Table 2.
Endo-PAT 2000 in paediatric patients who are overweight (OW)/obese (14 studies)
| Title, lead author | Year | Study design | Population: 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 values | Outcomes |
| Effects of a dietary strawberry powder on parameters of vascular health in adolescent males. Djurica et al28 | 2016 | Randomised, double-blind, cross-over study | n=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 al29 | 2018 | Case–control study | n=20 obese patients, median age 14 years | n=10 normal weight, median age 15 years, paired for gender | No 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 al30 | 2019 | Quasi-randomised study | n=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 sedentary | Obese 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 al31 | 2016 | Cross-sectional population-based study, conference abstract | n=94 obese, 7–17 years, used automatic waveform analyser (BP-203RPE-I) and Endo-PAT 2000. | n=452 normal weight | In 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 al87 | 2017 | Control study, research article | n=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 al88 | 2018 | Control study, conference abstract | Obese adolescents-no definite numbers | Healthy normal weight children | Positive 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 al36 | 2017 | Conference abstract | n=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 al37 | 2016 | Conference abstract | n=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 al39 | 2020 | Research article | n=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 al89 | 2015 | Cross-sectional study | n=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 al32 | 2020 | Research article—snow balling | n=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 al33 | 2016 | Research article—snow balling | n=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 al7 | 2019 | Research article | Author 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±0.524 | RHI 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 al35 | 2018 | Randomised control study | n=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 years | No 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.