Endothelial impairment evaluation by peripheral arterial tonometry in pediatric endocrinopathies: A narrative review

doi:10.4239/wjd.v12.i6.810

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World Journal of Diabetes

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World J Diabetes. Jun 15, 2021; 12(6): 810-826
Published online Jun 15, 2021. doi: 10.4239/wjd.v12.i6.810

Table 2 EndoPat 2000 in pediatric population with metabolic syndrome

Ref.	Design	Aim of the study	Population: age in years; mean ± SD or median (range)	Control group: age in years; mean ± SD or median (range)	RHI reported in arbitrary units. If RHI not specified, we reported p trend or positive/negative relation with parameters examined	RHI outcomes
Dongui et al[58], 2019	QRS	Impact of diet and exercise on microvascular function	Sedentary OB Age 12-18, n = 57 [F/M = 0/57]	Healthy NW Age 12-20, n = 10 [F/M 0/10]	OB 1.43 (0.35) vs CG 1.67 (0.36)^a. After exercise OB vs CG^a. OB Pre-exercise vs Post-Exercise^a.	RHI higher in CG. In OB RHI improved after 6 wk of diet and exercise.
Pareyn A et al[59], 2015	CSS	Assessment of EF in OB/OW adolescents	OW/OB Age 14.7, n = 27 [F/M 11/16]	NW Age 15.5, n = 25 [F/M 13/12]	NW 1.88 (1.7-2.4) vs OW 1.5 (1.3-1.9)^a. Positively with age^a and tanner stage^a. Negatively with diastolic BP^a. With BGL, insulin lipid profile^c.	RHI lower in OB/OW adolescents. RHI improved with age and Tanner stage. RHI decreased with higher diastolic BP. RHI not related with lipid, IR, BGL and gender. RHI inversely related with baseline pulse amplitude.
Agarwal et al[60], 2013	CSS	Assessment of EF in OB/NW adolescents	OB Age 15.3 (0.4) years, n = 37 [F/M 26/11]	NW Age 14.9 (0.6), n = 14 [F/M 9/5]	OB 1.7 (0) vs NW 1.9 (0.1)^a. OB IGR 1.63^a. Other values reported like p trend.	RHI lower in obese adolescents. RHI negatively related with BMI, WC, BGL, HOMA-IR, Leptin, TNF, hs-CRP. No relationship with lipid profile and BP.
Mahmud et al[61], 2009	RA	Evaluation of EF in OB adolescents with impaired IS	OB with HOMA-IR 5.4 Age 13.4 (1.7), n = 26 [F/M 10/16]	NW, healthyAge 14 (1.4), n = 51 [F/M 21/30]	OB 1.5 (0.4) vs NW 2 (0.4)^b. Other values reported like p trend.	EF lower in OB and negatively related with adiposity, TG, LDL and Tot-Chol. RHI improved with age. RHI not correlated with Leptin, IR or gender.
Tomsa et al[62], 2016	CSS	Comparing EF to body fat, IS, BGL and CIM in dysglicemic and OW adolescents	OW with NGT, n = 25, OW with IGT n = 19, OW with T2D but HB1Ac < 8% n = 16; Age 15.5 (0.2) Total n = 60 [F/M 37/23]	NW Age 15.5 (0.2), n = 21 [F/M 9/12]	BMI 30.91.2 (0) vs BMI 30.41.5 (0) vs BMI 26.72.0 (0)p trend^a. Negatively with WC, BGL, TNF, PAI^a, leptin^b. Positively with age and insulin sensitivity^a. BP, lipid profile^c. For exact values see reference.	RHI lower in OB and T2DM. RHI negatively related with percentage body fat, WC, Leptin, TNF-alpha, BGL. RHI positively related with age and. RHI not related with BP and lipid profile.
Del Ry et al[63], 2016	RA	C-type Natriuretic Peptide in OW, OB and NW. Relation with RHI and other endothelial markers	OW AGE 12.8 (1.6) n = 10; [F/M 5/5]. OB, G 3.5 (1), AGE 12.8 (1.6) n = 45; [F/M19/26].	NW, AGE 12.8 (1.4) n = 27; [F/M 14/13]	NW 2.1 (0.2) vs OW 1.6 (0.4)^a. NW vs OB 1.4 (0.3)^b. Negatively with CNP^b. Exact values non reported.	RHI was significantly lower in OW/OB. CNP negatively related with RHI.
Del Ry et al[64], 2020	RA	Natriuretic peptide network in normal weight and obese adolescents, its relation with RHI.	Primary OB Not diabetic, Age 13.3 (0.5) n = 16; [F/M8/8].	NW, Age 14.3 (0.4) n = 24; [F/M14/10].	NW 2.1 (0) vs OB 1.4 (0)^b. Negatively with CNP, hs CRP, diastolic BP^b. Exact values non reported.	RHI significantly lower in OB.RHI negatively related with hs-CRP, CNP, diastolic BP, fat mass and A1C.
Singh et al[65], 2017	RA	Relation between EF and urinary markers	OW and OB Age 13.8 (2.4) n = 43; [F/M 23/20]	Healthy NW Age 13.9 (2) n = 20; [F/M 8/12]	NW 1.6 (0.1) vs OW 1.66 (0.1)^c and OB 1.67 (0.1)^c. NW girls 1.9 vs NW boys 1.25^b.	No correlation between RHI, BMI and urinary markers. RHI higher in NW female adolescents
Czippelova et al[66], 2019	RA	Assessment of EF in different systemic vascular resistances. Comparing EF to Cardio Ankle Vascular Index	OB No DM or HBP Age 16.4 (2.7) n = 29 [F/M 14/15]	NW Age 16.5 (2.6) n = 29 [F/M NR]	NW 1.45 (0.3) vs OB 1.4 (0.3)^c. Positively with SVR^a.	No difference between RHI in OB and CG RHI was influenced by vascular tone and resistance. RHI in OB positively related with SVR.
Kochummen et al[24], 2019	CSS	Evaluation of EF in OB with normal BGL comparing to NW with T1DM1 and OB with T2DM	NW with DM1 and OB DM2 Age 12.7 (3.8) n = 41 [F/M 25/16]	OB with normal BGL, BP and lipid profile. Age 12.8 (2.7) n = 17 [F/M 9/8]	A1C > 10% 1.2 (0.2) vs A1C < 10% 1.7 (0.6)^a. Negatively with A1C^a. DM 1.4 (0.5) vs obese 1.4 (0.3)^c. T1D 1.4 (0.5) vs T2D1.5 (0.5)^c. Female 1.5 (0.5) vs male 1.3 (0.4)^a.	RHI lower in poorly controlled DM. RHI negatively related with A1C. RHI similar between OB and NW with DM and between DM1 and DM2. RHI lower in males especially in OB without DM.
Bruyndonckx et al[67], 2014	CSS	Evaluation of EF and correlation with CVRF in children	OB Age 15.2 (1.4) n = 57	NW Age 15.5 (1.5) n = 30	NW 2 (0.6) vs OB 2.2 (0.7)^c. Lipid, HOMA-IR, BP, hsCRP^c.	RHI not related with BMI, HOMA-IR, BP, lipid or hsCRP. RHI not homogenous with “Time to peak”.
Tryggestad et al[68], 2012	RA	Evaluation of vascular function in OB and NW children	OB Age 13.9 (2.5) n = 62 (F/M 32/30)	NW Age 13.3 (3) n = 61 (F/M 30/31)	OB vs CG^c. Exact values reported for age and BMI ( see reference). Age group 8-12 yr: 1.6-2.0^a. Age group 13-18 yr: 2.0-2.5^a.	RHI similar in OB and CG. RHI improved 0.07 for each year of age in CG. RHI was reduced in older OB. RHI not related with BP and lipid profile.
Fusco et al[69], 2020	RA	Assessment of precocious microvascular dysfunction in OB adolescents	OB Age 14.1 (2.5), n = 22 [F/M 13/9]	NW Age 15.1 (1.5) n = 24 [F/M 11/13]	OB 1.8 (0.6) vs CG1.9 (0.5)^c.	RHI not different between CG and OB. RHI not correlated with LDF (that is impaired in OB).
Bacha et al[74], 2017	CSS	Comparing EF in hispanic adolescents with and without NAFLD	OW with pre diabetes or T2DM with NAFLD Age 15.2 (0.5) n = 23 [F/M 12/11]	OW with pre-diabetes or TD2 without NAFLD Age 15.7 (0.4) n = 13 [F/M 3/10]	NAFLD 1.4 (0) vs CG 1.7 (0)^b.	Hepatic fat and AST/ALT levels were inversely related with RHI.

