Avon population

Arterial stiffness in adolescence may potentiate

image: Higher arterial stiffness appears to independently cause hyperinsulinemia and insulin resistance in adolescents and young adults. Prevention of risk factors for the development of early-onset type 2 diabetes in the young population may include strategies to reduce arterial stiffness.
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Credit: Andrew Agbaje.

Arterial stiffness may be a new risk factor to target in the prevention and treatment of insulin resistance and dyslipidemia at an early age, according to a new study published today in Hypertension.

Researchers from the University of Eastern Finland, the University of Exeter, Cardiovascular Engineering Inc. and the University of Bristol conducted the study using data from one of the prospective cohort studies the world’s most comprehensive birth charts – the Avon Longitudinal Study of Parents and Children. (ALSPAC).

Insulin resistance and dyslipidemia such as high triglycerides and low HDL cholesterol are major preventable risk factors for type 2 diabetes mellitus, cardiovascular disease and death. Globally, the prevalence of early-onset type 2 diabetes, that is, type 2 diabetes diagnosed before the age of 40, is increasing. Additionally, several long-term interventions and clinical trials to prevent and treat early-onset type 2 diabetes have failed. Importantly, emerging evidence in adults has revealed that arterial stiffness may be a new causative risk factor in the development of incident type 2 diabetes, but studies in adolescents are lacking. The Lancet Commission on Diabetes recently recommended further research into early-onset type 2 diabetes. Therefore, identifying new pathways in the natural development and pathogenesis of type 2 diabetes and early-onset dyslipidemia may be important in reducing the incidence of these diseases in adolescents and young adults.

In this recently published study, researchers investigated whether preclinical atherosclerotic traits such as arterial stiffness temporarily precede the development of insulin resistance, hyperinsulinemia, and dyslipidemia. For the first time, more than 3,800 17-year-olds were followed for seven years and their longitudinal data was analyzed using advanced statistical models to unravel potential causal associations.

Researchers found that adolescent arterial stiffness may be a causative risk factor for hyperinsulinemia and insulin resistance in young adults despite control of important risk factors such as smoking, activity, body fat, skeletal muscle mass, heart rate, blood pressure, family history. cardiovascular diseases, etc. Similarly, adolescent arterial stiffness appears to temporally precede low HDL-cholesterol in young adults, although with borderline statistical significance. Nevertheless, the 7-year increase in arterial stiffness was positively associated with the 7-year increase in triglycerides, suggesting that arterial stiffness may play a role in the development of dyslipidemia.

“Our new findings are clinically significant for the health of children and adolescents, as the prevention and treatment of insulin resistance, early-onset type 2 diabetes mellitus, and dyslipidemia may require strategies to simultaneously reduce arterial stiffness, especially from adolescence,” says Andrew Agbaje, physician and clinical epidemiologist at the University of Eastern Finland.

This research was supported in part by research grants from the Jenny and Antti Wihuri Foundation, Finnish Cultural Foundation Central Fund, Finnish Cultural Foundation North Savo Regional Fund, Orion sr Research Foundation, Aarne Koskelo Foundation, Antti and Tyyne Soininen Foundation, Paulo Foundation, Yrjö Jahnsson Foundation, Paavo Nurmi Foundation and Doctoral Program in Clinical Research, Faculty of Health Sciences, University of Eastern Finland. The UK Medical Research Council, the Wellcome Trust and the University of Bristol provided essential support for the ALSPAC study. The figurine was created with Biorender.com

For more information, please contact:

Andrew Agbaje, MD, MPH, Cert. Clinical research (Harvards), Principal researcher (urFIT-child). Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland. [email protected], +358 46 896 5633


Link to article:

Agbaje AO, Barker AR, Mitchell GF, Tuomainen TP. Effect of arterial stiffness and progression of carotid intima-media thickness on the risk of dysglycemia, insulin resistance and dyslipidemia: a temporal causal longitudinal study. Hypertension. 2022. https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.18754


urFIT-CHILD Research Group:


ALSPAC research group:


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