Preclinical vascular alterations in obese adolescents detected by Laser-Doppler Flowmetry technique.
BACKGROUND AND AIMS
Childhood obesity promotes adverse changes in cardiovascular structure and function. This study evaluated whether alterations in skin microcirculation were already present in obese adolescents in a pre-clinical phase of cardiovascular disease.


METHODS AND RESULTS
After an overnight fasting 22 obese adolescents and 24 normal-weight controls of similar age and gender distribution underwent clinical and blood examination and assessment of microvascular function by using two non-invasive techniques such as Peripheral Artery Tonometry (PAT) and Laser-Doppler Flowmetry (LDF). As compared to normal weight subjects, obese children had higher blood pressure, were significantly more hyper-insulinemic and insulin resistant, showing significantly higher plasma total cholesterol, LDL cholesterol, triglycerides and alanine aminotransferase (ALT). LDF showed lower pre- and post-occlusion forearm skin perfusion (perfusion units/second (PU/sec); median [IQR]) in obese than in normal weight subjects (pre-occlusion: 1633.8 [1023.5] vs. 2281.1 [1344.2]; p = 0.015. Post-occlusion: 4811.3 [4068.9] vs. 7072.8 [7298.8]; p = 0.021), while PAT revealed similar values of reactive hyperemia index (RHI). In entire population, fat mass % (FM%) was an independent determinant of both pre-and post-occlusion skin perfusion. Finally, being obese was associated with a higher risk to have a reduction of both pre- and post-occlusion skin perfusion (OR = 5,82 and 9,27, respectively).


CONCLUSION
LDF showed very early, pre-clinical, vascular involvement in obese adolescents, characterized by impaired skin microcirculation, possibly reflecting a more diffuse microvascular dysfunction to other body tissues. Whether changing life style and improving weight may reverse such pre-clinical alterations remains to be established.
['Fusco|Eleonora|E|', 'Pesce|Margherita|M|', 'Bianchi|Vanessa|V|', 'Randazzo|Emioli|E|', 'Del Ry|Silvia|S|', 'Peroni|Diego|D|', 'Rossi|Marco|M|', 'Federico|Giovanni|G|']
D050154:Adiposity D000293:Adolescent D001783:Blood Flow Velocity D002318:Cardiovascular Diseases D016022:Case-Control Studies D005260:Female D005542:Forearm D006801:Humans D017078:Laser-Doppler Flowmetry D008297:Male D008365:Manometry D008833:Microcirculation D063766:Pediatric Obesity D011237:Predictive Value of Tests D012867:Skin
Obesity Laser-Doppler flowmetry Skin Microcirculation Peripheral artery tonometry