INTERRELATIONSHIP OF CARDIOVASCULAR RISK FACTORS IN EARLY ADULTHOOD. THE ROLE OF ENDOTHELIAL GLYCOCALYX

Objective: The presence of obesity or/and arterial hypertension in young adults represent well recognized risk factors for later cardiovascular (CV) events during adult life. Obesity and arterial hypertension contribute to increased arterial stiffness, another important CV risk factor. The integrity of endothelial glycocalyx (EG), as part of the endothelium, plays a vital role in vascular permeability, inflammation, and elasticity and finally to CV disease. We investigated the relationship between obesity and arterial hypertension to target organ damages as arterial stiffness and endothelial function in young adults.Design and method: A group of 65 healthy young adults, 17-26 years old, was evaluated regarding the presence of CV risk factors [obesity, systolic (SBP) and diastolic (DBP) blood pressure] and EG integrity. Carotid-femoral arterial stiffness (PWV) was measured by Complior apparatus. Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (5-25 micrometers) was measured as a non-invasive accurate index of reduced EG thickness and subsequent endothelial dysfunction. Results: Population was divided in Group A (young males, n=33, 20+2 years, BMI=27+5) and Group B (young females, n=32, 20+2 years, BMI=24+4). Young males had increased BMI (27+5 vs. 24+4, p=0.01), SBP (124+9 vs. 111+8, p<0.001), PWV (8+1 vs. 7+1m/sec, p=0.001) and reduced PBR5-25 (1.79 vs. 1.97mum, p=0.002) compared to young females. In the whole population, both weight and SBP were related to PBR5-25 (rho=-0.23, p=0.05 and r=-0.34, p=0.005) and PWV (=0.41, p=0.001 and r=0.56, p<0.001). In young males and females, SBP was related to PBR5-9 (r=-0.39, p=0.02 and r=-0.33, p=0.05) and PWV (r=0.38, p=0.03 and r=0.57, p=0.001). In a multiple regression analysis regarding the whole population and using age, weight and SBP as independent variables, we found that PBR5-9 was independently associated to SBP (beta=-0.59, p<0.001) and weight (beta=0.43, p=0.004) while PWV to SBP (beta=0.56, p<0.001). Conclusions: In early adulthood, independent associations between CV risk factors (obesity and arterial hypertension), and target organ damage (arterial stiffness and endothelial dysfunction), already exist. Our results underscore the need of primary prevention of future CV events by keeping body weight and BP into optimal levels, even in young adults