Abstract
Given the growing obesity rates among children, a more complete evaluation of their potential cardiometabolic risk is needed. Carotid intima-media thickness (CIMT), a marker of endothelial distress and a predictor of atherosclerotic progression in adulthood, may complete the day-to-day evaluation of children at risk. Multiple risk factors act as additional precipitant causes of atherosclerosis. We analyzed 60 patients aged 6–17 years old by measuring their CIMT using the Aixplorer MACH 30 echography machine automatic measurement software. All subjects were clinically and anamnestically assessed to identify risk factors. CIMT values are significantly higher in older children and boys. Over 20 kg weight gain during pregnancy and other at-risk disorders (p = 0.047), family history of cardiovascular risk (p = 0.049), hypertension (p = 0.012), and smoking (p = 0.015) are linked to increased CIMT. Our study also supports international data on artificial postnatal nutrition, high/low birth weight, and sedentary lifestyle being linked to increased CIMT. Significant correlations were detected between CIMT and the entire lipid panel. Weight excess and abdominal adiposity in children is clearly linked to increased CIMT. Moreover, waist circumference and TG/HDL-c are significant predictors of CIMT. Although each parameter of the lipid panel is correlated to CIMT, fasting glucose is not.
Highlights
Weight excess has been one of the largest public health problems of modern society for decades and, in the obesogenic context of the COVID-19 pandemic, obesity has been affecting children at rates faster than we have ever encountered before [1]
Beauloye et al showed that blood parameters that are classically assessed in obese children are significantly correlated to carotid intima-media thickness (CIMT) [5]
That means that CIMT mean values grew as BMI and weight excess severity grew
Summary
Weight excess has been one of the largest public health problems of modern society for decades and, in the obesogenic context of the COVID-19 pandemic, obesity has been affecting children at rates faster than we have ever encountered before [1]. The importance of a comprehensive evaluation of obesity in children is of paramount importance for early detection of cardiovascular and metabolic complications. Atherosclerosis and high blood pressure, frequent complications of obesity, are slow but steady ongoing processes in obese children, manifesting in adolescence and early adulthood, depending on the severity of the weight excess [3]. Increased carotid intima-media thickness (CIMT) is one of the first observable signs of subclinical atherosclerosis, making this ultrasonographic technique probably the most accurate non-invasive method of detecting early stages of atherosclerosis. Studies estimate that the use of CIMT, a non-invasive, non-painful, non-radiating, cost-effective, and reproducible method, can become one of the pillars of risk evaluation for pediatric patients at risk
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