Intima-media Thickness In Adolescents Research Articles

Is there an association between metabolically healthy obesity and carotid intima-media thickness in adolescents with overweight and obesity?: Commentary on "Association between metabolically healthy obesity and carotid intima-media thickness in Korean adolescents with overweight and obesity"

Is there an association between metabolically healthy obesity and carotid intima-media thickness in adolescents with overweight and obesity?: Commentary on "Association between metabolically healthy obesity and carotid intima-media thickness in Korean adolescents with overweight and obesity"

Glycated Hemoglobin is a Significant Predictor of Femoral, but Not of Carotid or Popliteal, Intima-Media Thickness in Adolescents with Type 1 Diabetes: A Case-Series Study

In healthy adults, the association between the glycated hemoglobin A1c (HbA1c) level and intima-media thickness (IMT) is stronger in the femoral artery than that in the carotid artery. However, whether this differential strength of association also applies to adolescents with type 1 diabetes (T1D) is unknown. Therefore, this study aimed to examine whether IMT increases in extracarotid arteries (specifically in the lower extremities) prior to the carotid artery. In total, 286 adolescents with T1D (15.9 ± 4.9 years; 42.0% male participants) were enrolled, and the B-mode ultrasonographic measurement of IMT in the carotid, femoral, and popliteal arteries was performed. Cardiovascular risk factors, including blood pressure (BP), body mass index, lipid levels, and glycemic parameters, were evaluated. To evaluate the site-dependent relationship between IMT and cardiovascular risk factors, a linear mixed-effects model was developed with repeated IMT measurements at various arterial sites as fixed effects and participants as random effects. Glycemic parameters, lipids, uric acid, high-sensitivity C-reactive protein, and advanced glycation end-products were some cardiovascular risk factors that worsened with increasing HbA1c levels. Patients with a higher HbA1c level (>10% vs. ≤10%) had thicker IMT in the femoral artery but not in the carotid or popliteal arteries. Patients with poorer diabetic control exhibited significant changes in certain cardiovascular functions, including central systolic BP, left ventricular (LV) ejection time, LV dp/dt max, stroke volume, and brachial artery compliance. A standard mediation analysis revealed that none of the aforementioned cardiovascular functions mediated the relationship between higher HbA1c level and greater femoral IMT. In adolescents with T1D, cardiovascular risk factors deteriorate with worsening blood glucose control. In the early stages of T1D, femoral IMT may serve as a more sensitive surrogate marker for hyperglycemia-induced subclinical atherosclerosis, an effect that may not be mediated by alterations in cardiovascular functions.

Correlation of uric acid with carotid intima media thickness in obese adolescents

obesity in the pediatric population is a public health problem. The correlation of uric acid and carotid intima media thickness in adults has been demonstrated. to identify the correlation of uric acid and carotid intima media thickness in adolescents with obesity. an observational, cross-sectional study was carried out. Patients aged ten to 16 years with a diagnosis of obesity were included. Uric acid, lipid profile and carotid intima media thickness were determined. In relation to the statistical analysis, carotid intima media thickness was correlated with uric acid levels through Spearman's correlation coefficient. one hundred and sixty-nine adolescents were included with a median age of 13 years, without predominance of sex. A positive correlation of uric acid with carotid intima media thickness was identified (r = 0.242, p = 0.001). When stratified according to sex, there was no correlation in women (r = -0.187, p = 0.074), while in men it increased (r = 0.36, p = 0.001) and by pubertal stage, pubertal male adolescents had a positive correlation (p = 0.384, p = 0.002). a weak positive correlation was identified between carotid intimal thickness and uric acid in obese adolescents.

