This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2006.07.035v1 48/9/1865    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Meyer, A. A. Articles by Kienast, W. Search for Related Content PubMed PubMed Citation Articles by Meyer, A. A. Articles by Kienast, W.

CLINICAL RESEARCH

Improvement of Early Vascular Changes and Cardiovascular Risk Factors in Obese Children After a Six-Month Exercise Program

Andreas A. Meyer, MD^_*,_*, Günther Kundt, PhD, Ute Lenschow, MD^_*, Peter Schuff-Werner, PhD and Wolfgang Kienast, PhD^_*

^_* Division of Pediatric Cardiology, Children's Hospital, University of Rostock, Rostock, Germany
Institute of Medical Informatics and Biometry
Institute of Clinical Chemistry and Laboratory Medicine, University of Rostock, Rostock, Germany

Manuscript received April 25, 2006; revised manuscript received June 26, 2006, accepted July 3, 2006.

^_* Reprint requests and correspondence: Dr. Andreas Alexander Meyer, Universitätskinder- und Jugendklinik Rostock, Rembrandtstrasse 16-17, D-18055 Rostock, Germany (Email: andreas-alexander.meyer{at}medizin.uni-rostock.de).

OBJECTIVES: The present study aimed to assess the effect of a 6-month exercise program in obese children on flow-mediated vasodilation (FMD) carotid intima-media thickness (IMT) and cardiovascular risk factors (RF).

BACKGROUND: Childhood obesity contributes to adult obesity and subsequent cardiovascular disease. Physical inactivity is a major RF for obesity, endothelial dysfunction, and elevated carotid IMT, culminating in early atherosclerotic disease.

METHODS: Sixty-seven obese subjects (age 14.7 ± 2.2 years) were randomly assigned to 6 months' exercise or non-exercise protocol. We examined the influence of exercises (1 h, 3 times/week) on FMD, IMT, and cardiovascular risk profile.

RESULTS: Compared with lean control subjects, obese children demonstrated at baseline significantly impaired FMD (4.09 ± 1.76% vs. 10.65 ± 1.95%, p < 0.001), increased IMT (0.48 ± 0.08 mm vs. 0.37 ± 0.05 mm, p < 0.001), and a number of obesity-related cardiovascular RF. Significant improvements were observed in the exercise group for IMT (0.44 ± 0.08 mm, p = 0.012, –6.3%) and FMD (7.71 ± 2.53%, p < 0.001, +127%). This improvement correlated with reduced RF, such as body mass index standard deviation scores, body fat mass, waist/hip ratio, ambulatory systolic blood pressure, fasting insulin, triglycerides, low-density lipoprotein/high-density lipoprotein ratio, and low-degree inflammation (C-reactive protein, fibrinogen).

CONCLUSIONS: The present study documented increased IMT, impaired endothelial function, and various elevated cardiovascular RF in young obese subjects. Regular exercise over 6 months restores endothelial function and improves carotid IMT associated with an improved cardiovascular risk profile in obese children.

Abbreviations and Acronyms   BMI = body mass index   BP = blood pressure   CRP = C-reactive protein   FMD = flow mediated vasodilation   HDL = high-density lipoprotein   IL = interleukin   IMT = intima-media thickness   LDL = low-density lipoprotein   NO = nitric oxide   RF = risk factor(s)

This article has been cited by other articles:

				B. Fernhall and S. Agiovlasitis Arterial function in youth: window into cardiovascular risk J Appl Physiol, July 1, 2008; 105(1): 325 - 333. [Abstract] [Full Text] [PDF]

				A. Dogu, M. Erguven, O. Yilmaz, A. Hayirlioglu, and A. Erbahceci Investigation of Relationship of Atherosclerotic Risk Factors and Early Atherosclerotic Findings in Obese Children by Doppler Ultrasonography J Trop Pediatr, April 1, 2008; 54(2): 145 - 147. [Full Text] [PDF]

				R. Kelishadi, M. Hashemi, N. Mohammadifard, S. Asgary, and N. Khavarian Association of Changes in Oxidative and Proinflammatory States with Changes in Vascular Function after a Lifestyle Modification Trial Among Obese Children Clin. Chem., January 1, 2008; 54(1): 147 - 153. [Abstract] [Full Text] [PDF]

				S. S. Gidding Special Article: Physical Activity, Physical Fitness, and Cardiovascular Risk Factors in Childhood American Journal of Lifestyle Medicine, December 1, 2007; 1(6): 499 - 505. [Abstract] [PDF]

				A. S. Pena, E. Wiltshire, R. Gent, L. Piotto, C. Hirte, and J. Couper Folic Acid Does Not Improve Endothelial Function in Obese Children and Adolescents Diabetes Care, August 1, 2007; 30(8): 2122 - 2127. [Abstract] [Full Text] [PDF]