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CLINICAL RESEARCH: PEDIATRIC CARDIOLOGY

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, University of Rostock, Rostock, Germany
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)

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