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Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children

  • Fernanda Mussi Gazolla EMAIL logo , Maria Alice Neves Bordallo , Isabel Rey Madeira , Cecilia Noronha de Miranda Carvalho , Alexandra Maria Vieira Monteiro , Nádia Cristina Pinheiro Rodrigues , Marcos Antonio Borges , Paulo Ferrez Collett-Solberg , Bruna Moreira Muniz , Cecilia Lacroix de Oliveira , Suellen Martins Pinheiro and Rebeca Mathias de Queiroz Ribeiro
Published/Copyright: March 14, 2015

Abstract

Background: Early exposure to cardiovascular risk factors creates a chronic inflammatory state that could damage the endothelium followed by thickening of the carotid intima-media.

Objective: To investigate the association of cardiovascular risk factors and thickening of the carotid intima.

Subjects/Methods: Media in prepubertal children. In this cross-sectional study, carotid intima-media thickness (cIMT) and cardiovascular risk factors were assessed in 129 prepubertal children aged from 5 to 10 year. Association was assessed by simple and multivariate logistic regression analyses.

Results: In simple logistic regression analyses, body mass index (BMI) z-score, waist circumference, and systolic blood pressure (SBP) were positively associated with increased left, right, and average cIMT, whereas diastolic blood pressure was positively associated only with increased left and average cIMT (p<0.05). In multivariate logistic regression analyses increased left cIMT was positively associated to BMI z-score and SBP, and increased average cIMT was only positively associated to SBP (p<0.05).

Conclusions: BMI z-score and SBP were the strongest risk factors for increased cIMT.


Corresponding author: Fernanda Mussi Gazolla, MD, Endocrinologist from the Unidade Docente Assistencial (UDA) de Endocrinologia e Metabologia, Hospital Universitário Pedro Ernesto (Pedro Ernesto Hospital) (HUPE), Universidade do Estado do Rio de Janeiro (State University of Rio de Janeiro) (UERJ) Rua Hélio Maurício, 103, Barra da Tijuca. Rio de Janeiro. Rio de Janeiro, Brasil, CEP: 22631-300, Phone: +55-21-33262107, +55-21-999879595, Fax: +55-21-33262107, E-mail:

Acknowledgments

This project received financial support (APQ1) from the Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), protocol number E-26/110.485/2010.

Conflict of interest statement: There was no conflict of interest.

References

1. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. The Lancet 2011;377:557–67.10.1016/S0140-6736(10)62037-5Search in Google Scholar

2. Steinberg D, Witzum JL. Is the oxidative modification hypothesis relevant to human atherosclerosis? Circulation 2002;105: 2107–11.10.1161/01.CIR.0000014762.06201.06Search in Google Scholar

3. Belay B, Belamarich P, Racine AD. Pediatric precursors of adult atherosclerosis. Pediatri Rev. 2004;25:4–16.10.1542/pir.25.1.4Search in Google Scholar

4. Celermajer DS, Sorensen KE, Gooch VM, Miller OI, Sullivan ID, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340:1111–5.10.1016/0140-6736(92)93147-FSearch in Google Scholar

5. Groner JA, Joshi M, Bauer JA. Pediatric precursors of adult cardiovascular disease: noninvasive assessment of early vascular changes in children and adolescents. Pediatrics 2006;118:1683–91.10.1542/peds.2005-2992Search in Google Scholar PubMed

6. Torrejón C, Hevia M, Ureta E, Valenzuela X, Balboa P. Intima-media thickness in obese adolescents and their relation with metabolic syndrome. Nutr Hosp 2012;27:192–7.Search in Google Scholar

7. Gállego Pérez-Larraya J, Irimia P, Martínez-Vila E, Barba J, Guembe MJ, et al. The influence of obesity on the assessment of carotid intima-media thickness. J Clin Ultrasond 2012;40: 479–85.10.1002/jcu.21916Search in Google Scholar PubMed

8. Juonala M, Magnussen CG, Venn A, Dwyer T, Burns TL, et al. Influence of age on associations between childhood risk factors and carotid intima-media thickness in adulthood the cardiovascular risk in Young Finns Study, The Childhood Determinants of Adult Health Study, The Bogalusa Heart Study, and The Muscatine Study for The International Childhood Cardiovascular Cohort (i3c) Consortium. Circulation 2010;122:2514–25.10.1161/CIRCULATIONAHA.110.966465Search in Google Scholar PubMed

