Common carotid intima-media thickness was measured by B-mode ultrasound imaging in 46 children (mean age, 7.4 years) with serum cholesterol 26.4 mmol/L (mean, 8.25 mmol/L) and in 48 children (mean age, 6.4 years) with serum cholesterol <6.4 mmol/L (mean, 4.60 mmol/L). Maximum thickness was significantly higher in hypercholesterolemic children than in control children (0.50 versus 0.47 mm, P=.007). Subgroup analysis showed that only in children >6.2 years old (the median of all the children's ages) was maximum thickness significantly higher in hypercholesterolemic children than in control children (0.51 versus 0.48 mm, P=.O14). The odds ratio (OR) of common carotid intima-media thickening T he relationship between hypercholesterolemia and coronary artery diseases (CAD) has been proved in adult CAD patients. 1 " 3 The significance of this relationship is more controversial in healthy subjects, particularly if their serum cholesterol is <6.4 mmol/L, 4 -6 Children form a special subgroup of healthy individuals.Population-based or "high-risk"-based screenings for serum cholesterol are usually recommended, 710 although others oppose this view on the basis of potential harm and of nonproven efficacy in the prevention of adult CAD. 1112Autopsy studies on arterial specimens of human subjects have shown that fatty streaks (nonraised lesions) can be found in the aortas even of 3-year-olds 13 and appear in the coronary arteries during the second decade of life.14 More advanced coronary atherosclerosis was seen in a majority of young adults in whom autopsies were performed during the Korean and Vietnam wars. -16 Aortic fatty streaks detected in subjects who had died between full-term birth and age 29 years appeared to be strongly related to antemortem levels of both total and low-density lipoprotein (LDL) cholesterol. 17 Raised lesions, like fibrous plaques, are related to clinical CAD, 18 but the progression of fatty streaks to fibrous plaques is uncertain. Arterial fibrous plaques have been found in autopsy specimens from children, Received October 5, 1993; revision accepted March 25, 1994. From the Institute of Internal Medicine and Metabolic Diseases and the Department of Pediatrics (R.S., A. Di C), Federico II University, Naples, Italy.Correspondence to Dr Paolo Pauciullo, Institute of Internal Medicine and Metabolic Diseases, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy.© 1994 American Heart Association, Inc.(maximum thickness of the far wall higher than the 95th percentile of the control group, 0.51 mm) between patients and control subjects was statistically significant both in univariate analysis (OR, 6.39; 95% confidence interval, 1.19 to 32.3; f>=.025) and after age (OR, 5.96; 95% confidence interval, 1.09 to 32.4; P=.O39) and sex (OR, 7.54; 95% confidence interval, 1.38 to 41.2; P=.02O) were controlled for. Children >6 years old with serum cholesterol ^6.4 mmol/L show increased thickness of the common carotid intima-media.

Background/Objectives: Body mass index (BMI), waist circumference (WC), body weight modification, and rate of weight increase over 10 years were evaluated in relation to high-sensitive C-reactive protein (hs-CRP) to assess the association of cross-sectional or longitudinal estimates of obesity/overweight with levels of circulating CRP, a well established and standardized marker of low-grade inflammation, in relation to cardiovascular risk. Subjects: This study included a subgroup of 390 menopausal women participating in a large currently ongoing epidemiological study (Progetto Atena; N ¼ 5062). Results: At the final visit, women in the third tertile of BMI, compared with those in the first tertile, showed the following odds ratio (OR) of having high hs-CRP values: III vs I tertile OR, 3.55; 95% confidence interval, 1.94-6.49, Po0.001, adjusted for age, and metabolic syndrome. Similar results were obtained when we evaluated women in the third tertile of WC, or those in the highest group of estimated weight increase, relative to their weight at age 20 years or in the group of highest rate of weight increase over 10 years of observation (weight at the final visitÀweight at the baseline visit divided by time in months between visits). Conclusions: The independent relations between different markers of overweight/obesity and elevated hs-CRP consistently indicate that high (above 1.5 mg l -1 , median) hs-CRP is a major biochemical counterpart of cross-sectional or longitudinal estimates of increased adipose tissue mass.

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