Central adiposity in childhood increases the likelihood of early vascular aging

Objective: Arterial stiffness, measured by pulse wave velocity (PWV), is a central component of early vascular aging (EVA) and has been associated with obesity and hypertension. However, the association between overweight/obesity and arterial stiffness is controversial in the general population, with less known in children from South Africa. We aimed to determine whether overweight/obesity increases the likelihood of EVA in South African school-aged children. Design and method: A total of 994 children (aged 5–9 years) were included in this study. Groups were stratified according to body composition (low-normal weight, overweight and obesity) and EVA (lower 75th (n = 725) and upper 25th (n = 269) percentiles of PWV) categories. We collected anthropometric data and conducted arterial pulse wave analysis. Results: Body mass index z-score (BMI-z) was higher in the upper versus the lower PWV group (p < 0.001). A higher percentage of overweight (23.8% vs 11.2%; p < 0.001) and obese (7.8% vs 3.0%; p < 0.001) participants were in the upper compared to the lower PWV group. In stepwise regression analysis, PWV showed a modest association with waist circumference (β=0.02; p = 0.044) in the upper PWV group only, but not with BMI-z (β=0.02; p = 0.065) and waist/height ratio (β=0.01; p = 0.085). In the lower PWV group, white ethnicity (β=0.07; p < 0.001) and higher age (β=0.02; p≦0.009) were contributors of PWV. Conclusions: In conclusion, higher adiposity (BMI-z and waist circumference) increased the odds of being in the upper PWV group, but only waist circumference remained the predictor of increased PWV in independent analysis. These findings suggest that central adiposity especially contributes to the development of increased arterial stiffness in South African school-aged children.