Association of serum levels of 4-tertiary-octylphenol with cardiovascular risk factors and carotid intima-media thickness in adolescents and young adults

In the family of alkylphenolic compounds, 4-tertiary-Octylphenol (4-t-OP) is extensively used in many products. In animal and in vitro studies, 4-t-OP exposure has been linked to cardiovascular disease (CVD) risk factors; however, there are no previous human epidemiological studies. In this study, 886 subjects were recruited from a cohort of Taiwanese adolescents and young adults to study the relationship between serum levels of 4-t-OP, CVD risk factors, and common carotid artery intima-media thickness (CIMT). The geometric mean (SD) 4-t-OP concentration was 32.52 (1.71) ng/mL. We found that serum levels of 4-t-OP were negatively associated with markers of glucose homeostasis (insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β)), z score of body mass index (BMI z score) and CIMT but were positively associated with lipid profiles (high density lipoprotein cholesterol (HDL-C), Apolipoprotein A1). A one-unit elevation in natural log-transformed 4-t-OP (ng/mL) was negatively correlated with CIMT (mm) (β = −0.029, SE = 0.003, P < 0.001) in multiple linear regression analyses. The relationship between 4-t-OP and CIMT remained the same in all subgroups or if bisphenol A (BPA) was considered a covariate. In this study, we observed that higher levels of 4-t-OP levels were negatively correlated with markers of glucose homeostasis, BMI z score, and CIMT; positively correlated with lipid profiles (HDL-C and apolipoprotein A) in this cohort. Future research on exposure to 4-t-OP and CVD risk factors is warranted.

Risk factors associated with carotid intima media thickness in adolescents with type 2 diabetes mellitus

Risk factors associated with carotid intima media thickness in adolescents with type 2 diabetes mellitus

Short Sleep Duration Is Weakly Associated with Carotid Intima-Media Thickness in Adolescents

To investigate the relationship between sleep duration and carotid intima-media thickness (CIMT) in adolescents. We hypothesized that short sleep duration was associated with an increased CIMT. This was a cross-sectional study. Healthy participants aged 10-18 years were recruited from a school-based cohort established to examine the prevalence of obstructive sleep apnea in Hong Kong. All participants completed a prospective 7-day sleep diary, underwent anthropometric measurements, overnight polysomnography, and CIMT assessment. Overweight participants or those with an obstructive apnea hypopnea index of ≥5 were excluded from analysis. Regression analysis was used to assess the association between CIMT and sleep duration and other possible correlates. One hundred forty-two participants completed the assessments. Male participants tended to have shorter sleep duration than females (P = .012). There were no differences in age, body mass index, Tanner developmental stage, or parental history of hypertension between groups of different sleep durations. There was a weak but significant association between short sleep duration and CIMT (r = -0.273; P < .001). Sleep duration was found to have a weakly negative association with CIMT. Further research is needed to determine whether adult adverse cardiovascular events may originate in childhood owing to short sleep duration.

Phthalate Exposure is associated with Carotid Intima-Media Thickness in Adolescents and Young Adults

Background/Aim: Exposure to phthalates has been linked to cardiovascular risk factors. However, it is unclear regarding phthalates exposure and the risk of subclinical atherosclerosis. This study investigated the association between phthalates exposure and carotid intima-media thickness (CIMT) in young population. Methods: From a nationwide mass urine screening for renal health, conducted in 1992-2000 among school children 6 to 18 years of age in Taiwan, we recruited 789 subjects to participate the cardiovascular health examination in 2006-2008. Among them, 787 received measurements of 7 urinary phthalate metabolites and CIMT. Results: Both mean and maximal values of CIMT at all segments of carotid arteries significantly increased with the urinary mono-2-ethylhexyl phthalate (MEHP), ∑MEHP, and mono-n-butyl phthalate (MnBP) in a dose-response relationship after adjustment for multiple linear regression models. Multivariate logistic regression analysis showed that higher quartiles of urinary concentrations of MEHP, ∑MEHP, and MnBP were associated with a higher risk of thicker CIMT. Compared to subjects with the lowest quartile (Q1) of urinary MEHP, the adjusted odds ratios (aORs) (95% confidence interval (CI)) for thicker CIMT among subjects with higher urinary MEHP were 2.13(1.18-3.84) at Q2, 4.02(2.26-7.15) at Q3 and 7.39(4.16-13.12) at the highest Q4. Comparing those with lowest urinary MnBP, the corresponding aORs (95% CI) were 1.84 (1.08-3.15) for subjects at Q3, and 2.80 (1.65-4.75) for subjects at the highest Q4. Conclusions: Urinary phthalate metabolites of MEHP, ∑MEHP, and MnBP are strongly associated with CIMT in adolescents and young adults in Taiwan.

