Iranian Heart Journal

Iranian Heart Journal

Flow-Mediated Arterial Dilatation, Hypertension, and ACE2 in Adolescent Obesity: A Cross-Sectional Study

Document Type : Original Article

Authors
Meity Ardiana 1
Nur Aisiyah Widjaja 2
Achmad Faisal Dwi Raharja 1
Ika Rahmawati Caesarina 1
1 Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
2 Division of Nutrition and Metabolic Diseases, Childhealth Department, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Abstract
Background: Endothelial dysfunction is a significant mechanism underlying various cardiovascular diseases. In the context of COVID-19, soluble angiotensin-converting enzyme 2 (sACE2) and flow-mediated dilation (FMD) are linked to endothelial dysfunction. This study aimed to evaluate sACE2 and FMD levels among obese and non-obese Indonesian adolescents.
 
Methods: This study involved 72 Indonesian adolescents, with a mean age of 195 months (range = 178–217). The majority of participants were male (61%). They were divided into 3 groups: those with obesity and hypertension (n=21), those with obesity without hypertension (n=19), and non-obese individuals (n=32). FMD assessment involved measuring the brachial artery using supra-systolic pressure applied to the forearm for 5 minutes. Further, sACE2 levels were determined using the Sandwich ELISA method.
 
Results: The median level of sACE2 was 25.4 pg/mL, with a range of 0.25 to 181.8 pg/mL. Nonetheless, no statistically significant differences in sACE2 levels were observed between the three groups (P = 0.464). Although descriptive statistics indicated that FMD values were higher in normal adolescents, no significant differences were found in FMD values between the groups: those with obesity and hypertension (9.1 ± 5%), those with obesity without hypertension (8.3 ± 3.1%), and normal adolescents (10.9 ± 6.2%) (P = 0.159). Furthermore, the comparison of sACE2 levels between the groups with and without endothelial dysfunction revealed no differences (P = 0.95). There was also no statistically significant correlation between sACE2 levels and FMD (P = 0.59, r = 0.064).
 
Conclusions: Our results showed no differences in sACE2 and FMD values between obese and non-obese Indonesian adolescents, regardless of hypertension status. Additionally, the correlation between endothelin-1 and FMD is not significant in this population of Indonesian adolescents. (Iranian Heart Journal 2025; 26(3): 51-58)
Keywords
Endothelial dysfunction
Flow-mediated dilatation
Obese
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Iranian Heart Journal
Volume 26, Issue 3
Summer 2025
Pages 51-58