Tracking arterial stiffness from childhood to adolescence: the role of adiposity and cardiometabolic factors.

BACKGROUND: Carotid-femoral pulse wave velocity (PWV) is the gold standard measure of central arterial stiffness and a predictor of cardiovascular events in adults, with growing relevance in pediatric populations. Although PWV increases naturally with age, cardiometabolic risk factors may accelerate this process. This study compared carotid-femoral PWV between non-overweight and overweight/obese adolescents, evaluated its progression from prepubertal age to early adolescence, and identified independent determinants of arterial stiffness. METHODS: This longitudinal study included 118 participants from the Generation XXI cohort (Porto, Portugal) assessed at ages 8-9 and 13-14 years. Carotid-femoral PWV was measured at both time points using a validated portable device. Anthropometric data, office blood pressure, and fasting blood samples for lipid profile, glucose, and insulin were collected. Body mass index (BMI) classification followed World Health Organization references. RESULTS: PWV increased significantly from childhood to adolescence (5.01 ± 0.47 to 6.30 ± 1.05 m/s; p < 0.001). At 13-14 years, overweight/obese adolescents had significantly higher PWV than non-overweight peers. PWV at 13-14 years correlated positively with BMI, BMI z-score, systolic and diastolic blood pressure, and fasting glucose. In adjusted models, PWV at 8-9 years (β = 0.39; p = 0.039) and BMI z-score at 13-14 years (β = 0.33; p < 0.001) remained independent predictors of PWV at 13-14 years. CONCLUSIONS: Arterial stiffness in early adolescence reflects both vascular tracking from childhood and concurrent adiposity. These findings support early vascular screening and weight management interventions during key developmental periods to optimize long-term cardiovascular health.