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Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children.

ABSTRACT: Background:Obesity is a global epidemic, including among children. It is therefore necessary to identify cardiovascular changes in overweight/obese children as early as possible. Mode B ultrasonography of the common carotids can be used to precisely evaluate in real time early changes in the thickness of the intima-media complex (IMC), which can detect onset of the atherosclerosis process. Objectives:This study compared IMC thickness between schoolchildren with and without overweight/obesity. Methods:A sample of 59 children of both sexes, aged 7 to 10 years, were recruited from health centers in São Paulo, Brazil. Children were classified by z scores for body mass index (BMI) into two groups, with or without overweight/obesity. These groups were then compared in terms of IMC thickness. Results:The groups were homogenous for age and sex. The mean IMC measurement in the group with overweight/obesity was 0.49 (± 0.07) mm, whereas in the group free from overweight/obesity it was 0.41 (± 0.05) mm (p < 0.01). These differences were maintained when groups with and without overweight/obesity were compared separately by sex and for right and left sides. The coefficient for the correlation between IMC measurement and BMI z score was 0.61 (95% confidence interval = 0.42-0.75). Within the same nutritional status group, there were no differences between sexes or between right and left sides. Conclusions:Intima-media thickness was greater among children with overweight/obesity and was directly proportional to BMI z score, denoting increased cardiovascular risk in this group.

SUBMITTER: Garcia J

PROVIDER: S-EPMC6788858 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children.

Garcia Jorge J Benedeti Augusto César Garcia Saab ACGS Caixe Simone Helena SH Mauad Francisco F Nogueira-de-Almeida Carlos Alberto CA

Jornal vascular brasileiro 20191001

<h4>Background</h4>Obesity is a global epidemic, including among children. It is therefore necessary to identify cardiovascular changes in overweight/obese children as early as possible. Mode B ultrasonography of the common carotids can be used to precisely evaluate in real time early changes in the thickness of the intima-media complex (IMC), which can detect onset of the atherosclerosis process.<h4>Objectives</h4>This study compared IMC thickness between schoolchildren with and without overwei ...[more]

PMID: 31645861

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Project description:Objectives: Early identification of children at risk of atherosclerosis is of paramount importance for implementing primary preventive measures addressing vascular health. Carotid intima-media thickness (cIMT) is a non-invasive biomarker of atherosclerosis. Semiautomatic radiofrequency-based software-guided technique quality intima-media thickness (RF-QIMT) was used to determine cIMT normative values in a healthy cohort of Caucasian children aged 6 to 18 years. Study design: In a cross-sectional study, data on age, chronic illness, medication use, and pubertal status was acquired by a questioner. Anthropometric and blood pressure measurements were performed by standardized methods and trained medical personnel. cIMT of the right common carotid artery far wall (1 centimeter proximal to bifurcation) was determined using a multifrequency (3-13 MHz) electronic linear array transducer SL1543, a portable ultrasound device (MyLab Gamma Esaote, Genoa, Italy), and RF-QIMT software. A systematic review of the published normal cIMT in children was done using PRISMA methodology, and identified normative values were compared to those obtained in the presented study. Results: 1137 non-obese normotensive children (males: n = 512; mean age 12.04 ± 3.52 years, females: n = 625, mean age 12.98 ± 3.83 years) were included. Gender-, age-, and height-specific mean cIMT percentile tables, percentile charts, and LMS tables for the RF-QIMT method were provided. They were comparable to the previously published data on mean cIMT gained by other validated ultrasound imaging techniques. cIMT increased with age, height, hip circumference, and BMI and was higher in males. Conclusions: Gender-, age-, and height-specific normative cIMT values, using the semiautomatic software-guided RF-QIMT technique, in children aged 6 to 18 years were developed and validated in respect to the previously published pediatric normative cIMT data. It is suggested that the investigated method could be used for the estimation of atherosclerotic risk in children, especially in epidemiological studies.

Project description:In children, arterial alterations occur with increased intima-media thickness as well as vascular diameter enlargement. Both conditions correlate with higher cardiovascular risk in adults, and both the array and proportion of these alterations are important hemodynamic parameters. In terms of functional adaptation processes, they influence several arterial wall properties as for example the shear and tensile stress of the vessel. There are no reference values for the vascular diameter and intima-media thickness/diameter ratio of the carotid artery in children. Therefore, this study aimed to assess vascular diameter, intima-media thickness/diameter ratio and related tensile stress values in children and to further investigate the influence of sex, age, body mass index, and blood pressure. The parameters were measured with high-resolution semi-automated ultrasound. Sex- and age-dependent values were calculated with the LMS method for a cross-sectional sample of 642 healthy, non-obese children aged 8-17 years. The mean vascular diameter was 5.45?±?0.46 mm; the median intima-media thickness/diameter ratio was 0.085 (0.079-0.092); the median tensile stress was 105.4 (95.2-116.4) kPa. The vascular diameter and the tensile stress were higher, and the intima-media thickness/diameter ratio was lower in boys than in girls. In comparison to the normal weight study population the excludedobese children had a significantly higher diameter, a lower intima-media thickness/diameter ratio, and a higher tensile stress. In multiple regression analyses of diameter, intima-media thickness/diameter ratio, and tensile stress, all parameters were influenced by sex and body mass index. Furthermore, systolic and diastolic blood pressure significantly influenced the vascular diameter, and systolic blood pressure significantly influenced the intima-media thickness/diameter ratio. Conclusion: This study is the first to report values for the diameter, the intima-media thickness/diameter ratio of the carotid artery, and the related tensile stress allowing a more differentiated view of cardiovascular adaptations as it combines structural and functional vascular parameters. What is known: • Intima-media thickness and vascular diameter are related to a higher cardiovascular risk in adults • The intima-media thickness/diameter ratio gives information about hemodynamic and functional vessel adaptation What is new: • Values for vascular diameter, intima-media thickness/diameter ratio, and tensile stress of the carotid artery in children are presented in this study • Intima-media thickness as a surrogate marker for arterial health in children should be complemented by intima-media thickness/diameter ratio measurement.

Dataset Information

Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children.

Publications

Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children.

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