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. 2023 Jul 1;41(7):1100-1107.
doi: 10.1097/HJH.0000000000003433. Epub 2023 May 19.

Relationship between measures of adiposity, blood pressure and arterial stiffness in adolescents. The MACISTE study

Giacomo Pucci  1 , Maria R Martina  2 , Elisabetta Bianchini  2 , Marco D'abbondanza  1 , Rosa Curcio  1 , Francesca Battista  3 , Fabio Anastasio  4 , Mariano E Crapa  5 , Leandro Sanesi  1 , Vincenzo Gemignani  2 , Gaetano Vaudo  1
Affiliations

Relationship between measures of adiposity, blood pressure and arterial stiffness in adolescents. The MACISTE study

Giacomo Pucci et al. J Hypertens. .

Abstract

Objective: Children and adolescents with adiposity excess are at increased risk of future cardiovascular (CV) disease. Fat accumulation promotes the development of elevated blood pressure (BP) and arterial stiffness, two main determinants of CV risk which are strongly inter-related. We aimed at investigating whether the association between overweight and arterial stiffness, taken at different arterial segments, is mediated by increased BP or is BP-independent.

Methods: Three hundred and twenty-two Italian healthy adolescents (mean age 16.9±1.4 years, 12% with overweight) attending the "G. Donatelli" High School in Terni, Italy, underwent measurement of arterial stiffness by arterial tonometry (aortic stiffness) and semiautomatical detection of pressure-volume ratio of the common carotid (carotid stiffness). The mediator effect of BP was tested for each anthropometric or biochemical measure of fat excess related to arterial stiffness.

Results: Both carotid and aortic stiffness showed positive correlations with body mass index, waist, hip, and neck circumferences (NC). Only carotid stiffness, but not aortic stiffness, was associated with serum markers of fat accumulation and metabolic impairment such as insulin, homeostatic model of insulin resistance (HOMA-IR), serum gamma-glutamyl transferase (sGGT) and uric acid. The association with NC was stronger for carotid than for aortic stiffness (Fisher z -to- R 2.07, P = 0.04), and independent from BP.

Conclusions: In healthy adolescents, fat accumulation is associated with arterial stiffness. The degree of this association differs by arterial segments, since carotid stiffness is more strongly associated to adipose tissue excess than aortic stiffness and shows a BP-independent association with NC whereas aortic stiffness does not.

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Conflict of interest statement

E.B. and V.G. are co-founders of QUIPU s.r.l., Pisa, Italy, a spin-off company of the Italian National Research Council and the University of Pisa developing software medical devices.

Figures

FIGURE 1
FIGURE 1
Pearson's R correlation coefficients between BMI and neck circumference. P-values above the columns represent the significance of the Fisher r-to-z transformation. P-values on the horizontal lines represent the two levels of significance of R.
FIGURE 2
FIGURE 2
Mediation analysis. (a) General conceptual model. (b) Mediator effect of mean arterial pressure on the relationship between neck circumference and carotid stiffness. (c) Mediator effect of mean arterial pressure on the relationship between neck circumference and carotid-femoral pulse wave velocity (cf-PWV). (d) Mediator effect of pulse pressure on the relationship between neck circumference and carotid stiffness. Numerical values represent unstandardized regression coefficients.
See this image and copyright information in PMC

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