^aP< 0.05.

^bP< 0.005.

^cP> 0.05.

A1C: Glycosylated hemoglobin; AE: Anti-epileptic drugs; CIM: Circulating inflammatory markers; CNP: C-type natriuretic peptide; CSS: Cross sectional study; T1DM: Type 1 diabetes mellitus; T2DM: Type 2 diabetes mellitus; CVR: Cardio vascular risk; CVRF: Cardio vascular risk factors; EF: Endothelial function; HBP: High blood pressure; IGT: Impaired glucose tolerance; IR: Insulin resistance; IS: Insulin sensitivity; LDF: Laser Doppler flowmetry; NW: Normal weight; OB: Obese > 95’cc; OS: Oral steroids; OW: overweight > 85’ cc; NGT: Normal Glucose Tolerance; PM: Psychiatric medications; QRS: Quasi randomized study; RA: Research Article; SVR: Systemic vascular resistance; TG: Triglycerides; Tot-Chol: Total cholesterol; RHI: Reactive hyperemic index; WC: Waist circumference.

Citation: La Valle A, Crocco M, Chiarenza DS, Maghnie M, d'Annunzio G. Endothelial impairment evaluation by peripheral arterial tonometry in pediatric endocrinopathies: A narrative review. World J Diabetes 2021; 12(6): 810-826
URL: https://www.wjgnet.com/1948-9358/full/v12/i6/810.htm
DOI: https://dx.doi.org/10.4239/wjd.v12.i6.810