Adiposity has no direct effect on carotid intima-media thickness in adolescents and young adults: Use of structural equation modeling to elucidate indirect & direct pathways

BackgroundCarotid intima-media thickness (cIMT) is associated with CV events in adults. Thicker cIMT is found in youth with CV risk factors including obesity. Which risk factors have the most effect upon cIMT in youth and whether obesity has direct or indirect effects is not known. We used structural equation modeling to elucidate direct and indirect pathways through which obesity and other risk factors were associated with cIMT. MethodsWe collected demographics, anthropometrics and laboratory data on 784 subjects age 10–24 years (mean 18.0 ± 3.3 years). Common, bulb and internal carotid cIMT were measured by ultrasound. Multivariable regression analysis was performed to assess independent determinants of cIMT. Analyses were repeated with structural equation modeling to determine direct and indirect effects. ResultsMultivariable regression models explained 11%–22% of variation of cIMT. Age, sex and systolic blood pressure (BP) z-score were significant determinants of all cIMT segments. Body mass index (BMI) z-score, race, presence of type 2 diabetes mellitus (T2DM), hemoglobin A1c (HbA1c) and non-HDL were significant for some segments (all p = 0.05). The largest direct effect on cIMT was age (0.312) followed by BP (0.228), Blood glucose control (0.108) and non-HDL (0.134). BMI only had a significant indirect effect through blood glucose control, BP & non-HDL. High sensitivity C-reactive protein (CRP) had a small indirect effect through blood glucose control (all p = 0.05). ConclusionsAge and BP are the major factors with direct effect on cIMT. Glucose and non-HDL were also important in this cohort with a high prevalence of T2DM. BMI only has indirect effects, through other risk factors. Traditional CV risk factors have important direct effects on cIMT in the young, but adiposity exerts its influence only through other CV risk factors.

Association between levels of serum bisphenol A, a potentially harmful chemical in plastic containers, and carotid artery intima-media thickness in adolescents and young adults.

Bisphenol A (BPA) is a chemical produced at high volumes and used widely in food and drink packaging. In adults, elevated BPA concentrations are associated with cardiovascular disease. BPA exposure is plausibly linked to atherosclerosis in adolescents and young adults, but evidence is lacking to date. We recruited 886 subjects (12-30 years of age) from a population-based sample of adolescents and young adults based on a mass urine screening to determine the relationship between serum levels of BPA and carotid intima-media thickness (CIMT). The geometric mean (standard deviation) of concentrations of BPA were 1.72 (5.5) ng/mL After controlling for confounding factors, linear regression analyzes showed a 1-unit increase in natural log BPA was significantly associated with an increase in mean CIMT (mm) (β=0.005, 95% C.I.=0.003-0.007, p<0.001) and other measurement of CIMT (including right and left side of common carotid artery, carotid bulb and internal carotid artery). Higher serum concentrations of BPA were associated with increased CIMT in this cross-sectional study of adolescents and young adults. Studies to clarify the mechanisms of these associations are needed.

Serum Copeptin, Pentraxin 3, Anti-Mullerian Hormone Levels With Echocardiography and Carotid Artery Intima-Media Thickness in Adolescents With Polycystic Ovary Syndrome.

BackgroundThe aim of the study was to investigate the presence of possible markers in the prediction of polycystic ovary syndrome (PCOS)-related metabolic alterations and cardiovascular events in adolescent PCOS cases and also to investigate the applicability of anti-Mullerian hormone (AMH) levels for the diagnosis of PCOS.MethodsIn this cross-sectional study, a total of 75 non-obese women (adolescent PCOS group, n = 25; adult PCOS group, n = 25; control group, n = 25) were included. Measurements of copeptin, pentraxin 3 (PTX3), and AMH serum levels were performed.ResultsSerum copeptin, PTX3 and echocardiographic indices were not significantly different in PCOS subjects and they did not have higher common carotid artery intima-media thickness (CIMT) measurement. AMH levels were significantly higher in PCOS patients. There was a positive correlation between AMH and mean ovarian volume (r = 0.58, P < 0.001) and between AMH and total testosterone level (r = 0.63, P < 0.001). In order to predict a threshold value for the diagnosis of PCOS by using AMH, the receiver operating characteristic (ROC) method was used. Area under the curve was 0.820 and cut-off point was 6.66 ng/mL for AMH with a sensitivity of 62% and specificity of 76%.ConclusionsPossible markers for PCOS-related metabolic alterations may not present in the adolescent years. Serum AMH may be useful as a diagnostic test for adolescents.

