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Lean body mass may explain apparent racial differences in carotid intima-media thickness in obese children

Shahryar M Chowdhury1, Melissa H Henshaw1, Brad Friedman2

  • 1Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|February 12, 2014
PubMed

Insights

Black children have thicker carotid intima-media thickness (cIMT) than white children. This difference in cIMT is explained by lean body mass, a key factor in cardiovascular risk assessment for obese youth.

Area of Science:

  • Pediatrics
  • Cardiology
  • Public Health

Background:

  • Racial disparities in cardiovascular disease (CVD) prevalence suggest underlying biological or environmental factors.
  • Carotid intima-media thickness (cIMT) is a marker of subclinical atherosclerosis and predictor of CVD events.
  • Obesity is a growing concern in children, potentially exacerbating CVD risk factors.

Purpose of the Study:

  • To investigate racial differences in cIMT among obese children.
  • To determine the influence of cardiovascular risk factors on these racial variations in cIMT.

Main Methods:

  • Prospective recruitment of obese children and adolescents (ages 4-21).
  • Comprehensive data collection including anthropometrics, blood pressure, metabolic markers, and body composition (dual-energy x-ray absorptiometry).
  • Standardized B-mode ultrasound for cIMT measurement by a blinded physician.

Main Results:

  • Black children exhibited significantly greater cIMT compared to white children.
  • Lean body mass index was significantly higher in Black subjects.
  • Multivariate analysis revealed that lean body mass, not race, was the primary predictor of cIMT.

Conclusions:

  • Racial differences in cIMT among obese children are mediated by lean body mass.
  • Lean body mass is a critical factor to consider when evaluating CVD risk in obese youth.
  • Future research should incorporate lean body mass into analyses of cIMT and CVD risk factors in pediatric populations.
Abstract

Keywords:
Carotid intima-media thicknessChildrenLean body massObesityRace

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