augmentation index normalized to heart rate of 75 of bpm
Fig. 3
Fig. 3
Association between cardiovascular parameters and other arterial stiffness indices with central pulse pressure (PPc) in obese children. PPp, peripheral pulse pressure; AIx@75, augumentation index normalized to heart rate of 75 bpm; PWV, pulse wave velocity; PPA, pulse pressure amplification
Fig. 4
Fig. 4
Association between anthropometric characteristics, cardiovascular parameters, and other arterial stiffness indices with central systolic blood pressure (SBPc) in obese children. BMI, body mass index; SBPp, peripheral systolic blood pressure; PWV, pulse wave velocity; AIx@75, augumentation index normalized to heart rate of 75 bpm; PPA, pulse pressure amplification
See this image and copyright information in PMC

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