Abstract 13223: Structural Equation Modeling Demonstrates only an Indirect Effect of Obesity on Carotid Intima-Media thickness in Adolescents and Young Adults

Introduction: Increased carotid intima-media thickness (cIMT) is associated with cardiovascular (CV) events in adults. Thicker cIMT is found in youth with elevated CV risk factors including obesity although biologically plausible reasons for a direct effect are not clear. We hypothesized that obesity affects cIMT only indirectly through other CV risk factors and this could be demonstrated with use of structural equation modeling (SEM). Methods: Ultrasound of the right and left common, bulb and internal carotid arteries was performed in 784 adolescent and young adults (10-24 years old, 65% female, 41% Caucasian, 32% T2DM). Demographics, anthropometrics and fasting laboratory data were collected. Traditional multiple regression analyses (MRA) were performed to assess independent determinants of cIMT. Analyses were then repeated with SEM. Results: MRA models explained 11%-22% of variation of common, bulb and internal cIMT. Obesity, age, sex and SBP z-score were significant determinants of all cIMT segments. Race, presence of T2DM, HbA1c and non-HDL contributed for some segments. In SEM, latent variable “cIMT” was used to represent the 3 segments of cIMT. Latent variable “BP” was extracted from SBP and DBP z-score. Latent variable “BGC” (blood glucose control) was extracted from fasting glucose and HbA1c. The final SEM explained a larger amount of the variance of cIMT (43%). The largest direct effect on cIMT was age followed by BP, blood glucose control and non-HDL. BMI, another central risk factor in the pathway towards atherosclerosis, only had a significant indirect effect through blood glucose control, BP &amp; non-HDL. CRP had a small indirect effect through blood glucose control. We conclude that traditional CV risk factors have important direct effects on cIMT in adolescents and young adults but adiposity exerts its influence only through other CV risk factors. SEM may be a useful tool in modeling complex biological pathways.

Relationship between trigliceryde to high density lipoprotein cholesterol ratio and carotid intima media thickness in adolescents

Relationship between trigliceryde to high density lipoprotein cholesterol ratio and carotid intima media thickness in adolescents

Clinical and biochemical predictors of carotid intima media thickness in adolescents with type 2 diabetes

The aim of this study was to identify clinical parameters associated with increased carotid intima media thickness (CIMT) in adolescents with type 2 diabetes. Overweight children and adolescents are at increased risk of type 2 diabetes and early development of atherosclerotic lesions and cardiovascular complications. Patients were selected among diabetics who presented to diabetes out patients’ clinic. Criteria for selection were age (12–19 years), being overweight (BMI above the 95th percentile for age and gender), normal or high C-peptide, and negative studies for islet cell antibodies. Age and gender matched healthy subjects, were enrolled as a control group. Laboratory investigations included lipid profile, hypersensitive C-reactive protein (hs-CRP), HbA1c and assessment of insulin resistance by HOMA. According to HbA1c, patients were divided into, uncontrolled group (with HbA1c >6.5) and controlled group (with HbA1c ⩽ 6.5). Ultrasonographic analysis of CIMT was performed for all participants and its association with risk variables was analyzed. BMI, triglycerides, C-reactive protein, HbA1c and HOMA were significantly higher in diabetic patients than the controls. CIMT, HbA1c, systolic blood pressure, triglycerides, HOMA and C-reactive protein were significantly higher in uncontrolled than controlled diabetics, while there was no significant difference between the two groups as regard BMI, total cholesterol, LDL, HDL and C-peptide. In diabetic patients, CIMT correlated positively with BMI, duration of diabetes, systolic and diastolic blood pressure, HbA1c, HOMA, and C reactive protein. CIMT is increased in adolescents with type 2 diabetes as compared to control subjects. Poor glycemic control, HOMA, increased C reactive protein, BMI, duration of diabetes and elevated blood pressure are associated with early atherosclerosis in these patients.

