Carotid Intima-Media Thickness and Metabolic Syndrome Components in Obese Children and Adolescents

Abstract

Obesity in children and adolescents contributes to increased prevalence of metabolic and hemodynamic complications, which may impair endothelial function and structure. A high resolution B-mode ultrasound measurement of intima-media thickness (IMT) is a useful tool to assess early, preclinical stage of atherosclerosis. The objective of this study was to evaluate the carotid artery IMT in obese children and its association with insulin resistance and other traditional metabolic syndrome components. The study entailed 80 obese children, aged 5.3-17.9 year and a control group of 31 children. Obesity was defined using the International Obesity Task Force (IOTF) criteria. Metabolic syndrome was defined using the International Diabetes Federation (IDF) criteria of 2007. Each patient's anthropometric measurements, blood parameters, and the carotid IMT were evaluated. Insulin resistance indices were calculated. We found that children with metabolic syndrome had a significantly increased IMT compared to children who did not meet the syndrome criteria (0.62 ± 0.09 mm vs. 0.55 ± 0.18 mm, p = 0.03) and compared to control group (0.62 ± 0.09 vs. 0.52 ± 0.14, p = 0.02). In a multivariable linear regression analysis, IMT correlated with systolic blood pressure (p = 0.005). The results did not show an association between IMT and insulin resistance. We conclude that abdominal obesity and the accompanying components of metabolic syndrome lead to increased carotid IMT. The enhanced systolic blood pressure plays a major role in changing the carotid IMT.

Aortic elasticity and carotid intima-media thickness in children with mitral valve prolapse

“…Increased carotid intima-media thickness was found in various disease states such as obesity, systemic hypertension, diabetes, Kawasaki disease, and late after coarctation repair, which are known risk factors for atherosclerotic heart disease. [45][46][47][48][49] We found thinner carotid intima-media thickness in patients with mitral valve prolapse. This difference was more prominent in non-classical mitral valve prolapse.…”

Marcadores Ultrassonográficos De Risco Cardiovascular Em Crianças Obesas

“…Obesity in childhood is an important risk factor to cardiovascular disease (CVD), dyslipidemia, impaired glucose tolerance, hypertension, adult obesity and premature mortality. 1 , 2 In the last decades, the prevalence of obesity has markedly increased: about 10% of school-aged children worldwide are overweight; inwestern countries, approximately 35% are overweight, and about one fourth of those children are obese. 3 , 4 Thus, excess weight in children represents a public health issue, and is associated with endothelial damage and metabolic abnormalities.…”

“… 3 , 4 Thus, excess weight in children represents a public health issue, and is associated with endothelial damage and metabolic abnormalities. 1 , 5 , 6 …”

Diagnostic imaging in the management of patients with metabolic syndrome

“…115, 131 Interestingly, periaortic adipose tissue measured by 1 H-MRS is not related to insulin resistance in MetS. 115 Similarly, in obese children no association was found between CIMT and insulin resistance, 132 although CIMT was correlated with other components of MetS, especially increased BP. 132…”