Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening

doi:doi:10.1038/sj.ijo.0802539

International Journal of Obesity homepage

International Journal of Obesity (2004) 28, 852–857. doi:10.1038/sj.ijo.0802539 Published online 1 June 2004

Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening

K S Woo¹, P Chook¹, C W Yu², R Y T Sung², M Qiao¹, S S F Leung², C W K Lam³, C Metreweli⁴ and D S Celermajer⁵

¹Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
²Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
³Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
⁴Department of Diagnostic Radiology & Organ Imaging, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
⁵Department of Medicine, Royal Prince Alfred Hospital, University of Sydney, Australia

Correspondence: Professor KS Woo, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. E-mail: kamsangwoo@cuhk.edu.hk

Received 1 April 2003; Revised 28 August 2003; Accepted 29 September 2003; Published online 1 June 2004.

Top

Abstract

OBJECTIVE: We sought to study arterial endothelial function and carotid intima-media thickness (IMT), both early markers of atherosclerosis, in overweight compared to normal children.

DESIGN: Case–control comparison.

SUBJECTS: A total of 36 asymptomatic overweight children (body mass index (BMI)>23; mean 25 plusminus 3) aged 9–12 y and 36 age- and gender-matched nonobese healthy children (BMI<21) from a school community.

MEASUREMENTS: The key parameters were: BMI, arterial endothelial function (ultrasound-derived endothelium-dependent dilation) and carotid artery IMT. The secondary parameters measured included body fat content, waist–hip ratio (WHR), blood pressures, blood lipids, insulin and glucose.

RESULTS: The two groups were well matched for blood pressures, cholesterol and glucose levels, but BMI (P<0.0001), body fat (P=0.001), WHR (P<0.05), fasting blood insulin (P=0.001) and triglyceride levels (P<0.05) were higher in obese children. Overweight was associated with impaired arterial endothelial function (6.6 plusminus 2.3 vs 9.73.0%, P<0.0001) and increased carotid IMT (0.490.04 mm vs 0.450.04 mm, P=0.006). The degree of endothelial dysfunction correlated with BMI (P<0.003) on multivariate analysis.

CONCLUSION: Obesity, even of mild-to-moderate degree, is independently associated with abnormal arterial function and structure in otherwise healthy young children.