Background

Adolescents with intellectual and developmental disabilities (IDD) have twice the prevalence of overweight/obesity as the general population with the potential for early obesity-related cardiovascular (CV) disease.The effects of weight loss on CV disease in the IDD population are unknown.

Methods

We evaluated markers of early CV disease in 20 adolescents with IDD before and after a 6 month caloric restriction-weight loss program.Subjects with structurally normal hearts (age 17 ± 2 years; 40% female; 40% Down syndrome) enrolling in this weight loss program received an echocardiogram analyzing longitudinal left ventricular global strain (GLVS; a sensitive measure of left ventricular function), carotid intima-medial thickness (CIMT) for atherosclerotic burden and a maximal treadmill exercise test (VO2max) at 0 and 6 months.Continuous variables were reported as mean ± standard deviation.The analysis consisted of T-test and simple linear regression, p≤0.05 significant

Results

Overweight (5) and obese (15) subjects (average baseline BMI 32.2 ± 5.3 kg/m2) had abnormal baseline CV markers compared to published age/gender norms with mildly diminished left ventricular function by GLVS, CIMT > 95th%ile, and VO2max < 5th%ile.Higher baseline BMI predicted diminished baseline GLVS (P=0.034).Following the 6 month weight loss program, BMI decreased 6% to 30.4 kg/m2 (p=0.0031) and GLVS improved significantly (p=0.0002) into the normal range with a correlation between 0-6 month changes in BMI and GLVS (p=0.016).Change in CIMT showed a non-significant trend lower (p=0.064) at 6 months with no change in VO2max (p=0.33).

Conclusions

Early CV disease is present in this overweight/obese adolescent IDD population at baseline.Caloric restriction-weight loss is associated with improved left ventricular function and a trend towards improved atherosclerotic burden in this small study.Unsurprisingly, VO2max was not significantly impacted by this program that did not include an exercise intervention.