Pediatric Cardiology

Biography

Biography: Luc Bruyndonckx

Abstract

Endothelial dysfunction (ED), an early indicator of atherosclerosis, is present in obese adolescents. The first signs occur in small resistance vessels (micro vascular endothelial dysfunction), whereas later on, the larger conduit arteries are affected (macro vascular endothelial dysfunction). Macro vascular endothelial dysfunction in obese adolescents can be reversed by 6 weeks of exercise training. Whether micro vascular endothelial dysfunction is also reversible isn’t known.
The aim was to investigate the influence of a multicomponent treatment program on micro vascular function in obese adolescents. Additional endpoints were a reduced BMI SD-score, improved exercise capacity and an increase in Endothelial Progenitor Cells (EPC) and a decrease in Endothelial Micro Particles (EMP). Two cohorts of obese adolescents were recruited: an intervention group (n= 33; 15.4 ± 1.5 years, BMI: 36.44 ± 4.82 kg/m²), receiving supervised diet and exercise training and an ambulant treated usual care group (n= 28; 15.1 ± 1.2 years, BMI: 36.72 ± 5.83 kg/m²). Changes in body mass, cardiorespiratory fitness, micro vascular endothelial function, circulating EPC and EMP were evaluated after 5 months and at the end of the 10 month program. Residential treatment improved BMI and increased exercise capacity (p<0.001 after 5 and 10 months). Micro vascular endothelial function also improved in the intervention group (p= 0.04 at 10 months). Furthermore, intervention led to a significant increase in EPC numbers after 5 months (p=0.01); EMP counts decreased after 10 months (p=0.004).
Conclusion: A treatment regimen consisting of supervised diet and exercise training was effective in improving multiple adolescent obesity-related endpoints.