Relations between Vitamin D level and Carotid Artery Intima-Media Thickness in Adolescents with Type 1 Diabetes

Relations between Vitamin D level and Carotid Artery Intima-Media Thickness in Adolescents with Type 1 Diabetes

Lipids and lipoprotein ratios: Contribution to carotid intima media thickness in adolescents and young adults with type 2 diabetes mellitus

Dyslipidemia is common among adolescents with type 2 diabetes (T2D). To assess whether the lipoprotein ratios of low-density lipoprotein (LDL) cholesterol/high-density lipoprotein (HDL) cholesterol or triglycerides/HDL or non-HDL cholesterol are more useful than the traditional lipid panel to predict increased arterial thickness in adolescents and young adults with T2D. We evaluated 244 adolescents and young adults with T2D in a cross-sectional study (mean age 18 years; 56% African American; 65% female). Demographics, anthropometrics, and laboratory data were collected. Arterial thickness was assessed with carotid intima media thickness (IMT). Bivariate correlations and general linear models were used to determine the independent contributions of the various lipid parameters to carotid IMT. Bivariate correlations showed LDL/HDL ratio was the strongest predictor of carotid IMT (P < .02). After adjustment for potential covariates LDL/HDL was no longer significant. HDL cholesterol was the only lipid to independently (negatively) contribute to carotid IMT. Other risk factors that were independently associated with carotid IMT included age, race, sex, body mass index z score, and hemoglobin A1c. Together these cardiovascular risk factors explained <20% of the variance in carotid IMT. HDL cholesterol is the only lipid to independently associate with carotid IMT. Lipoprotein ratios and non-HDL did not provide additional information. The low variance in carotid IMT explained by traditional risk factors suggests nontraditional risk factors may be important to assess to better understand the contributors to early-stage atherosclerosis in adolescents and young adults with T2D.

Association of socioeconomic status, truncal fat and sICAM-1 with carotid intima-media thickness in adolescents: The HELENA study

ObjectiveTo measure the carotid intima-media-thickness (cIMT) and to assess its determinant factors in healthy adolescents. Methods319 adolescents aged 12.5–17.5 years (135 boys, 184 girls) were enrolled in this cross-sectional study. cIMT and carotid diameter were measured by high-resolution B-mode ultrasound. Anthropometric parameters, blood pressure, physical activity (PA), aerobic fitness and dietary intakes were assessed. Socioeconomic status was determined with the family affluence scale (FAS 4). Serum biological markers (lipids, glucose, high-sensitivity C-reactive protein, soluble adhesion molecules) were measured in a subsample of 96 adolescents. ResultsMultiple regression analysis showed that cIMT was positively associated with truncal fat (p = 0.021) and negatively with FAS 4 (p = 0.002) independently of age and blood pressure. There were no significant associations between cIMT and PA, fitness and dietary intakes. In the subsample soluble intercellular adhesion molecule 1 was positively correlated with cIMT (p = 0.017), independently of truncal fat, age and blood pressure. ConclusionsLow socioeconomic conditions and increased truncal fat are associated with greater carotid intima-media-thickness in adolescents.

Erratum to: Increased large artery intima media thickness in adolescents with either classical or non-classical congenital adrenal hyperplasia

Erratum to: Increased large artery intima media thickness in adolescents with either classical or non-classical congenital adrenal hyperplasia

Increased large artery intima media thickness in adolescents with either classical or non-classical congenital adrenal hyperplasia.

