It is well recognised that many fat (obese) children go on to develop cardiovascular disease (disease of the arteries that leads to heart attacks and strokes) later in life. The reasons why this happens are unclear. In a study of severely obese children, reported in this week's Lancet, Dr Patrick Tounian and colleagues from Paris, France, show that obese children already had abnormalities in their arteries.
The authors’ investigation of 48 obese children compared the results of tests done on arteries with those done on 27 children who were not obese. All the tests done were non-invasive - the tests did not use needles or any other methods to cause the children pain or discomfort. The obese children had severe obesity, with a body-mass index (BMI, calculated from weight and height) three times or more than the average for French children of the same age. The tests involved examining the carotid artery (the main artery in the neck) with ultrasound and the way an artery in the arm reacted to brief obstruction with a blood-pressure-measuring cuff or to glyceryl trinitrate sprayed under the tongue.
Results showed that there were striking differences in several measures of arterial health: stiffness and elasticity of the arterial wall, and the function of the lining of the arteries (endothelium), which are known to be associated with heart disease, strokes, and other diseases.
The authors remark that paediatricians treating obese children are well aware how difficult it is get these children to lose weight, but warn that unless greater success is achieved, “The current large increase in the prevalence of childhood obesity will translate into a rise in cardiovascular morbidity and mortality”.
Contact: Dr Patrick Tounian, Department of Paediatric Gastroenterology and Nutrition, Armand-Trousseau Hospital, 26 avenue de Dr Arnold Netter, 75012 Paris, France. T) +33 44 73 63 61; F) +33 144 73 62 28; E) p.tounian@trs.ap-hop-paris.fr
Journal
The Lancet