Waist circumference change and risk of high carotid intima-media thickness in a cohort of Chinese children

Diagnostic performance of different anthropometric indices among Iranian adolescents for intima media thickness in early adulthood: A prospective study and literature review

Background

There is debate regarding which anthropometric indices is the most appropriate predictor of cardiovascular disease (CVD) among adolescents. The purpose of this study was to investigate the association of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) in adolescents with high carotid intima-media thickness (cIMT) in early adulthood, as the surrogate marker of CVD in a cohort study.

Methods

A total of 875 Iranian adolescents (female = 421) aged 10-17 years old were entered the study. The cIMT was measured in early adulthood (20-38 years old) after 18.2 (median) years of follow-up and defined as > 90th percentile for sex and age groups. The gender specific association between a 1-SD increase in each anthropometric measures with high cIMT was examined using multivariate logistic regression analysis adjusted for age, smoking, family history of CVD, systolic blood pressure, total cholesterol, and fasting blood sugar. In the multivariable analysis, the interaction between sex and age groups with anthropometric measures were significant (all p-values < 0.05).

Results

Among males, all anthropometric measures including BMI, WC, WHR, and WHtR were associated with high cIMT; the corresponding odds ratios were 1.43 (1.05-1.94), 1.63 (1.22-2.19), 1.33 (1.03-1.71), and 1.41 (1.07-1.87), respectively. However, after considering the related adulthood anthropometric measurements, the association remained significant for WC 1.48 (1.04-2.10) and WHR [1.28 (0.99-1.66), P = 0.06]. Moreover, among early adolescent boys aged 10-14 years, all of the anthropometric measures were significantly associated with high cIMT in the multivariate analysis that included the related adulthood anthropometric measures. The area under the curve (AUC) for the anthropometric measurements among males ranged from 0.576 for WHtR up to 0.632 for WC, without any superiority between them. Among females, only in linear regression analysis, a significant association were found between the higher value of WC and WHtR with cIMT measurement in adulthood; however, the risk reached to null after considering adult anthropometric measures.

Conclusion

General and central obesity measures were significantly associated with high cIMT only among Iranian male adolescents, the relationship that were more prominent among pre-pubertal males.

Serum MOTS-C Levels are Decreased in Obese Children and Associated with Vascular Endothelial Function

PURPOSE

The increasing prevalence of obesity in children and its associated risk with cardiovascular diseases demand more discovery of the novel biomarkers for developing new treatment options for this complex disease. This study aimed to investigate the association of serum MOTS-C (a peptide encoded in the mitochondrial genome) levels and vascular endothelial function in obese children.

PATIENTS AND METHODS

A total of 225 obese children (aged 8.1 ± 2.6 years) and 218 healthy children (aged 7.9 ± 2.2 years) were enrolled. Related anthropometric assessment and biochemical evaluation were done in all subjects. Reactive hyperemia index (RHI), as assessed by the peripheral arterial tonometry, was used for evaluation of peripheral endothelial function. Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of serum MOTS-C.

RESULTS

Levels of serum MOTS-C and RHI were lower in the obese children compared with the healthy children (P < 0.01). The RHI level was independently associated with body mass index, high-density lipoprotein cholesterol, and MOTS-C in linear regression analysis. Further analysis showed a significant mediating effect of MOTS-C on the correlation between body mass index and RHI in children, with the ratio of mediating effect value of 9.12%.

CONCLUSION

These data identify that MOTS-C is a previously unknown regulator in the development process of obesity-induced vascular changes.

Weight status change from birth to childhood and high carotid intima-media thickness in childhood

BACKGROUND

High birth weight or childhood overweight increases the risk of high carotid intima-media thickness (cIMT) in childhood. However, no studies have assessed the association between change in weight status from birth to childhood and cIMT in childhood.

OBJECTIVES

We examined the association between weight status change from birth to childhood and cIMT in childhood based on a population-based study of Chinese children.