9. Slyper AH. Clinical review 168: what vascular ultrasound testing has revealed about pediatric atherogenesis, and a potential clinical role for ultrasound in pediatric risk assessment. J Clin Endocrinol Metab 2004;89:3089–95.10.1210/jc.2003-030644Search in Google Scholar PubMed

10. Reinehr T, Kiess W, Sousa G, Stoffel-Wagner B, Wunsch R. Intima media thickness in childhood obesity Relations to inflammatory marker, glucose metabolism, and blood pressure. Metabolism Clinical and Experimental 2006;55:113–8.10.1016/j.metabol.2005.07.016Search in Google Scholar PubMed

11. Beauloye V, Zech F, Mong HT, Clapuyt P, Maes M, et al. Determinants of early atherosclerosis in obese children and adolescents. J Clin Endocrinol Metabol 2007;92:3025–32.10.1210/jc.2007-0619Search in Google Scholar PubMed

12. Pacifico L, Cantisani V, Ricci P, Osborn JF, Schiavo E, et al. Nonalcoholic fatty liver disease and carotid atherosclerosis in children. Pediatr Res 2008;63:423–7.10.1203/PDR.0b013e318165b8e7Search in Google Scholar PubMed

13. Verçoza AM, Baldisserotto M, Los Santos CA, Poli-De-Figueiredo CE, D’avila DO. Cardiovascular risk factors and carotid intima-media thickness in asymptomatic children. Pediatr Cardiol 2009;30:1055–60.10.1007/s00246-009-9493-3Search in Google Scholar PubMed

14. Roh EJ, Lim JW, Ko KO, Cheon EJ. A useful predictor of early atherosclerosis in obese children: serum high-sensitivity C-reactive protein. J Korean Med Sci 2007;22:192–7.10.3346/jkms.2007.22.2.192Search in Google Scholar PubMed PubMed Central

15. Marchall WA, Tanner JM. Variations in the pattern of pubertal changes in girls and boys. Arch Dis Child 1969;44:291–303.10.1136/adc.44.235.291Search in Google Scholar PubMed PubMed Central

16. Callaway CW, Chumlea WC, Bouchard C, Himes JH, Lohman TG, Martin AD, et al. Circumferences. In: Lohman TG, Roche AF, Martorell R, editors. Anthropometric standardization reference manual. Champaign IL: Human Kinetics, 1988;39–54.Search in Google Scholar

17. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, et al. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 2007;85:660–7.10.2471/BLT.07.043497Search in Google Scholar PubMed PubMed Central

18. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114(suppl 2 4th Report):555–76.10.1542/peds.114.2.S2.555Search in Google Scholar

19. Friedwald WT, Levy RI, Fredrickson DS. Estimation of low-density lipoprotein cholesterol in plasma without use of preparative ultracentrifugate. Clin Chem 1972;18:499–502.10.1093/clinchem/18.6.499Search in Google Scholar

20. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Search in Google Scholar PubMed

21. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intima plus media thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 1986;74:1399–406.10.1161/01.CIR.74.6.1399Search in Google Scholar PubMed

22. Yang X, Liu Y, Mi J, Tang C, Du J. Pre-clinical atherosclerosis evaluated by carotid intima-media thickness and the risk factors in children. Chin Med J 2007;120:359–62.10.1097/00029330-200703010-00002Search in Google Scholar

23. Lamotte C, Iliescu C, Libersa C, Gottrand F. Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. Eur J Pediatr 2011;170:719–29.10.1007/s00431-010-1328-ySearch in Google Scholar

24. Aycan Z, Berberoglu M, Ocal G, Evliyaoglu O, Adiyaman P, et al. Relationship between plasma leptin, insulin and tumor necrosis factor alpha in obese children. J Pediatr Endocrinol Metab 2005;18:275–84.10.1515/JPEM.2005.18.3.275Search in Google Scholar

25. Böttner A, Kratzsch J, Mlüller G, Kapellen TM, Blüher S, et al. Gender differences of adiponectin levels develop during the progression of puberty and are related to serum androgen levels. J Clin Endocrinol Metab 2004;89:4053–61.10.1210/jc.2004-0303Search in Google Scholar

26. Aggoun Y, Farpour-Lambert NJ, Marchand LM, Golay E, Maggio AB, et al. Impaired endothelial and smooth muscle functions and arterial stiffness appear before puberty in obese children and are associated with elevated ambulatory blood pressure. Eur Heart J 2008;29:792–9.10.1093/eurheartj/ehm633Search in Google Scholar

