ADIPOSITY, BLOOD PRESSURE AND CAROTID INTIMA-MEDIA THICKNESS IN GREEK CHILDREN AND ADOLESCENTS: 9B.03

Abstract

Objective: To investigate the association between adiposity, blood pressure (BP) and carotid intima-media thickness (cIMT) in healthy children and adolescents. Method: The study included 307 high school students (mean age 14.4 ± 2.1 years, 132 boys) in Samos island, Greece. Participants underwent high resolution B-mode carotid ultrasonography and measurements of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), lipid profile, glucose and office BP (3 readings). Results: The prevalence of overweight was 27% and of obesity 12.4%. Office BP was in the high-normal range (systolic and/or diastolic >=90th to <95th percentile) in 25.7% of the participants and in the hypertension range (>=95th percentile) in 16.9%. BMI, WC and WHR were correlated with systolic (r = 0.41/0.17/0.19 respectively) and diastolic BP (0.37/0.19/0.14) (all p < 0.05). Left cIMT was correlated with WC (r = 0.20), WHR (0.18), systolic BP (0.17), diastolic BP (0.14) and low density lipoprotein cholesterol (LDL-C) (0.13) (all p < 0.05). Right cIMT was correlated with WHR (r = 0.14, p = 0.01). Mean left-right cIMT was correlated with WC (r = 0.16), WHR (0.18) and systolic BP (0.11) (all p < 0.05). In stepwise regression analysis (dependent predictors age, gender, WC, WHR, LDL-C, systolic, diastolic BP) only WC was an independent predictor of left cIMT, whereas WHR was predictive of right and average cIMT. Children with large WC (>=90th percentile, age-gender-specific; n = 84) compared to those <90th percentile had higher BP (120.3 ± 11.4/75.5 ± 7.7 mmHg systolic/diastolic vs. 113.5 ± 11.8/70.5 ± 8.3 mmHg, p < 0.001), LDL-C (102.2 ± 30.9 vs. 88.3 ± 21.5 mg/dl, p < 0.001) and left cIMT (0.65 ± 0.1 vs. 0.63 ± 0.09 mm, p = 0.04). In subjects with WC <90th percentile, regression analysis with the same variables identified WHR and systolic BP as independent predictors of left cIMT. Conclusions: In apparently healthy children and adolescents central adiposity appears to be the most important predictor of early carotid atherosclerosis, whereas elevated BP and LDL-C also contribute. In children without central adiposity, WHR and systolic BP predict carotid atherosclerosis.