Evaluation of Arterial Stiffness Markers in Childhood Obesity Using Different Anthropometric Indices

Abstract

Background: Childhood obesity is an increasing public health concern associated with early cardiovascular changes. Anthropometric indices may help identify children at risk of increased arterial stiffness. Objectives: This study aimed to investigate associations between conventional and novel anthropometric adiposity indices and echocardiographic markers of aortic stiffness in children. Methods: This cross-sectional study included 130 children referred to Ali Asghar Hospital in Iran in 2022. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), A Body Shape Index (ABSI), Body Roundness Index (BRI), and the conicity index (CI), were calculated. Blood pressure and echocardiographic aortic elasticity parameters, including aortic strain (AS), aortic stiffness beta index (ASβI), aortic distensibility (AD), and pressure strain elastic modulus (PSEM), were assessed. Participants were classified as overweight/obese or normal weight according to each index, and comparisons were performed (P < 0.05). Results: Among the participants, 39% were girls, and 50% were overweight or obese. The prevalence of overweight/obesity varied by index: WHtR (31.5%), WC (52.2%), ABSI (61.5%), BRI (35.4%), and CI (59.2%). Obesity defined by BMI, WC, WHtR, and BRI was associated with lower AS and AD and higher ASβI and PSEM. CI showed significant associations only with AD (P = 0.016) and PSEM (P = 0.031), whereas ABSI showed no significant associations with aortic stiffness parameters. Conclusions: Indices reflecting general and abdominal adiposity, particularly BMI, WC, WHtR, and BRI, were more consistently associated with aortic stiffness in children than CI and ABSI. ABSI may have limited sensitivity in pediatric populations because of growth-related changes in body proportions. Reduced aortic distensibility may serve as an early indicator of cardiovascular risk in children.