A recent study suggests that arterial stiffness, defined as the reduced distensibility (the stiffening) of the arterial wall, could be a new risk factor for metabolic syndrome in teens.

According to the World Health Organization, metabolic syndrome is “the constellation of three or more of the following: abdominal obesity, insulin resistance, hypertension, and hyperlipidemia”.

It increases the possibility of worsening obesity, type 2 diabetes, cardiovascular disease and premature death.

The study, a collaboration between the University of Bristol in the UK, the University of Exeter in the UK and the University of Eastern Finland, found that arterial stiffness is a new risk factor for childhood and adolescent metabolic disease alongside existing risk factors, such as obesity and insulin resistance.

Globally, metabolic syndrome is prevalent in three per cent of 6- to 12-year-olds and five per cent of 13- to 18-year-olds. Also, 12 per cent of children who are overweight and 29 per cent of children who are obese have the condition. These figures highlight the importance of identify causes and preventing or reversing metabolic syndrome.

Arterial stiffness is already recognised as a possible trigger of type 2 diabetes among adults and now, researchers have identified that arterial stiffness is the latest risk factor for childhood and adolescent metabolic disease.

The current study involved 3,862 adolescents (1,719 males and 2,413 females) aged 17 who were followed up seven years later, at 24-years-old.

The researchers measured arterial stiffness with carotid-femoral pulse wave velocity and “the presence of three or more of: dual-energy X-ray absorptiometry measured trunk fat obesity, decreased high-density lipoprotein cholesterol, elevated triglyceride, hyperglycaemia, and elevated/hypertensive blood pressure at baseline and follow up”.

They found that metabolic syndrome was prevalent in five per cent of males and 1.1 percent of females at age 17, which increased to 8.8 per cent of males and 2.4 per cent of females at age 24.

These percentage differences between males and females are due to elevated systolic blood pressure, hyperglycaemia and elevated triglyceride and reduced high-density lipoprotein cholesterol in a higher percentage of males. The females had a considerably higher trunk fat mass compared to the males.

Results from the follow up found that worsening arterial stiffness was linked to a nine per cent risk of metabolic syndrome in males but no change in risk in females. Researchers also discovered that arterial stiffness could cause metabolic syndrome, but not vice versa.

Andrew Agbaje, a physician and clinical epidemiologist at the University of Eastern Finland, said: “We are seeing for the first time that arterial stiffness in adolescents is an unknown risk factor for metabolic syndrome which may initiate a cascade of disease processes that might lead to type 2 diabetes, cardiovascular disease, and premature death.

“Early intervention might likely reduce high fasting insulin and low-density lipoprotein cholesterol thereby cutting off 20 per cent of the potential causal effect of arterial stiffness on metabolic syndrome.”

Agbaje added: “Pending when randomised clinical trials will be successful in reversing and treating arterial stiffness, it is expedient for caregivers, paediatricians, public health experts, and policymakers to focus on ways to reduce high fasting insulin or insulin resistance and low-density lipoprotein cholesterol, particularly from adolescence through improvement in diet and physical activity.”

The paper, published in the American Journal of Physiology-Heart and Circulatory Physiology, can be read in full here.

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