Flow-mediated Arterial Dilatation, Hypertension, Endothelin-1 and sICAM-1 in Obese Adolescents
Condition: Obesity; Hypertension; Adolescent Obesity
MeSH terms: Hypertension; Obesity; Pediatric Obesity; Dilatation, Pathologic
Study type: Observational [Patient Registry]

Summary: 
      Obesity in adolescents is associated with the development of cardiovascular disease and type
      2 diabetes mellitus. In order to detect early development of cardiovascular disease, early
      detection of the endothelium of obese adolescents is needed. Endothelium dysfunction is an
      early stage of developing atherosclerosis, which can be a predictor of cardiovascular disease
      development in the future. Flow mediated dilatation (FMD) is a non-invasive method that can
      measure endothelium function and predict the risk of cardiovascular disease, which is not
      only able to measure artery diameter, but also provides function index of nitric oxide (NO)
      in the endothelium. FMD is negatively related to BMI. Meanwhile, Endothelin-1 (ET-1) is
      thought to play a role in the pathogenesis of insulin resistance, because when its levels
      increase, ET-1 can cause a condition of hyperinsulinemia. ET-1 was found to be high in
      patients with cardiovascular disorders, as well as in obese and diabetic subjects.
      Alternative methods for assessing endothelial function by measurement of biomarkers of
      activation and endothelial dysfunction such as soluble intercellular adhesion molecule-1
      (sICAM-1). Levels of sICAM-1 have been found to be related positively to age, systolic and
      diastolic blood pressure, hypercholesterolemia, hypertriglyceridemia and inversely to
      estrogen. Furthermore, associations have been found between sICAM-1 and cardiovascular
      mortality in both healthy individuals and populations at high risk.

      The aim of the study was to evaluate FMD, concentrations of ET-1 and sICAM-1 in adolescents
      with a presence of obesity and hypertension and to compare these with controls (obesity and
      non hypertension), as well as to analyze the correlations between FMD, ET-1, sICAM-1 and
      blood pressure values.
    

Detailed description: 
      This study is cross sectional study with observational analytic that evaluates FMD, ET-1 dan
      sICAM-1 in obese adolescents with hypertension compared to obese adolescents without
      hypertension and normal adolescents. The subjects are 70 adolescents (obese and normal) aged
      13-18 years, healthy, not undergoing any medication, not smoking and not drinking alcohol,
      which are further divided into 3 groups: obesity with hypertension, obesity without
      hypertension and normal. Examination includes blood pressure examination, brachial ultrasound
      and blood sampling to measure levels of profile lipid, blood glucose, ET-1, and sICAM-1.
      Blood sample of subjects were taken by laboratory employee of the general hospital in
      Surabaja, Indonesia.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Obese adolescents aged 13-18 years old
      
Biospecimen description: 
      the samples in the form of blood for investigation: lipid profile, fasting blood glucose,
      fasting insulin, endothelin-1 adn sICAM-1
    
Keywords: Obesity; Flow-mediated Arterial Dilatation; Hypertension; sICAM-1