CORRELATING THE CAROTID INTIMA- MEDIA THICKNESS WITH CARDIO- METABOLIC RISK FACTORS IS USEFUL IN ASSESSING SUBCLINICAL ATHEROSCLEROSIS PROGRESSION IN OBESE CHILDREN

Abstract

OBJECTIVE
Multiple risk factors can act as precipitant causes for atherosclerosis and analyzing them can offer a better understanding of the cardio-metabolic status of obese children and provide a better prediction of overall cardio- metabolic risk in adulthood. Our aim is to evaluate how the carotid intima-media thickness (CIMT) correlates to identifiable risk factors.

METHODOLOGY
We analyzed 85 patients aged 6–18 years old by measuring their CIMT using the Aixplorer MACH 30 echography machine - automatic measurement software. Three study groups were defined: obese, overweight and normal weight. The clinical examination included: BMI, waist circumference, puberty development, blood pressure measurements. Risk factors analyzed were: artificial postnatal nutrition, birth weight <2500 g or >3500 g, pregnancy-associated risk factors (>20 kg weight gain, gestational diabetes, gestational hypertension, autoimmune thyroiditis, smoking during pregnancy), family history (obesity, dyslipidemia, type 2 diabetes, coronary disease, stroke, autoimmune thyroiditis), smoking, sedentary life- style and abnormal sleeping habits.

RESULTS
CIMT values were significantly higher in adolescents. No difference was observed between sexes. CIMT values correlated positively with Tanner stages. More than 20 kg weight gain during pregnancy and other at-risk disorders during pregnancy (p=0.025), family history of cardiovascular risk (p=0.047), hypertension (p=0.01), and smoking (p=0.018) were linked to increased CIMT. Artificial postnatal nutrition, high/low birth weight and sedentary lifestyle were also linked to increased CIMT.

CONCLUSION
Childhood obesity predicts higher values of CIMT in young adulthood. Weight gain of >20 kg during pregnancy, family history of cardiovascular risk, high blood pressure and smoking are easily identifiable risk factors that are linked to increased CIMT. A medical history focused on risk factors is indispensable for assessing the cardio-metabolic risk status of patients.