Microvascular function is impaired in children with morbid obesity

Children’s obesity is a growing problem in Western societies. We hypothesized that morbid obesity (body mass index [BMI] > 99.5th percentile) might affect microvascular function at an early stage. Therefore, we assessed the microvascular function of 41 obese children (13.2 ± 2.8 years, BMI 32.9 ± 6.6) in comparison to 91 healthy controls (12.7 ± 2.1 years, BMI 18.2 ± 2.5) by post-occlusive reactive hyperemia measured by a laser Doppler: baseline perfusion, biological zero (defined as ‘no-flow’ laser Doppler signal during suprasystolic occlusion), peak perfusion (following occlusion), time to peak perfusion and recovery time (time until resuming baseline perfusion) were recorded and compared between both groups. Peak perfusion was higher in children with morbid obesity than in controls (1.67 ± 0.76 AU [arbitrary units] vs 1.26 ± 0.5 AU, p < 0.001). Consecutively, recovery time was longer in children with morbid obesity (118.21 ± 34.64 seconds) than in healthy children (83.18 ± 35.08 seconds, p < 0.001). In conclusion, higher peak perfusion and prolonged recovery time in children with morbid obesity seem to reflect microvascular dysfunction due to an impaired vasoconstrictive ability of precapillary sphincters.

[1]  L. Kheirandish-Gozal,et al.  Endothelial dysfunction in obese non-hypertensive children without evidence of sleep disordered breathing , 2010, BMC pediatrics.

[2]  Y. Aso,et al.  Relationship between post‐occlusive forearm skin reactive hyperaemia and vascular disease in patients with Type 2 diabetes—a novel index for detecting micro‐ and macrovascular dysfunction using laser Doppler flowmetry , 2009, Diabetic medicine : a journal of the British Diabetic Association.

[3]  S. Daniels,et al.  Lipid Screening and Cardiovascular Health in Childhood , 2008, Pediatrics.

[4]  M. Wolzt,et al.  A Proinflammatory State Is Detectable in Obese Children and Is Accompanied by Functional and Morphological Vascular Changes , 2006, Arteriosclerosis, thrombosis, and vascular biology.

[5]  K. Flegal,et al.  Prevalence of overweight and obesity in the United States, 1999-2004. , 2006, JAMA.

[6]  A. Humeau,et al.  Simplified model of laser Doppler signals during reactive hyperaemia , 2006, Medical and Biological Engineering and Computing.

[7]  K. Widhalm,et al.  Actions and programs of European countries to combat obesity in children and adolescents: a survey , 2005, International Journal of Obesity.

[8]  S. Schwarzenberg Obesity in children: epidemic and opportunity. , 2005, Minnesota medicine.

[9]  A. Halim,et al.  Reproducibility of different laser Doppler fluximetry parameters of postocclusive reactive hyperemia in human forearm skin. , 2005, Journal of pharmacological and toxicological methods.

[10]  Nish Chaturvedi,et al.  Albumin excretion rate and cardiovascular risk: could the association be explained by early microvascular dysfunction? , 2005, Diabetes.

[11]  Wiendelt Steenbergen,et al.  How to assess post-occlusive reactive hyperaemia by means of laser Doppler perfusion monitoring: application of a standardised protocol to patients with peripheral arterial obstructive disease. , 2005, Microvascular research.

[12]  M. Trevisan,et al.  Increased carotid intima-media thickness and stiffness in obese children. , 2004, Diabetes care.

[13]  A. Slyper Clinical review 168: What vascular ultrasound testing has revealed about pediatric atherogenesis, and a potential clinical role for ultrasound in pediatric risk assessment. , 2004, The Journal of clinical endocrinology and metabolism.

[14]  R. Sung,et al.  Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening , 2004, International Journal of Obesity.

[15]  L. Roman,et al.  Bioactive nitric oxide concentration does not increase during reactive hyperemia in human skin. , 2004, Journal of applied physiology.

[16]  A. Morris,et al.  Impaired Microvascular Function in Normal Children: Effects of Adiposity and Poor Glucose Handling , 2003, The Journal of physiology.

[17]  C. Minson,et al.  Nitric oxide synthase inhibition does not alter the reactive hyperemic response in the cutaneous circulation. , 2003, Journal of applied physiology.