METHODS

Data were from the Huantai Childhood Cardiovascular Health Cohort Study. A total of 1307 primary school children aged 6-11 years were included. Children were categorized into four groups based on their weight status at birth and at childhood: persistently normal weight, weight loss, weight gain, and persistently high weight.

RESULTS

Compared with children with persistently normal weight from birth to childhood, those with weight gain (odds ratio [OR] = 6.01, 95% confidence interval [CI] = 3.36-10.76) and persistently high weight (OR = 5.78, 95% CI = 2.60-12.82) had increased odds of high cIMT in childhood. In contrast, children who had high birth weight but became normal weight in childhood did not have significantly increased odds of high cIMT in childhood (OR = 1.27, 95% CI = 0.28-5.67).

CONCLUSIONS

Overweight in childhood was associated with increased odds of high cIMT irrespective of birth weight status. The odds of high cIMT in childhood could be reversed if newborn with high birth weight become normal weight in childhood.

A Systematic Review of the Associations of Adiposity and Cardiorespiratory Fitness With Arterial Structure and Function in Nonclinical Children and Adolescents

PURPOSE

To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents.

METHODS

Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5-17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies.

RESULTS

Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality.

CONCLUSION

While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.

Relationship between lifestyle and metabolic factors and carotid atherosclerosis: A survey of 47,063 fatty and non-fatty liver patients in China

Background and aims

Carotid atherosclerosis and stenosis are common lesions of the artery wall that form the basis of cardiovascular events. Compared with coronary atherosclerosis, few studies have explored the influencing factors of carotid atherosclerosis. The aim of this study was to explore the influencing factors of carotid atherosclerosis and carotid stenosis without and with fatty liver disease (FLD).

Methods

A total of 47,063 adults were recruited for this cross-sectional study. The color Doppler ultrasound, including metabolic factors and lifestyle surveys, was used to determine whether the participants had FLD and carotid artery disease. Multiple logistic regression was used to investigate the influencing factors of lifestyle and metabolism of carotid atherosclerosis and stenosis in the participants with and without FLD.

Results

In participants without FLD, current alcohol consumption (OR: 0.749, 95% CI: 0.588) and hip circumference (OR: 0.970, 95% CI: 0.961, 0.979) were the main protective factors for carotid atherosclerosis. Systolic blood pressure (OR: 1.022, 95% CI: 1.019, 1.025) and diastolic blood pressure (OR: 1.005, 95% CI: 1.001, 1.010), elevated fasting blood glucose (OR: 1.012, 95% CI: 1.005, 1.019), and non-sedentary behavior (OR: 1.084, 95% CI: 1.014, 1.160) were the main risk factors for carotid atherosclerosis. Hip circumference (OR: 0.932, 95% CI: 0.910, 0.954) and low-density lipoprotein (OR: 0.979, 95% CI: 0.964, 0.994) were protective factors for carotid stenosis. Smoking (OR: 3.525, 95% CI: 1.113, 11.169) and unqualified exercise (OR: 1.402, 95% CI: 1.083, 1.815) were risk factors for carotid stenosis. In participants with FLD, smoking (OR: 0.827, 95% CI: 0.703, 0.973) and hip circumference (OR: 0.967, 95% CI: 0.958, 0.977) were the main protective factors for carotid atherosclerosis. BMI 18.5–23.9 (OR: 1.163, 95% CI: 1.002, 1.351), non-sedentary behavior (OR: 1.086, 95% CI: 1.009, 1.168), and waist circumference (OR: 1.030, 95% CI: 1.022, 1.038) were the main risk factors for carotid atherosclerosis.

Conclusion

Based on a large-sample check-up population in China, this study investigated the influencing factors of carotid atherosclerosis and carotid stenosis in fatty liver and non-fatty liver patients and explored the influencing factors of metabolism and lifestyle, which were mainly focused on exercise, sedentary behavior, smoking, alcohol consumption, hip circumference, and blood pressure.