Increased Carotid Intima-Media Thickness and Stiffness in Obese Children

Iannuzzi, Arcangelo; Licenziati, Maria Rosaria; Acampora, Ciro; Salvatore, Vittorio; Auriemma, Lucia; Romano, Maria Luigia; Panico, Salvatore; Rubba, P.; Trevisan, Maurizio

doi:10.2337/diacare.27.10.2506

Cited by 186 publications

(136 citation statements)

References 13 publications

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“…4,19,20 Our data are also in line with earlier studies in 13-to 15-year-old mostly normal weight children showing an independent association between BMI and brachial artery distensibility. 21,22 Interestingly, childhood obesity is also shown to relate with carotid artery stiffening later in adulthood.…”

Section: Discussionsupporting

confidence: 82%

Cardiometabolic Determinants of Carotid and Aortic Distensibility From Childhood to Early Adulthood

et al. 2017

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A rterial stiffness or decreased arterial distensibility has been implicated as a predictor of cardiovascular diseases.1,2 Cardiometabolic risk factors, such as high LDL-C (low-density lipoprotein cholesterol), elevated blood pressure (BP), and obesity, have been associated with arterial stiffness in adults. 3 We have shown that exposure to cardiometabolic risk markers in childhood is associated with decreased carotid artery distensibility (cdist) in adulthood. 4 Already at early age, obese children and those with familial hypercholesterolemia have stiffer arteries compared with lean, healthy peers in a cross-sectional setting. 5,6 We have previously reported in the longitudinal STRIP (Special Turku Coronary Risk Factor Intervention Project) studying healthy children that cdist and aortic distensibility (adist) decrease from childhood to early adulthood and that boys have markedly stiffer arteries than girls. 7 The STRIP dietary intervention focused on quality of fat was not associated with arterial distensibility at this early age. 7 We have also shown that childhood exposure to tobacco smoke is associated with decreased adist at age of 11 years 8 while higher cardiorespiratory fitness and ideal cardiovascular health score associate with increased arterial distensibility in adolescence. 9,10 However, to date, in healthy children, a comprehensive, longitudinal assessment of cardiometabolic determinants of arterial distensibility from childhood to adulthood is still lacking.Therefore, we studied in the prospective STRIP cohort the association of several cardiometabolic risk markers and dietary variables with distensibility of the 2 key arteries, aorta Abstract-Children who are obese or have familial hypercholesterolemia have stiffer arteries compared with lean, healthy peers. Limited data are, however, available on the association of cardiometabolic risk markers and arterial distensibility in healthy children, particularly in a longitudinal setting. Therefore, we studied in the prospective STRIP (Special Turku Coronary Risk Factor Intervention Project) comprising healthy, predominantly normal weight participants the association of several cardiometabolic and dietary risk markers with arterial distensibility from childhood to early adulthood. Carotid and aortic distensibility (cdist, adist) was assessed repeatedly with ultrasonography at the age of 11, 13, 15, 17, and 19 years in the longitudinal atherosclerosis prevention study (n cdist =420-503, n adist =407-476 Dietary variables were not independently associated with arterial distensibility. Participants with low arterial distensibility had higher body mass index (P cdist =0.0090, P adist =0.098) and higher systolic (P cdist <0.0001, P adist <0.0001) and diastolic blood pressures (P cdist <0.0001, P adist =0.0002) already from early childhood. Body mass index, blood pressure, low-density lipoprotein cholesterol, and homeostasis model of insulin resistance identified since childhood associate with arterial distensibility in healthy children and adolescents. Thes...

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Section: Discussionsupporting

confidence: 82%

Cardiometabolic Determinants of Carotid and Aortic Distensibility From Childhood to Early Adulthood

et al. 2017

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“…13 The predictive value of childhood IMT is unknown, but our finding that IMT was increased in children who were heavier, had higher systolic blood pressure, or were less physically active adds to the evidence that early exposure to cardiovascular risk factors may promote atherogenesis. 14,15,36 The observation that lower maternal energy intake in pregnancy predicts increased IMT suggests that the prenatal environment is also important in atherogenesis. Further investigations are needed to replicate this finding and to clarify the underlying mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Maternal Diet During Pregnancy and Carotid Intima–Media Thickness in Children

