Table 2

Endo-PAT 2000 in paediatric patients who are overweight (OW)/obese (14 studies)

Title, lead authorYearStudy designPopulation: n=sample size, age; mean±SD or median (range),(F/M)Control group: n=sample size, age; mean±SD or median (range),(F/M)Results: RHI reported. if RHI not specified, we reported p/r valuesOutcomes
Effects of a dietary strawberry powder on parameters of vascular health in adolescent males. Djurica et al282016Randomised, double-blind, cross-over studyn=15 OW/obese males, 14–18 years (mean 16). 1-week daily 50 g freeze-dried strawberry powder (FDSP) Before/after nitrate/nitrite levels measured.n=10 control powder, 14–18 years (mean 16).Acute plasma nitrate/nitrite levels increased 1 hour after consuming the FDSP (p<0.001). When nitrate levels increased after FDSP intake compared with controls, had an increase in RHI (p=0.014).Strawberries can provide vascular health benefits to OW/obese adolescent males.
Flow-mediated dilation in obese adolescents: Correlation with waist circumference (WC) and systolic blood pressure (SBP). Hussid et al292018Case–control studyn=20 obese patients, median age 14 yearsn=10 normal weight, median age 15 years, paired for genderNo RHI difference between groups. 35% obese group had metabolic syndrome, none in control group. OSA in 86.6% obese and 50% of normal weight group.Obese group had evidence of ED and metabolic syndrome. Increased WC and SBP seem to be related to this finding.
Improvement of microvascular endothelial dysfunction induced by exercise and diet is associated with microRNA-126 in obese adolescents. Donghui et al302019Quasi-randomised studyn=57 obese male adolescents, 12–18 (15.38±2.82) years,(F/M=0/57), 6-week exercise programme with dietary intervention.n=10 normal weight adolescents, 15.38±2.82 years,(F/M 0/10), maintained sedentaryObese group RHI 1.43 (0.35) vs controls 1.67 (0.36) (p<0.05). After 6 weeks RHI increased (p<0.01) and microRNA-126 decreased (p<0.01). miRNA-126 positively correlated with ΔRHI (r=0.69, p<0.05).RHI improved in obese group after exercise and diet interventions. Findings might be related to changes in serum miRNA-126.
Distribution of peripheral arterial stiffness and endothelial function as well as their correlations with cardiovascular risk factors in children and adolescents. Mu et al312016Cross-sectional population-based study, conference abstractn=94 obese, 7–17 years, used automatic waveform analyser (BP-203RPE-I) and Endo-PAT 2000.n=452 normal weightIn normal weight group, RHI increased with age (r=0.33, p<0.01; r=0.36, p<0.01). RHI positively correlated with BMI (r=0.10, p=0.018) but negatively with DBP (r=−0.10, p=0.016).RHI increased along with age. Arterial stiffness and endothelial function continued to develop in the normal weight group.
Urinary biomarkers as indicator of chronic inflammation and endothelial dysfunction in obese adolescents. Singh et al872017Control study, research articlen=63 total. n=14 overweight (OW), n=29 obese, age 13.8 (2.4),(F/M 23/20)n=20 normal weight (NW), age 13.9,2(F/M 8/12)There were no differences in RHI levels: NW 1.6 (0.1), OW 1.66 (0.1) and obese 1.67 (0.1). NW girls RHI 1.9 vs NW boys 1.25.No significant correlation between RHI and urinary markers. RHI higher in NW female adolescents.
Prevalence of Type D personality in obese adolescents and associated cardiovascular risk. Bruyndonckx et al882018Control study, conference abstractObese adolescents-no definite numbersHealthy normal weight childrenPositive correlation in obese adolescents between negative affectivity and vascular stiffness (r=0.28; p=0.04)Obese adolescents have worse cardiovascular risk profile with ED.
Endothelial function and arterial stiffness in obese adolescents - A relation to barorefex function. Czippelova et al362017Conference abstractn=22 obese, 15.28±2.8 years,(F/M 10/12)n=22 non-obese, 15.98±2.46 years,(F/M 10/12)No significant difference in RHI (p=0.473). Baro-reflex sensitivity was also calculated.No difference in RHI between groups. Findings require further study.
