ESPE Abstracts (2015) 84 P-3-835

How Early are Vascular Changes in Obese Children Among North Indian Population?

Krishna Kishore Umapathia, Sangeeta Yadava, Sanjay Tyagib & T K Mishraa

aMaulana Azad Medical College, New Delhi, India; bG B Pant Hospital, NeW Delhi, India

Background: Obese children are known to be at high risk for vascular complications and there is paucity in Indian literature regarding the onset and magnitude of vascular complications. Carotid intima media thickness (cIMT) and Brachial artery distensibility are known to predict future atherogenesis.

Objective and hypotheses: To compare vascular parameters of obese children aged 5–18 years with age and sex matched controls and its relationship with pubertal age.

Method: 80 children, 40 obese and 40 age & sex matched controls 5–18 years recruited after approval from Institutional Ethics Committee and informed assent/consent. cIMT &brachial artery distensibility measured by echocardiography. Endothelial independent vasodilatation measured using sublingual glycerlytrinitrate spray (GTN) and endothelial dependent vasodilatation by reactive hyperemia.

Results: Mean age was similar in both cases and controls – 11.15±2.52 (M:F=23:17). 19 (47.5%) were pre-pubertal (M:F=10:9) and 21 (52.5%) were post-pubertal (M:F=13:8). BMI significantly higher in obese vs controls (26.58±1.88 kg/m2 vs 17.58±1.72 kg/m2P<0.001). Flow mediated vasodilatation significantly lesser in obese group (2.0±0.06 vs 2.2±0.05 – P=0.05). GTN induced vasodilatation less in obese but not significant (4.6±0.23 vs 6.2±0.31 – P=0.07). cIMT significantly higher in obese (0.57±0.14 vs 0.38±0.07, P<0.001). On comparing prepubertal and postpubertal obese, FMD and GTN induced vasodilatation were comparable (P=0.49, 0.22). cIMT significantly higher in postpubertal obese (0.60±0.13 vs 0.44±0.14, P<0.01) in comparison to prepubertal obese. 27/40(67.5%) obese (24 postpubertal and three prepubertal) had cIMT greater than the normal cutoff of 0.49 mm.

Conclusion: Cohort of obese children have evidence of subclinical vascular alterations as observed by decreased endothelial independent vasodilatation and increased carotid intima media thickness. cIMT is higher with pubertal onset indicating that with age and puberty, there is further progression of atherogenesis. Thus indicating need for early screening and intervention for cardiac morbidities.

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