Increased artery intima-media thickness (IMT) was found in adults with classical congenital adrenal hyperplasia (CAH). No data are available in patients with non-classical (NC) CAH. To evaluate IMT in adolescents with classical and NC CAH and to compare the results with those recorded in a control population. Eighteen adolescents with either classical (Subgroup A1) or NC CAH (Subgroup A2) were compared with 16 controls (Group B). All subjects underwent IMT ultrasonography measurement at different sites; results were correlated with clinical, metabolic, and insulin resistance (IR) data. When compared with Group B, both subgroups exhibited higher IMT values at all sites. No differences were found between classical and NC CAH. Univariate analysis of factors impacting on IMT of CAH patients demonstrated that: a) abdominal aorta (AA) IMT was positively correlated with cumulative glucocorticoid doses, triglyceride serum levels, and diastolic blood pressure SD score and negatively with androstenendione and ACTH levels; b) common carotid (CC) IMT was positively associated with triglycerides and triglyceride/HDL ratio. At multiple regression analysis, the independent positive predictors of AA and CC IMT were respectively triglyceride levels and triglyceride/HDL ratio. a) Even adolescents with NC CAH and not only those with classical form may be at higher risk of artery alterations; b) this risk is not necessarily associated with either obesity or waist/height ratio or dyslipidemia; c) an important role in the pathogenesis of artery alterations in CAH may be played by intermittent iatrogenic hypercortisolism and secondary IR.

Intrauterine growth restriction is associated with persistent aortic wall thickening and glomerular proteinuria during infancy

Low birth weight, caused either by preterm birth or by intrauterine growth restriction, has recently been associated with increased rates of adult renal and cardiovascular disease. Since aortic intima–media thickening is a noninvasive marker of preclinical vascular disease, we compared abdominal aortic intima–media thickness among intrauterine growth restricted and equivalent gestational age fetuses in utero and at 18 months of age. The relationship between intrauterine growth restriction, fetal aortic thickening, and glomerular function during infancy was measured by enrolling 44 mothers with single-fetus pregnancies at 32 weeks gestation: 23 growth restricted and 21 of appropriate gestational age as controls. Abdominal aortic intima–media thickness was measured by ultrasound at enrollment and again at 18 months of age. Fetuses with intrauterine growth restriction had significantly higher abdominal aortic intima–media thickness compared with age controls when measured both in utero and at 18 months. At 18 months, the median urinary microalbumin and median albumin–creatinine ratio were significantly higher in those infants who experienced intrauterine growth restriction compared to the controls. Our results show that intrauterine growth restriction is associated with persistent aortic wall thickening and significantly higher microalbuminuria during infancy.

The impact of serum homocysteine on intima-media thickness in normotensive, white-coat and sustained hypertensive adolescents

Background and purpose. In recent decades, elevated levels of homocysteine (Hcy) have been found to be associated with an increased risk of vascular events. Additionally, in some case–control studies, hyperhomocysteinaemia has been found to be related to higher intima-media thickness (IMT), but the results are inconclusive. Therefore, in the present study we intended to assess the relationship between serum levels of Hcy and IMT in normotensive and hypertensive adolescents. Patients and methods. 59 normotensive 47 white coat hypertensive and 73 sustained hypertensive adolescents were included in our study. IMT of the common carotid arteries was measured by B-mode ultrasonography. Plasma NOx as well as homocysteine levels were measured in all cases. The relationship between IMT and Hcy and NOx were assessed by a pooled analysis. Additionally, serum levels of Hcy and NOx were compared between normotensives and hypertensive subgroups. Results. IMT was elevated in hypertensive adolescents (means ± SD: 0.055 ± 0.01 cm) compared with normotensives (0.048 ± 0.008 cm, p < 0.01). Higher serum concentrations of homocysteine were measured in hypertensive teenagers (11.9 ± 7.25 µmol/l for hypertensive and 9.85 ± 3.12 µmol/l for normotensives respectively, p < 0.01). In contrast to this, serum NOx was lower in patients (28.8 ± 14.9 µmol/l) compared with controls (38.8 ± 7.6 µmol/l, p < 0.01). The pooling of homocysteine and IMT data of hypertensive and normotensive adolescents revealed a significant positive relationship between the two parameters (r = 0.43, p < 0.001). Conclusions. We conclude that elevated serum levels of homocysteine may play a role in increased IMT in adolescent hypertension.