Obesity in children and adolescents: A relation to endothelial function and arterial stiffness. Czippelova et al372016Conference abstractn=16 obese adolescents,15.22±2.2 years, (F/M 7/9)n=16 non-obese, 16.22±1.5 years, (F/M 7/9)Significant difference in RHI (p=0.018) with RHI higher in obese group (1.66±0.28 vs 1.4±0.25).Less early atherosclerotic changes in obese group; in contrast to expectations. Findings require further study.
Preclinical vascular alterations in obese adolescents detected by Laser-Doppler Flowmetry technique. Fusco et al392020Research articlen=22 obese adolescents, 14.11
±2.53, (F/M 13/9)
n=24 normal weight, 15.2±1.56, (F/M 11/13)Similar RHI between obese and non-obese groups (1.80±0.62 and 1.86±0.51).RHI did not differ between groups. RHI did not correlate with LDF.
Impaired endothelial function in adolescents with overweight or obesity measured by peripheral artery tonometry. Pareyn et al892015Cross-sectional studyn=27 overweight (OW)/obesity, 14.7 (13.0–16.4) years, (F/M 11/16)n=25 normal weight controls, 15.5 (13.9–16.2) years,(F/M 13/12)RHI normal weight 1.88 (1.7–2.4) vs OW/
obese 1.5 (1.3–1.9) (p<0.05). Lower RHI if OW/obese (p=0.027).
RHI positively correlated with age and tanner stage (p<0.05).
ED and higher baseline pulse amplitude in OW group.
C-type natriuretic peptide (CNP) plasma levels and whole blood mRNA expression show different trends in adolescents with different degree of endothelial dysfunction. Del Ry et al322020Research article—snow ballingn=16 primary obesity, not DM, age 13.3 (0.5) years, (F/M 8/8).n=24 normal weight, age 14.3 (0.4) years, (F/M 14/10).RHI normal weight 2.1 (0) vs obese 1.4 (0) (p<0.005). RHI negatively associated with CNP and diastolic BP (p<0.005).RHI significantly lower in obese group. RHI negatively related with CNP, DBP, fat mass and HbA1C.
C-type natriuretic peptide (CNP) is closely associated to obesity in Caucasian adolescents. Del Ry et al332016Research article—snow ballingn=10 overweight, age 12.8 (1.6) years, (F/M 5/5). n=45 obese, 12.8 (1.6) years, (F/M 19/26)n=27 normal weight, age 12.8 (1.4) years, (F/M 14/13)Normal weight group RHI 2.1 (0.2) vs OW 1.6 (0.4) (p<0.05). Normal weight vs obese group RHI 1.4 (0.3) (p<0.005). RHI negatively associated with CNP (p<0.005).RHI lower in overweight/ obese groups. CNP negatively related with RHI.
Arterial Stiffness and Endothelial Function in Young Obese Patients - Vascular Resistance Matters. Czippelova et al72019Research articleAuthor contacted for separate paediatric data. n=16 obese group, age<16 years, (F/M 7/9)n=15 controls, age<16 years, (F/M 7/8)RHI control vs obese groups: 1.320±0.427 and 1.457±0.280. RHI obese girls and boys: 1.410±0.253 and 1.494±0.308. RHI control girls and boys: 1.171±0.210 and 1.436±0.524RHI is influenced by vascular tone and resistance. RHI in obese positively related with SVR.
Cardiovascular adaptations after 10 months of intense school-based physical training for 8- to 10-year-old children. Larsen et al352018Randomised control studyn=93 small-sided games group, 9.3±0.4 years. n=83 circuit strength training group, 9.3±0.3 years (10–16 years)n=115 controls, 9.3±0.3 yearsNo significant differences in RHI. Pubertal status is a main predictor of RHI; positive correlation between Tanner stages and RHI.10 months of regular exercise per week decreased DBP and had effects on cardiovascular health.
  • CNP, C-type natriuretic peptide; ED, endothelial dysfunction; FDSP, freeze-dried strawberry powder; LDF, laser-Doppler flowmetry; NW, normal weight; OW, overweight; RHI, reactive hyperemia index; WC, waist circumference.