Cardiovascular risk factors and carotid intima-media thickness in asymptomatic children
Ana Maria Verçoza1, Matteo Baldisserotto, Carlos Abaeté de Los Santos
1Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS 90016-000, Brazil.
Insights
Childhood atherosclerosis risk factors like male gender and obesity predict increased carotid intima-media thickness. Family history of cardiovascular disease was not a significant predictor in this pediatric study.
Area of Science:
- Pediatric cardiology
- Vascular biology
- Public health
Background:
- Atherosclerosis, a process beginning in childhood, is linked to cardiovascular disease risk factors and predicts adult coronary artery disease.
- Subclinical atherosclerosis, measured by carotid intima-media thickness, is an early indicator of vascular events.
- Understanding risk factors in children is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To investigate the associations between carotid intima-media thickness and known cardiovascular risk factors in asymptomatic children.
- To identify predictors of subclinical atherosclerosis in a pediatric cohort.
Main Methods:
- Cross-sectional study involving 93 children (ages 49-169 months).
- Measurements included anthropometrics (BMI z-scores), demographics, clinical data, serum glucose, lipids, fibrinogen, and C-reactive protein.
- High-resolution ultrasonography assessed carotid intima-media thickness.
Main Results:
- Boys exhibited significantly thicker carotid intima-media thickness than girls (p = 0.028).
- Overweight/obesity and higher Body Mass Index (BMI) z-scores were positively associated with increased intima-media thickness (p = 0.012 and p = 0.027, respectively).
- Multiple regression analysis revealed male gender and overweight/obesity as significant predictors of intima-media thickness (R² = 0.125; p = 0.002), while family history of cardiovascular disease was not.
Conclusions:
- Male gender and overweight/obesity are significant risk factors for subclinical atherosclerosis in children, as indicated by carotid intima-media thickness.
- These findings highlight the importance of monitoring weight and gender in pediatric cardiovascular risk assessment.
- Early identification and management of these risk factors in childhood may help prevent future vascular events.
Abstract:
Atherosclerosis, beginning in childhood, is dependent on several risk factors and may be predictive of coronary artery disease in adulthood. The risk factors for subclinical atherosclerosis are similar to those for clinical disease. Carotid intima-media thickness is a measure of subclinical atherosclerosis and a predictor of subsequent vascular events. This study aimed to examine the relationships of carotid intima-media thickness with known risk factors in asymptomatic children. Family history of cardiovascular disease was collected, together with anthropometric, demographic, and clinical data. Body mass index z-scores were calculated. Serum glucose, lipid fractions, fibrinogen, and C-reactive protein were determined. High-resolution ultrasonography was used to assess intima-media thickness. Associations and relationships of risk factors with composite intima-media thickness were explored. The study enrolled 93 children (44 girls) ranging in age from 49 to 169 months. The boys had a thicker intima-media (0.46 +/- 0.06 mm) than the girls (0.43 +/- 0.06 mm; p = 0.028). The unadjusted triglyceride levels were significantly higher in the overweight and obese children (p = 0.010). Body mass index and overweight/obesity were positively related to intima-media thickness (r = 0.259; p = 0.012 and r (s) = 0.230; p = 0.027, respectively), whereas family history of cardiovascular disease was unrelated. Only gender and overweight/obesity were related to intima-media thickness in a multiple linear regression model (R (2) = 0.125; p = 0.002). Male gender and overweight/obesity were associated with increased intima-media thickness, whereas family history of cardiovascular disease was unrelated.
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