Carotid Artery Stiffness as an Early Marker of Vascular Lesions in Children and Adolescents With Cardiovascular Risk Factors

Núñez, Francisco; Martínez‐Costa, Cecilia; Sánchez-Zahonero, Julia; Morata, Julia; Chorro, Francisco J.; Brinés, J

doi:10.1016/s1885-5857(10)70250-4

Cited by 31 publications

(23 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies also report associations between stiffness index β and peripheral artery disease. 8 We found that CIMT was significantly higher in the obese than the control group, in keeping with previous studies.…”

Section: Discussionsupporting

confidence: 92%

The importance of carotid artery stiffness and increased intima-media thickness in obese children

et al. 2012

View full text Add to dashboard Cite

Childhood obesity is a major health problem throughout the world. Obese children are more likely to become obese adults in whom one can expect a higher rate of hospitalisation, interventions and premature death. 1 In obese people, coronary heart disease generally manifests in middle age or later life. However, atherosclerosis has its roots in childhood, its first signs in obese children appearing before puberty; therefore, it is important to develop efficient strategies to reduce the incidence of cardiovascular disease (CVD) in the population. Carotid artery intima-media thickness (CIMT) serves as a marker of preclinical atherosclerosis.2 CVD develops as a result of arterial damage in the form of arteriosclerosis. Arteriosclerosis is a general term for conditions in which diffuse thickening and stiffening in mainly large-and medium-sized arteries develop under different conditions. Both the media and intima of the arteries could be involved in the pathology. Risk factors diagnosed in childhood can predict the development of preclinical carotid atherosclerosis in adults.2 However, there is limited information about early atherosclerosis and its mechanisms in childhood.Many studies mention close relationships between traditional anthropometric, haemodynamic and biochemical cardiovascular risk factors during childhood and adolescence, and high rates of CIMT and vascular events in the 40s. Importantly, exposure to cardiovascular risk factors is associated with vascular damage. In addition, because of the cumulative nature of risk factors, obesity and central fat distribution in childhood can provide clues about CIMT in adulthood. 3 We aimed to study the effect of obesity on main carotid artery lumen diameter and intima-media thickness and the relationships with the early stages of atherosclerosis. Material and methods PatientsThis was a prospective case-control study from October 2010 to February 2011 on schoolchildren aged 8 -16 years. Obese children were transferred from a primary healthcare paediatrician to our paediatric outpatient clinic in Gaziosmanpasa University Hospital. Patients with dysmorphic syndromes and/or endocrine disorders were excluded. A control group of children of similar age and gender distribution without obesity and dyslipidaemia was included in the study. None of the children was on cardiovascular medication, and all were non-smokers. Children were included only after obtaining informed consent from their guardians. The study protocol was approved by the Committee on Ethical Practice of the hospital. Clinical evaluationFor each patient, data about family and personal history for cardiovascular events, growth curve and nutritional assessment were recorded. Height, weight and blood pressure (BP) were measured.

show abstract

Section: Discussionsupporting

confidence: 92%

The importance of carotid artery stiffness and increased intima-media thickness in obese children

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Assessment of structure/function measures of the vasculature by simple noninvasive methods can identify early vascular damage in young asymptomatic subjects. Pulse wave velocity, central aortic pressure, and augmentation index are among modern and novel measures of cardiovascular assessment among children [31]. BHS reports that cardiovascular risk factors influence adversely measures of both structure and function of the vasculature to varying degrees in young subjects, with small artery compliance showing maximum variance [32].…”

Section: Screening For High Blood Pressure In Childrenmentioning

confidence: 99%

Metabolic Syndrome: Bridging the Gap from Childhood to Adulthood

Ağırbaşlı

Tanrikulu

Berenson

2016

Cardiovascular Therapeutics

View full text Add to dashboard Cite

SUMMARYChildhood and adolescence are particularly vulnerable periods of life to the effects of cardiometabolic risk and later development of atherosclerosis, hypertension, and diabetes mellitus. Developing countries with limited resources suffer most heavily from the consequences of cardiometabolic risk in children and its future implications to the global health burden. A better understanding of mechanisms leading to cardiometabolic risk in early life may lead to more effective prevention and intervention strategies to reduce metabolic stress in children and later disease. Longitudinal "tracking" studies of cardiometabolic risk in children provide a tremendous global resource to direct prevention strategies for cardiovascular disease. In this review, we will summarize the pathophysiology, existing definitions for cardiometabolic risk components in children. Screening and identifying children and adolescents of high cardiometabolic risk and encouraging them and their families through healthy lifestyle changes should be implemented to as a global public health strategy.

