Impact of weight loss on cardiovascular function in adolescents and young adults with overweight/ obesity and intellectual and developmental disabilities.

BACKGROUND

Overweight and obesity affect over 60% of adolescents and young adults with intellectual and developmental disabilities (IDD) and are associated with impairments in cardiovascular (CV) function.

OBJECTIVE

This study aims to evaluate the impact of weight loss on cardiac strain and other measures of CV function in adolescents and young adults with IDD and obesity, addressing a current literature gap.

METHODS

Adolescents and young adults with IDD and obesity entering a weight loss parent trial (NCT02561754) were voluntarily co-enrolled in this observational ancillary study (49 participants representing 45% of those enrolled in the parent trial). The ancillary study CV testing was performed at baseline and 6 months including echocardiograms optimized for strain, pulse wave velocity, and treadmill stress testing. Changes in CV parameters were compared to changes in body mass index (BMI). Statistical analyses included medians (interquartile range), Spearman correlation with bootstrapping, and regression modeling (adjusting for IDD diagnosis), p < 0.05 significant.

RESULTS

The ancillary study cohort consisted of 21 females (42%), 23 participants with Down syndrome (47%), and 26 with autism (53%); the mean age was 16.5 ± 2.4 years (range 13-21 years). Average weight loss through the parent trial intervention was 6.5% (BMI decreased 6.0%) over 6 months, with 9/49 (18%) losing >10% body weight. The decrease in BMI correlated with increases in left ventricular (LV) global longitudinal strain (p < 0.01), tricuspid annular plane systolic excursion (TAPSE) (p = 0.02), LV lateral E/e' (p = 0.007), LV global circumferential strain (p = 0.01), and LV end-diastolic strain rate (p = 0.005). Modest changes in LV global longitudinal strain (p < 0.001) and TAPSE (p = 0.003) remained significant on multivariant modeling.

CONCLUSIONS

Weight loss in adolescents and young adults with IDD and overweight/obesity relates to improvements in certain parameters of ventricular function.