Andrea Kelly1, Sheela N Magge2, Rachel Walega2, Claire Cochrane3, Mary E Pipan4, Babette S Zemel5, Meryl S Cohen6, Samuel S Gidding7, Ray Townsend8. 1. Division of Endocrinology & Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA. Electronic address: kellya@chop.edu. 2. Children's National Health System, Children's Research Institute, The George Washington University School of Medicine and Health Sciences, Division of Endocrinology and Diabetes and CTSI-CN, Washington, DC. 3. Division of Endocrinology & Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA. 4. Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA; Division of Developmental Behavioral Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA. 5. Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA; Division of Gastroenterology, Hepatology, & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA. 6. Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA; Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA. 7. Familial Hypercholesterolemia Foundation, Pasadena, CA. 8. Department of Medicine, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA.
Abstract
OBJECTIVES: To test whether youth with Down syndrome have aortic stiffness indices, as measured by pulse wave velocity (PWV), that differ from youth without Down syndrome and to compare reference-based age-adjusted (age-PWV-Z) and height-adjusted (Ht-PWV-Z) in youth with and without Down syndrome. STUDY DESIGN: Cross-sectional study of PWV in 129 adolescents with Down syndrome and 97 youth of comparable age, sex, race/ethnicity, and body mass index (BMI). PWV, age-PWV-Z, and Ht-PWV-Z were compared. Regression models were developed to test for associations with PWV. RESULTS: Youth with Down syndrome and controls were comparable in BMI-Z (1.4 [-1.5 to 2.8] vs 1.2 [-2.0 to 2.8], P = .57) but not Ht-Z (-2.3 [-4.7 to 0.8] vs 0.4 [-2.0 to 2.6], P < .0001). PWV (m/s, 5.0 [3.1-7.9] vs 5.0 [3.6-8.0], P = .5) and mean arterial pressure (MAP, mm Hg) (78 [61-102] vs 74 [64-97], P = .09) were not different between groups. In adjusted analyses confined to Down syndrome, PWV was associated only with BMI, but not age, black race, or MAP (R2 = 0.11). In contrast, BMI, age, black race, and MAP were all positively associated with and better explained PWV in controls (R2 = 0.50). PWV was not associated with height in youth with or without Down syndrome. Although age-PWV-Z was not different in Down syndrome (-0.36 [-2.93 to 3.49]) vs -0.15 [-2.32 to 3.22]), Ht-PWV-Z was greater in Down syndrome (0.32 [-2.28 to 4.07] vs -0.08 [-2.64 to 2.64], P = .002), and Ht-PWV-Z was greater than age-PWV-Z in Down syndrome (P < .0001). CONCLUSIONS: The lack of relationship of PWV, an independent predictor of adult cardiovascular events, with its traditional determinants including MAP suggests Down syndrome-specific phenomena may alter such relationships in this population. In youth with Down syndrome, Ht-adjusted PWV may overestimate aortic stiffness. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01821300.
OBJECTIVES: To test whether youth with Down syndrome have aortic stiffness indices, as measured by pulse wave velocity (PWV), that differ from youth without Down syndrome and to compare reference-based age-adjusted (age-PWV-Z) and height-adjusted (Ht-PWV-Z) in youth with and without Down syndrome. STUDY DESIGN: Cross-sectional study of PWV in 129 adolescents with Down syndrome and 97 youth of comparable age, sex, race/ethnicity, and body mass index (BMI). PWV, age-PWV-Z, and Ht-PWV-Z were compared. Regression models were developed to test for associations with PWV. RESULTS: Youth with Down syndrome and controls were comparable in BMI-Z (1.4 [-1.5 to 2.8] vs 1.2 [-2.0 to 2.8], P = .57) but not Ht-Z (-2.3 [-4.7 to 0.8] vs 0.4 [-2.0 to 2.6], P < .0001). PWV (m/s, 5.0 [3.1-7.9] vs 5.0 [3.6-8.0], P = .5) and mean arterial pressure (MAP, mm Hg) (78 [61-102] vs 74 [64-97], P = .09) were not different between groups. In adjusted analyses confined to Down syndrome, PWV was associated only with BMI, but not age, black race, or MAP (R2 = 0.11). In contrast, BMI, age, black race, and MAP were all positively associated with and better explained PWV in controls (R2 = 0.50). PWV was not associated with height in youth with or without Down syndrome. Although age-PWV-Z was not different in Down syndrome (-0.36 [-2.93 to 3.49]) vs -0.15 [-2.32 to 3.22]), Ht-PWV-Z was greater in Down syndrome (0.32 [-2.28 to 4.07] vs -0.08 [-2.64 to 2.64], P = .002), and Ht-PWV-Z was greater than age-PWV-Z in Down syndrome (P < .0001). CONCLUSIONS: The lack of relationship of PWV, an independent predictor of adult cardiovascular events, with its traditional determinants including MAP suggests Down syndrome-specific phenomena may alter such relationships in this population. In youth with Down syndrome, Ht-adjusted PWV may overestimate aortic stiffness. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01821300.
Authors: M de Divitiis; C Pilla; M Kattenhorn; M Zadinello; A Donald; P Leeson; S Wallace; A Redington; J E Deanfield Journal: Circulation Date: 2001-09-18 Impact factor: 29.690
Authors: Vera Bittner; Regina Hardison; Sheryl F Kelsey; Bonnie H Weiner; Alice K Jacobs; George Sopko Journal: Circulation Date: 2002-11-12 Impact factor: 29.690
Authors: Robert J Kuczmarski; Cynthia L Ogden; Shumei S Guo; Laurence M Grummer-Strawn; Katherine M Flegal; Zuguo Mei; Rong Wei; Lester R Curtin; Alex F Roche; Clifford L Johnson Journal: Vital Health Stat 11 Date: 2002-05
Authors: Marcello de Divitiis; Carlo Pilla; Mia Kattenhorn; Ann Donald; Mariutzka Zadinello; Sharon Wallace; Andrew Redington; John Deanfield Journal: J Am Coll Cardiol Date: 2003-06-18 Impact factor: 24.094
Authors: Weiquan Lu; Helaine E Resnick; Kathleen A Jablonski; Kristina L Jones; Arvind K Jain; Wm James Howard; David C Robbins; Barbara V Howard Journal: Diabetes Care Date: 2003-01 Impact factor: 19.112