Mráz M., Olexa P., Spurný P., Potočeková D., Kúseková M., Podracká Ľ.
1-st Dept. of Paediatrics, Šafárik University, Košice, Slovakia

AIMS: The aim of the study was to evaluate endothelial function and established serum markers of cardiovascular risk among the adolescents and young adults with higher cardiovascular risk.

METHODS: The study group included 204 subjects (104 males, 100 females; mean age 19,1±3,4 years) – of them 40 were active smokers (S), 36 patients were suffering from overweight or obesity (OO), 29 from essential hypertension and 26 from diabetes mellitus (DM). 73 healthy controls (C) with normal BMI matched for age and gender were included. Endothelial function was evaluated using brachial artery flow-mediated dilation (FMD). Maximal artery dilation response against baseline diameter up to 180 seconds after cuff deflation (peak FMD, %) and response in 60 seconds after cuff deflation (FMD 60) were assessed. Total cholesterol, HDL, LDL, triglycerides, uric acid, glucose and creatinine levels were analyzed from fasting blood samples. Glomerular filtration rate was calculated using Cockcroft-Gault formula and Schwartz formula (in DM subjects who were adolescents). Concentrations of glycated haemoglobin and albuminuria from 8-hours urine sample were evaluated within DM group.

RESULTS: Peak FMD and FMD 60 response was significantly lower in all groups with higher cardiovascular risk comparing to healthy controls indicating impaired endothelial function as the first manifestation of premature atherosclerosis. Peak FMD response was significantly higher when compared with FMD 60 within all studied groups. Serum total cholesterol, LDL, triglycerides, uric acid and fasting glucose were significantly elevated within the subjects with higher BMI (OO, EH).

CONCLUSIONS: The presence of main cardiovascular risk factors in adolescents and young adults is associated with impaired endothelial function and proatherogenic serum profile (in OO and EH) towards premature atherosclerosis emphasizing the need for cardiovascular diseases prevention already among the youth at risk. FMD seems to be a suitable ultrasound screening method to fulfill this goal. To determine the true peak FMD response several brachial artery diameter measurements up to 180 seconds after cuff release are needed.