ORIGINAL PAPER Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children Murat Muhtar Yilmazer & Vedide Tavli & Özgür Umaç Carti & Timur Mese & Barış Güven & Banu Aydın & Ilker Devrim & Talat Tavlı Received: 11 November 2009 / Accepted: 29 April 2010 / Published online: 15 May 2010 # Springer-Verlag 2010 Abstract Obesity is associated with a number of risk factors, such as hyperlipidemia, hyperinsulinemia, hyper- tension, and early atherosclerosis. Evidence indicates that atherosclerosis begins in childhood and progresses over decades. In this work, we examined the relationship between cardiovascular risk factors and ultrasonographic signs of subclinical atherosclerosis in 77 obese children and adolescents compared to 40 non-obese healthy peers. Carotis intima media thickness (cIMT), carotid artery compliance (CAC), brachial artery flow-mediated dilatation (FMD), and established cardiovascular risk factors were studied. In the obese patients, cIMT was significantly increased (0.57 mm vs 0.45 mm, p <0.001) whereas CAC (1.84% vs 3.29%, p <0.001) and FMD (9.67 % vs 14.81%, p <0.001) were significantly decreased. In multiple linear regression analysis, a relation was observed between cIMT, CAC, brachial FMD on one hand, and body mass index (BMI) on the other. Among the lipid anomalies, only hypertriglyceridemia was found to be positively correlated with cIMT. Additionally, we found a significant association between waist circumference (WC) and FMD. These findings indicate that obesity in children is associated with arterial wall alterations and endothelial dysfunction. In hyperlipidemic situations, only hypertriglyceridemia was found to be positively correlated with cIMT. This finding has consistently indicated TG to be a risk factor for the development of atherosclerosis. To our knowledge this is the first study to determine the relation between FMD and WC, which is used as a parameter of obesity in childhood. Keywords Carotid intima media thickness . Endothelial dysfunction . Carotid artery compliance . Childhood . Obesity . Cardiovascular risk factors Introduction Obesity is an epidemic public-health problem in the world [23]. The prevalence of childhood obesity is increasing rapidly worldwide [23, 47]. Nearly 1/3 of obese children and 4/5 of obese adolescents were found to be obese in adulthood [3]. Obese individuals are at risk of hyperlipidemia, hyperinsulinemia, hypertension, and early atherosclerosis [4, 36]. Although in obesity clinical complications of coronary heart disease mainly occur in middle age or in later life, atherosclerosis has its roots in M. M. Yilmazer (*) : V. Tavli : T. Mese : B. Güven Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children’ s Hospital, 35210-Alsancak, Izmir, Turkey e-mail: drmuratmuhtar@hotmail.com V. Tavli e-mail: vedidetavli@yahoo.com T. Mese e-mail: timurmese@yahoo.com Ö. U. Carti : I. Devrim Department of Pediatrics, Izmir Dr. Behcet Uz Children’ s Hospital, Izmir, Turkey I. Devrim e-mail: ilkerdevrim2003@yahoo.com B. Aydın Istanbul Medical Faculty, Department of Pediatric Endocrinology, Istanbul University, Istanbul, Turkey T. Tavlı Medical Faculty, Department of Cardiology, Celal Bayar University, Manisa, Turkey Eur J Pediatr (2010) 169:1241–1248 DOI 10.1007/s00431-010-1216-5