27. Giannini C, de Giorgis T, Scarinci A, Ciampani M, Marcovecchio ML, et al. Obese related effects of inflammatory markers and insulin resistance on increased carotid intima media thickness in pre-pubertal children. Atherosclerosis 2008;197:448–56.10.1016/j.atherosclerosis.2007.06.023Search in Google Scholar

28. Pacifico L, Cantisani V, Anania C, Bonaiuto E, Martino F, et al. Serum uric acid and its association with metabolic syndrome and carotid atherosclerosis in obese children. Eur J Endocrinol 2009;160:45–52.10.1530/EJE-08-0618Search in Google Scholar

29. Morrison KM, Dyal L, Conner W, Helden E, Newkirk L, et al. Cardiovascular risk factors and non-invasive assessment of subclinical athero-sclerosis in youth. Atherosclerosis 2010;208:501–5.10.1016/j.atherosclerosis.2009.07.034Search in Google Scholar

30. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001;358:1400–4.10.1016/S0140-6736(01)06525-4Search in Google Scholar

31. Di SG, Pacileo G, Del Giudice EM, Natale F, Limongelli G, et al. Abnormal myocardial deformation properties in obese, non-hypertensive children: an ambulatory blood pressure monitoring, standard echocardiographic, and strain rate imaging study. Eur Heart J 2006;27:2689–95.10.1093/eurheartj/ehl163Search in Google Scholar PubMed

32. Arnaiz P, Acevedo M, Barja S, Aglony M, Guzmán B, et al. Adiponectin levels, cardiometabolic risk factors and markers of subclinical atherosclerosis in children. Int J Cardiol 2008;138:138–44.10.1016/j.ijcard.2008.08.007Search in Google Scholar PubMed

33. Silva LR, Stefanello JM, Pizzi J, Timossi LS, Leite N. Atherosclerosis subclinical and inflammatory markers in obese and nonobese children and adolescents. Rev Bras Epidemiol 2012;15:804–16.10.1590/S1415-790X2012000400012Search in Google Scholar PubMed

34. NCEP Expert Panel on Blood Cholesterol Levels in Children and Adolescents. National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 1992;89:495–501.10.1542/peds.89.3.495Search in Google Scholar

35. Madeira IR, Carvalho CN, Gazolla FM, de Matos AJ, Borges MA, et al. Cut-off point for homeostatic model assessment for insulin resistance (HOMA-IR) index established from receiver operating characteristic (ROC) curve in the detection of metabolic syndrome in overweight pre-pubertal children. Arq Bras Endocrinol Metabol 2008;52:1466–73.10.1590/S0004-27302008000900010Search in Google Scholar

36. de Arriba Muñoz A, Cajal MM, Aizpún JI, Cunchillos MD, Dehesa EM, et al. Carotid intima-media thickness; normal values from 4 years. Nutr Hosp 2013;28:1171–6.Search in Google Scholar

37. Mangge H, Schauenstein K, Stroedter L, Griesl A, Maerz W, et al. Low grade inflammation in juvenile obesity and type 1 diabetes associated with early signs of atherosclerosis. Exper Clin Endocrinol Diabetes 2004;112:378–82.10.1055/s-2004-821023Search in Google Scholar PubMed

38. Pilz S, Horejsi R, Moller R, Almer G, Scharnagl H, et al. Early atherosclerosis in obese juveniles is associated with low serum levels of adiponectin. J Clin Endocrinol Metabol 2005;90:4792–6.10.1210/jc.2005-0167Search in Google Scholar PubMed

39. Luo X, Yang Y, Cao T, Li Z. Differences in left and right carotid intima-media thickness and the associated risk factors. Clin Radiol 2011;66:393–8.10.1016/j.crad.2010.12.002Search in Google Scholar PubMed

40. Kawada T, Otsuka T, Endo T, Kon Y. Aging, components of metabolic syndrome and serum C-reactive protein showed significant relationship with carotid atherosclerosis. Aging Male 2012;15:42–7.10.3109/13685538.2011.593656Search in Google Scholar PubMed

41. Ma S, Wei C, Liang C, Chou J, Lee S. The age correlation of the carotid intima-media thickness according to sex and side in asymptomatic subjects. Acta Neurol Taiwan 2011;20:29–34.Search in Google Scholar

Received: 2014-3-20
Accepted: 2015-1-29
Published Online: 2015-3-14
Published in Print: 2015-5-1

©2015 by De Gruyter

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