[18]  T. Lüscher,et al.  Statins enhance postischemic hyperemia in the skin circulation of hypercholesterolemic patients: a monitoring test of endothelial dysfunction for clinical practice? , 2003, Journal of the American College of Cardiology.

[19]  D. Atkins,et al.  American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. , 2003, Circulation.

[20]  S. Daniels,et al.  Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, , 2003, Circulation.

[21]  S. Arslanian Type 2 Diabetes in Children: Clinical Aspects and Risk Factors , 2004, Hormone Research in Paediatrics.

[22]  K. Flegal,et al.  Weight-for-stature compared with body mass index-for-age growth charts for the United States from the Centers for Disease Control and Prevention. , 2002, The American journal of clinical nutrition.

[23]  C. C. Hsu,et al.  Increased cutaneous blood flow but impaired post-ischemic response of nutritional flow in obese children. , 1999, Atherosclerosis.

[24]  F. Logerfo,et al.  Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes. , 1999, Diabetes.

[25]  A. Shore,et al.  The biological zero signal in laser doppler fluximetry – origins and practical implications , 1999, Pflügers Archiv.

[26]  O. Raitakari Imaging of subclinical atherosclerosis in children and young adults. , 1999, Annals of medicine.

[27]  R. Tracy,et al.  Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. , 1998, The New England journal of medicine.

[28]  M. Georgieff,et al.  Cholesterol in Childhood , 1998, Pediatrics.

[29]  American Academy of Pediatrics. Committee on Nutrition. Cholesterol in childhood. , 1998, Pediatrics.

[30]  B. Gower,et al.  Abdominal obesity and cardiovascular risk in children , 1998, Coronary artery disease.

[31]  J. Deanfield,et al.  Endothelium-dependent dilatation is impaired in young healthy subjects with a family history of premature coronary disease. , 1997, Circulation.

[32]  J. Hebebrand,et al.  Significant weight gains in a clinical sample of obese children and adolescents between 1985 and 1995 , 1997, International Journal of Obesity.

[33]  K Wårdell,et al.  Duplex laser Doppler perfusion imaging. , 1996, Microvascular research.

[34]  S. Srinivasan,et al.  Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. , 1996, Metabolism: clinical and experimental.

[35]  T. Williams,et al.  Evidence for sensory nerve involvement in cutaneous reactive hyperemia in humans. , 1993, Circulation research.

[36]  G. Nilsson,et al.  Laser Doppler perfusion imaging by dynamic light scattering , 1993, IEEE Transactions on Biomedical Engineering.

[37]  Abbot Nc,et al.  Biological zero in laser Doppler measurements in normal, ischaemic and inflamed human skin. , 1993 .

[38]  J S Beck,et al.  Biological zero in laser Doppler measurements in normal, ischaemic and inflamed human skin. , 1993, International journal of microcirculation, clinical and experimental.

[39]  J Swedenborg,et al.  Effects of local hyperemia and edema on the biological zero in laser Doppler fluxmetry (LD). , 1992, International journal of microcirculation, clinical and experimental.

[40]  P. Allhoff,et al.  Bogalusa Heart Study , 2020, Encyclopedia of Behavioral Medicine.

[41]  L. Petersen,et al.  Simultaneous assessment of blood flow in UVB-inflamed human skin by laser Doppler flowmetry and the 133-xenon washout technique. , 1991, Acta dermato-venereologica.

[42]  T. Nikkari,et al.  Histological and histochemical studies on local coronary wall thickenings (cushions) in Finnish children who died violently , 1990 .

[43]  T. Nikkari,et al.  Histological and histochemical studies on local coronary wall thickenings (cushions) in Finnish children who died violently. Cardiovascular risk in young Finns? , 1990, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[44]  Deric P. Jones,et al.  Noninvasive Measurement of the Human Peripheral Circulation: Relationship Between Laser Doppler Flowmeter and Photoplethysmograph Signals from the Finger , 1988, Angiology.

[45]  G. Cokelet,et al.  The Fahraeus effect. , 1971, Microvascular research.

[46]  Charles R. Scriver,et al.  Committee on Nutrition , 1956, Pediatric Clinical Practice Guidelines & Policies.