ESPN 50th Annual Meeting

ESPN 2017


 
Ambulatory Arterial Stiffness Index (AASI), a surrogate marker of arterial stiffness, is increased in obese children
MEHMET TAŞDEMİR 1 ERGİN ERGİNÖZ 2 ÖZLEM BOSTAN GAYRET 4 ILMAY BİLGE 3

1- KOÇ UNIVERSITY HOSPITAL, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ISTANBUL, TURKEY
2- KOÇ UNIVERSITY SCHOOL OF MEDICINE, ISTANBUL, TURKEY
3- KOÇ UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF PEDIATRICS, DIVISION OF PEDIATRIC NEPHROLOGY, ISTANBUL, TURKEY
4- MINISTRY OF HEALTH BAĞCILAR TRAINING AND RESEARCH HOSPITAL, ISTANBUL, TURKEY
 
Introduction:

Increased arterial stiffness is an important risk factor for cardiovascular disease. One way to measure arterial stiffness is the ambulatory arterial stiffness index (AASI), which is the relationship between diastolic and systolic ambulatory blood pressure (BP) over 24 hours. In this prospective study, we studied the difference in AASI between obese and lean children.

Material and methods:

AASI was calculated from ABPM in 53 obese children (33 girls) and compared with age- and gender-matched 42 healthy subjects (20 girls). AASI was obtained by performing a linear regression analysis of diastolic BP over systolic BP and subtracting the regression slope from 1. Hypertension was defined according to the criteria of American Heart Association. To evaluate inflammation, the blood level of high sensitive C-reactive protein (hsCRP) was measured.

Results:

The mean age was 10.6±2.83 years in obese children and 11.3±3.17 years in healthy subjects. Hypertension was determined in three (5.6%) obese children. AASI was significantly increased in obese children compared to healthy subjects (median, IQR: 0.43, (0.13-0.73) versus 0.28, (-0.05-0.85), p<0.001). Heart rate was also higher in the obese group (mean±SD: 88.2±7.5 versus 83.2±8.4, p=0.002) but pulse pressure and blood pressure values were similar. In a univariate analysis, AASI was independently correlated with indexed casual systolic blood pressure (cSBP, p=0.026), nighttime SBP-standard deviation score (p=0.005), systolic (p<0.001) and diastolic (p=0.022) nocturnal dipping, and hsCRP (p=0.02). In a multivariate analysis, AASI was independently predicted by indexed cSBP (p=0.005) and systolic nocturnal dipping (p=0.010).

Conclusions:

This study confirms that AASI and heart rate increased in obese children. AASI calculation is a useful, cheap, and an easy method to evaluate arterial stiffness. Early detection of increased arterial stiffness can help clinicians come up with preventive measures in the management of their patients.