Abnormal vascular reactivity at rest and exercise in obese boys

Obese children exhibit vascular disorders at rest depending on their pubertal status, degree of obesity, and level of insulin resistance. However, data regarding their vascular function during exercise remain scarce. The aims of the present study were to evaluate vascular morphology and function at rest, and lower limb blood flow during exercise, in prepubertal boys with mild-to-moderate obesity and in lean controls. Twelve moderately obese prepubertal boys [Body Mass Index (BMI: 23.9 +/- 2.6 kg m(-2))] and thirteen controls (BMI:17.4 +/- 1.8 kg m(-2)), matched for age (mean age: 11.6 +/- 0.6 years) were recruited. We measured carotid intima-media thickness (IMT) and wall compliance and incremental elastic modulus, resting brachial flow-mediated dilation (FMD) and nitrate-dependent dilation (NDD), lower limb blood flow during local knee-extensor incremental and maximal exercise, body fat content (DEXA), blood pressure, blood lipids, insulin and glucose. Compared to lean controls, obese boys had greater IMT (0.47 +/- 0.06 vs. 0.42 +/- 0.03 mm, P < 0.05) but lower FMD (4.6 +/- 2.8 vs. 8.8 +/- 3.2%, P < 0.01) in spite of similar maximal shear rate, without NDD differences. Lower limb blood flow (mL min(-1).100 g(-1)) increased significantly from rest to maximal exercise in both groups, although obese children reached lower values than lean counterparts whatever the exercise intensity. Mild-to-moderate obesity in prepubertal boys without insulin resistance is associated with impaired endothelial function and blunted muscle perfusion response to local dynamic exercise without alteration of vascular smooth muscle reactivity. Eur J Clin Invest 2009; 39 (2): 94-102.