Gale

Jiang

Robinson

et al. 2006

ATVB

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Objective-Autopsy studies show that intimal lipid accumulations in arteries are often present at birth, suggesting that the prenatal environment plays a role in the pathogenesis of atherosclerosis. In animal models, a restricted or unbalanced maternal diet during gestation can influence susceptibility to atherosclerosis, but the relation in humans between maternal diet during pregnancy and atherogenesis is unknown. Methods and Results-We measured carotid intima-media thickness (IMT) in 216 nine-year-old children whose mothers had participated in a study of nutrition during pregnancy. IMT was greater in boys, in children who were heavier, in those with higher systolic blood pressure, and in those who took less exercise. Increased IMT was associated with a lower maternal energy intake in early (Pϭ0.029) or late (Pϭ0.006) pregnancy, after adjustment for these factors. Mean IMT of children whose mothers were in the lowest quarter of the distribution of energy intake in late pregnancy was 0.027 mm (95% confidence interval, 0.004 to 0.049) greater than that of those whose mothers were in the highest quarter of the distribution. Conclusion-Lower maternal energy intake during pregnancy may increase the susceptibility to atherogenesis of the child. Key Words: carotid arteries Ⅲ atherosclerosis Ⅲ pregnancy Ⅲ diet Ⅲ children A therosclerosis is a progressive condition that begins early in life. Fatty streaks and intimal thickenings, the initial lesions of atherogenesis, have been found in the coronary arteries of infants and children. 1,2 These early lesions are present in the aortas and coronary arteries of many newborn babies and fetuses 3,4 and occur in a distribution similar to that of advanced lesions in adults, 1,3 suggesting a role for the prenatal environment in the pathogenesis of atherosclerosis.Animal models suggest that maternal diet during pregnancy influences susceptibility to atherosclerosis. Rats exposed during gestation to maternal energy-or proteinrestricted diets have an increased incidence of endothelial dysfunction and hypertension. 5-8 Similar outcomes have been observed in the offspring of rats fed a high-fat diet during pregnancy. 9,10 Whether there is any relation in humans between characteristics of maternal diet during pregnancy and atherogenesis is not known, although the observation that maternal hypercholesterolemia during pregnancy is linked with faster progression of early atherosclerotic lesions in children suggests that the type and quantity of fat in the maternal diet may play a role in fetal atherogenesis. 11 High-resolution B-mode ultrasound measurements of carotid intima-media thickness (IMT) are widely used as a marker of early atherosclerosis in adults 12,13 and predict vascular events across a wide age range. 13 Fewer studies have investigated IMT in children, but children who are obese, hypercholesterolemic, or diabetic have an increased IMT. 14 -16 Exposure to cardiovascular risk factors in early life has long-term influences on vascular function, predicting IMT and arterial elas...

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“…Many of our results confirm those of previous studies. Cross-sectional studies have found that carotid IMT is associated with BMI levels in both childhood [31][32][33] and adulthood. [8][9][10]20,34,35 Longitudinal studies have also shown that childhood BMI is related to adult levels of carotid IMT.…”

Section: Discussionmentioning

confidence: 99%

The contribution of childhood obesity to adult carotid intima-media thickness: the Bogalusa Heart Study

et al. 2008

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Objective: Although obese children are at increased risk for coronary heart disease in later life, it is not clear if the association results from the persistence of childhood obesity into adulthood. We examined the relation of both childhood and adult levels of body mass index (BMI, kg m À2 ) to carotid intima-media thickness (IMT) measured at the (mean) age of 36 years. Design and Subjects: Prior to the determination of adult IMT, the 1142 participants had been examined 7 (mean) times in the Bogalusa Heart Study. Measurements: In addition to BMI, levels of lipids, lipoproteins and blood pressure were measured at each examination. Cumulative levels of each risk factor were based on the areas under the individual growth curves calculated using multilevel models for repeated (BMI) measurements. We then examined the relation of these cumulative levels to adult IMT. Results: Carotid IMT was associated with cumulative levels of BMI in both childhood and adulthood (Po0.001 for each association). Furthermore, the association between childhood BMI and adult IMT persisted, but was reduced, after controlling for adult BMI. Although childhood levels of lipids, lipoproteins and blood pressure were also associated with adult IMT, these associations were not independent of adult levels of these risk factors. Conclusions: These results emphasize the adverse effects of elevated childhood BMI levels. In addition to the strong tracking of BMI levels from childhood to adulthood, there appears to be a modest, independent effect of childhood BMI on adult IMT. The prevention of childhood obesity should be emphasized.

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Increased Carotid Intima-Media Thickness and Stiffness in Obese Children

Cited by 186 publications

References 13 publications

Cardiometabolic Determinants of Carotid and Aortic Distensibility From Childhood to Early Adulthood

Cardiometabolic Determinants of Carotid and Aortic Distensibility From Childhood to Early Adulthood

Maternal Diet During Pregnancy and Carotid Intima–Media Thickness in Children

The contribution of childhood obesity to adult carotid intima-media thickness: the Bogalusa Heart Study

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