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Association of Changes in Oxidative and Proinflammatory States with Changes in Vascular Function after a Lifestyle Modification Trial Among Obese Children

¹ Preventive Pediatric Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences; ² Isfahan School of Medicine, Isfahan University of Medical Sciences; ³ Nutrition Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences; ⁴ Basic Science Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical, Sciences.

^aAddress correspondence to this author at: Roya Kelishadi, MD, Associate Professor of Pediatrics, Head, Preventive Pediatric Cardiology Department, Research Director, Isfahan Cardiovascular Research Centre, (WHO- Collaborating Centre in EMR), Isfahan University of Medical Sciences, Address: P.O. Box 81465-1148, Isfahan, Iran. Fax +98 311 3373435; e-mail kroya{at}aap.net, kelishadi{at}med.mui.ac.ir.

Background: The association of changes in oxidative and proinflammatory states with vascular function after diet and exercise intervention among obese children has not been previously explored.

Methods: In this 6-week diet and exercise intervention study in 35 obese children, age 12 to 18 years, we evaluated the relationship between changes in anthropometric indices, measures of insulin resistance, C-reactive protein (CRP), oxidized LDL (ox-LDL), and oxidative stress markers with changes in carotid intima-media thickness (C-IMT) and flow mediated dilation (FMD) of the brachial artery.

Results: At the end of the study, body mass index (BMI), waist circumference, and percentage body fat were decreased (P <0.05), but participants remained overweight (BMI 95th percentile). Although FMD improved (P <0.05), the improvement in C-IMT did not reach statistical significance. The changes in BMI, waist circumference, fat mass, ox-LDL, malondialdehyde (MDA), CRP, insulin, and homeostasis model assessment for insulin resistance (HOMA-IR) had an inverse correlation with the changes in mean FMD after adjustment for age and sex, with the highest correlations documented for ox-LDL, CRP, and WC. The age- and sex-adjusted changes in ox-LDL, waist circumference, CRP, MDA, and body fat mass had the highest correlations with changes in C-IMT.

Conclusions: Our findings suggest that a common inflammatory stress condition associated with childhood obesity, notably with abdominal fat deposition, may play a role in the development of the earliest stages of proatherosclerotic inflammatory processes and subsequent vascular dysfunction. These changes might be partially reversible by short-term diet and exercise intervention, even if patients do not reach ideal body weight.

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