Cross-Sectional Study of Arterial Stiffness in Adolescents with Down Syndrome

Andrea Kelly, Sheela Magge, Rachel Walega, Claire Cochrane, Mary E. Pipan, Babette S. Zemel, Meryl S. Cohen, Samuel S. Gidding, Ray Townsend

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Pulse Wave Analysis
Vascular Stiffness
Down Syndrome
Cross-Sectional Studies
Body Mass Index

Keywords

  • cardiovascular disease
  • Down syndrome
  • obesity
  • pulse-wave velocity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Cross-Sectional Study of Arterial Stiffness in Adolescents with Down Syndrome. / Kelly, Andrea; Magge, Sheela; Walega, Rachel; Cochrane, Claire; Pipan, Mary E.; Zemel, Babette S.; Cohen, Meryl S.; Gidding, Samuel S.; Townsend, Ray.

In: Journal of Pediatrics, 01.01.2019.

Research output: Contribution to journalArticle

Kelly, A, Magge, S, Walega, R, Cochrane, C, Pipan, ME, Zemel, BS, Cohen, MS, Gidding, SS & Townsend, R 2019, 'Cross-Sectional Study of Arterial Stiffness in Adolescents with Down Syndrome', Journal of Pediatrics. https://doi.org/10.1016/j.jpeds.2019.04.059
Kelly, Andrea ; Magge, Sheela ; Walega, Rachel ; Cochrane, Claire ; Pipan, Mary E. ; Zemel, Babette S. ; Cohen, Meryl S. ; Gidding, Samuel S. ; Townsend, Ray. / Cross-Sectional Study of Arterial Stiffness in Adolescents with Down Syndrome. In: Journal of Pediatrics. 2019.
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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.",
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AU - Kelly, Andrea

AU - Magge, Sheela

AU - Walega, Rachel

AU - Cochrane, Claire

AU - Pipan, Mary E.

AU - Zemel, Babette S.

AU - Cohen, Meryl S.

AU - Gidding, Samuel S.

AU - Townsend, Ray

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N2 - 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.

AB - 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.

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KW - obesity

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