Abstract
OBJECTIVE: To evaluate the efficacy of a multidisciplinary clinical intervention in children with obesity by longitudinally monitoring changes in vascular elasticity and liver stiffness via ultrasound-derived parameters. METHODS: A single-center longitudinal study was conducted on 120 children with obesity (aged 7-14 years, BMI ≥95th percentile). The participants underwent a 12-month intervention involving personalized low-calorie diets, structured aerobic exercise, and family-based cognitive-behavioral therapy. Vascular parameters (carotid intima-media thickness [IMT], flow-mediated dilation [FMD], elasticity coefficient [Ep], stiffness index [β], distensibility coefficient [CD], arterial compliance [AC]) and liver stiffness [shear wave velocity (SWV)] were assessed at baseline (T0), 6 months (T1), and 12 months (T2) via Siemens S2000 ultrasound with ARFI technology. Statistical analyses included repeated-measures ANOVA, Pearson correlation, and multivariate linear regression. RESULTS: Significant improvements were observed in FMD (7.1%-9.5%, P < 0.001), Ep (60.5 kPa-42.3 kPa, P < 0.001), β (6.25-4.55, P < 0.001), CD (10.05 kPa-14.9 kPa, P < 0.001), AC (0.96-1.29 mm(2)/kPa, P < 0.001), and SWV (1.36 m/s-0.98 m/s, P < 0.001). The carotid IMT did not significantly change (Δ = -0.01 mm, P = 0.16). Multivariate regression identified ΔBMI as an independent predictor of ΔFMD (β = 0.32, P = 0.003) and ΔSWV (β = -0.41, P < 0.001). CONCLUSION: Ultrasound-based multiparameter assessment effectively quantifies improvements in vascular and hepatic function following clinical intervention in children with obesity.