show abstract

“…Reported absolute BMI ranged from 23.9 to 37.2 (obese, youngest to eldest cohort) and 15.5 to 22.3 (controls). Only 3 studies reported BMI z-scores, [19][20][21] and 1 study used it in their regression analysis but did not report the mean values. 12 As such, we were unable to assess the linear relationship between arterial stiffness and BMI z-scores, and children were assessed based on their categorization as obese or as a healthy BMI control.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…The 12 studies reporting central PWV 12,[19][20][21][22][23][24][25][26][27]30,32 were of good methodological quality (Downs and Black scores ranged from 14 to 16). All but 2 of these papers 12,21 reported increased arterial stiffness in the children with obesity compared with healthy BMI controls.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…12,23,27,30,32 Six of these studies determined PWV using the carotid-femoral wave forms gated to the ECG, 12,21,24,27,30,32 2 studies used Doppler ultrasound traces from the ascending and descending aorta, 23,25 whereas 4 studies used a single-point method of PWV determination using carotid β stiffness, diastolic blood pressure, and blood density. 19,20,22,26 There were 4 studies assessing carotid β stiffness, 19,20,26,28 all reporting a higher carotid β stiffness index in the children with obesity. Similarly, in the 4 studies assessing aortic β stiffness, 25,27,29,31 all reported a higher aortic β stiffness index in the children with obesity.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Obesity and Arterial Stiffness in Children

Coté

Phillips

Harris

et al. 2015

ATVB

132

View full text Add to dashboard Cite

Objective-Childhood obesity is associated with risk factors for cardiovascular disease. Arterial stiffness is considered one of the earliest detectable measures of vascular damage. There is controversy in the literature regarding the effects of childhood obesity on arterial stiffness. The objective of this study is to systematically review the literature and to conduct a meta-analysis comparing measures of central arterial stiffness in children and adolescents with obesity to healthy body mass index controls. Approach and Results-Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies assessing central pulse wave velocity or β-stiffness index were included. A random effects meta-analysis of the standardized mean difference and 95% confidence intervals in arterial stiffness between children with obesity and control children was performed for each arterial stiffness measure. A total of 523 studies were identified. Fifteen case-control studies were included, with 2237 children/adolescents (1281 with obesity, 956 healthy body mass index controls) between 5 and 24 years of age. All studies measuring carotid and aortic β-stiffness index and 10/12 studies measuring central pulse wave velocity reported greater arterial stiffness in children/adolescents with obesity compared with controls. A random effects meta-analysis was performed revealing a significant effect of obesity on pulse wave velocity (standardized mean difference=0.718; 95% confidence interval=0.291-1.415), carotid β-stiffness index (0.862; 0.323-1.402), and aortic β stiffness index (1.017; 0.419-1.615). Conclusion-These findings indicate that child/adolescent obesity is associated with greater arterial stiffness. However, further research is needed to address confounders, such as pubertal status, that may affect this relationship in children. In the future, these techniques may be useful in risk stratification and guiding clinical management of obese children to optimize cardiovascular outcomes.

show abstract

Carotid Artery Stiffness as an Early Marker of Vascular Lesions in Children and Adolescents With Cardiovascular Risk Factors

Cited by 31 publications

References 35 publications

The importance of carotid artery stiffness and increased intima-media thickness in obese children

The importance of carotid artery stiffness and increased intima-media thickness in obese children

Metabolic Syndrome: Bridging the Gap from Childhood to Adulthood

Obesity and Arterial Stiffness in Children

Contact Info

Product

Resources

About