The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks.

Early detection of all complications of childhood obesity is imperative in order to minimize effects. Obesity causes vascular disruptions, including early increased arterial stiffness and high blood pressure. This study's aim is to assess the reliability of pulse wave analysis (PWA) in obese children and how additional risk factors influence the evaluated parameters. We analyzed 55 children aged 6-18 years old by measuring their pulse wave velocity (PWV), augmentation index (AIx), peripheral blood pressure (SBP, DBP), heart rate, central blood pressure (cSBP, cDBP) and central pulse pressure (cPP). We used the oscillometric IEM Mobil-O-Graph and performed a single-point brachial measurement. The subjects were divided into two groups: obese (n = 30) and normal-weight (n = 25) and were clinically and anamnestically assessed. BMI and waist circumference are significantly correlated to higher values for PWV, SBP, DBP, cSBP, and cDBP. Weight significantly predicts PWV, SBP, DBP and cPP. The risk factors that significantly influence the PWA and BP values are: a cardiometabolically risky pregnancy (higher PWV, AIx, SBP), active and passive smoking (higher PWV, SBP, cSBP, cDBP), sleep deprivation (higher PWV, SBP, cSBP) and sedentariness (higher PWV, AIx, peripheral and central BP). We conclude that obese children with specific additional cardiometabolic risk factors present increased arterial stiffness and higher blood pressure values.

No clinical utility of common polymorphisms in IGF1, IRS1, GCKR, PPARG, GCK1 and KCTD1 genes previously associated with insulin resistance in overweight children from Romania and Moldova.

Background Previous genome-wide association studies (GWAS) identified IGF1, IRS1, GCKR, PPARG, GCK1 and KCTD1 as candidate genes for insulin resistance and type 2 diabetes (T2D). We investigated the associations of these previously reported common variants in these genes with insulin resistance in overweight children from Romania and Moldova. Methods Six single nucleotide polymorphisms (SNPs), IGF1 (rs35767), IRS1 (rs2943634), GCKR (rs780094), PPARG (rs1801282), GCK1 (rs1799884) and KCTD15 (rs29941), were genotyped in 100 overweight children along with clinical and metabolic parameters. Homeostatic model assessment of insulin resistance (HOMA-IR) above 3.4 (defining insulin resistance) was used as the outcome. Results Children differed in insulin resistance status despite having similar body mass index (BMI) standard deviation scores (SDS) (World Health Organization, [WHO] reference). The identified predictors for altered insulin metabolism were higher cholesterol levels, higher diastolic blood pressure and higher waist-to-hip-ratio (as a marker for increased abdominal fat). None of the SNPs showed significant association with increase in the risk for insulin resistance in children (p range=0.478-0.724; odds ratio [OR] range=1.924-4.842); however, the risk allele in GCKR (rs780094, p=0.06, OR=6.871) demonstrated near statistical significance. Conclusions The interrogated risk alleles did not show any significant association with insulin resistance in children in our cohort; however, the GCKR (rs780094) might be a viable candidate in larger cohorts. The lack of replication of the proposed association may point to differences in linkage disequilibrium or effect modifiers across studies.

A novel method for measuring subcutaneous adipose tissue using ultrasound in children - interobserver consistency.

BACKGROUND: Currently, sufficiently accurate field methods for body composition assessment in children are missing. The ultrasound method for assessing adipose tissue thickness has been used extensively in sport medicine. However, there are no studies looking at the reliability of this method in non-athletic children. This paper aims to determine the inter-observer reliability in measuring the uncompressed subcutaneous adipose tissue thickness using ultrasound, in children. SUBJECTS, MATERIALS AND METHODS: Forty healthy children (20 males, 20 females), median age 11.85 years (5.3 to 18.1 years) were evaluated. Median body mass index standard deviation score (BMI SDS) was -0.13 (-3.9 to 4). Three observers used a Hosand BX 2000 Ultrasonic Adipometer to measure uncompressed subcutaneous adipose tissue thickness at three sites: triceps, subscapular, supraspinale. A single experienced observer used the three sites to also measure the compressed adipose thickness using a skinfold caliper. RESULTS: Individual observer deviations from the mean value of the three observers in adipometer measurement had a standard deviation of 1.74 mm, 92.8% were less than 3 mm. Analysis separated by individual anatomical sites showed high reliability values for triceps: linear regression R²=0.84, p=0.000; intraclass correlation coefficient (ICC)=0.92 and standard error of measurement (SEM)=0.63. The values at supraspinale site were R²=0.82, p=0.000, ICC=0.89 and SEM=1.17, while for subscapular the values were lower: R²=0.79, p=0.000, ICC=0.78 and SEM=1.02. The body fat percentage (BF%) calculated using skinfold measurements was highly correlated with the BF% calculated by the adipometer (R=0.92, R²=0.83, p=0.000). The Pearson's correlation between BMI SDS and BF% calculated from skinfold was R=0.52, R²=0.28, p=0.001, while for the adipometer it was R=0.53, R²=0.27, p=0.000. CONCLUSIONS: This novel ultrasound measurement technique can be used with good accuracy and reliability to measure uncompressed subcutaneous adipose tissue thickness in children, sustaining its application for research and clinical purposes, however larger studies are needed.