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

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 ± 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 ± 2.3 vs 9.7 ± 3.0%, P < 0.0001) and increased carotid IMT (0.49 ± 0.04 mm vs 0.45 ± 0.04 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.