Adiposity and carotid-intima media thickness in children and adolescents: a systematic review

BMC Pediatrics

Sanjay Kinra²  Russell M. Viner⁴  Sonia Saxena⁵  Anthony S. Kessel³  Sara De Matteis¹  Áine Skow²  Min Hae Park² 

[1] Department of Respiratory Epidemiology, Occupational Medicine and Public Health, NHLI, Imperial College London, London, UK;Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK;Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK;Department of General and Adolescent Paediatrics, Institute of Child Health, University College London, London, UK;Department of Primary Care and Public Health, Imperial College London, London, UK

关键词: Cardiovascular risk;    Carotid intima-media thickness;    Childhood obesity;   

Others  :  1234554
DOI  :  10.1186/s12887-015-0478-5

 received in 2014-08-05, accepted in 2015-10-06,  发布年份 2015

【 摘 要 】

Background

Adiposity in childhood is associated with later cardiovascular disease (CVD), but it is unclear whether this relationship is independent of other risk factors experienced in later life, such as smoking and hypertension. Carotid-intima media thickness (cIMT) is a measure of subclinical atherosclerosis that may be used to assess CVD risk in young people. The aim of this study was to examine the relationship between adiposity and cIMT in children and adolescents.

Methods

We searched Medline, Embase, Global Health, and CINAHL Plus electronic databases (1980–2014). Population-based observational studies that reported a measure of association between objectively-measured adiposity and cIMT in childhood were included in this review.

Results

Twenty-two cross-sectional studies were included (n = 7,366 children and adolescents). Thirteen of nineteen studies conducted in adolescent populations (mean age ≥12 years, n = 5,986) reported positive associations between cIMT and adiposity measures (correlation coefficients 0.13 to 0.59). Three studies of pre-adolescent populations (n = 1,380) reported mixed evidence, two studies finding no evidence of a correlation, and one an inverse relationship between skinfolds and cIMT. Included studies did not report an adiposity threshold for subclinical atherosclerosis.

Conclusions

Based on studies conducted mostly in Western Europe and the US, adiposity does not appear to be associated with cIMT in pre-adolescents, but may be associated in adolescents. If further studies confirm these findings, a focus on cardiovascular disease prevention efforts in pre-adolescence, before arterial changes have emerged, may be justified.

【 授权许可】

   
2015 Park et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Falkstedt D, Hemmingsson T, Rasmussen F, Lundberg I. Body mass index in late adolescence and its association with coronary heart disease and stroke in middle age among Swedish men. Int J Obes (Lond). 2007; 31:777-783.
• [2]Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med. 1992; 327:1350-1355.
• [3]Silventoinen K, Magnusson PK, Tynelius P, Batty GD, Rasmussen F. Association of body size and muscle strength with incidence of coronary heart disease and cerebrovascular diseases: a population-based cohort study of one million Swedish men. Int J Epidemiol. 2009; 38:110-118.
• [4]Tirosh A, Shai I, Afek A, Dubnov-Raz G, Ayalon N, Gordon B et al.. Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med. 2011; 364:1315-1325.
• [5]Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Res. 2008; 9:474-488.
• [6]Park MH, Falconer C, Viner RM, Kinra S. The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review. Obes Rev. 2012; 13:985-1000.
• [7]Kavey R-EW, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K. American heart association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation. 2003; 107:1562-1566.
• [8]Lahti-Koski M, Pietinen P, Heliovaara M, Vartiainen E. Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982–1997 FINRISK Studies. Am J Clin Nutr. 2002; 75:809-817.
• [9]Malnick SDH, Knobler H. The medical complications of obesity. QJM. 2006; 99:565-579.
• [10]Salonen R, Salonen JT. Determinants of carotid intima-media thickness: a population-based ultrasonography study in eastern Finnish men. J Intern Med. 1991; 229:225-231.
• [11]Tell GS, Howard G, McKinney WM. Risk factors for site specific extracranial carotid artery plaque distribution as measured by B-mode ultrasound. J Clin Epidemiol. 1989; 42:551-559.
• [12]Whisnant JP, Homer D, Ingall TJ, Baker HL, O’Fallon WM, Wievers DO. Duration of cigarette smoking is the strongest predictor of severe extracranial carotid artery atherosclerosis. Stroke. 1990; 21:707-714.
• [13]Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007; 115:459-467.
• [14]Peters SA, Grobbee DE, Bots ML. Carotid intima-media thickness: a suitable alternative for cardiovascular risk as outcome? Eur J Cardiovasc Prev Rehabil. 2011; 18:167-174.
• [15]Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ. 2012; 345: Article ID e4759
• [16]Bohm B, Hartmann K, Buck M, Oberhoffer R. Sex differences of carotid intima-media thickness in healthy children and adolescents. Atherosclerosis. 2009; 206:458-463.
• [17]Casariu ED, Virgolici B, Greabu M, Totan A, Daniela M, Mitrea N et al.. Associations between carotid intimamedia thickness and cardiovascular risk markers in obese children. Farmacia. 2011; 59:471-482.
• [18]Caserta CA, Pendino GM, Alicante S, Amante A, Amato F, Fiorillo M et al.. Body mass index, cardiovascular risk factors, and carotid intima-media thickness in a pediatric population in Southern Italy. J Pediatr Gastroenterol Nutr. 2010; 51:216-220.
• [19]Doyon A, Kracht D, Bayazit AK, Deveci M, Duzova A, Krmar RT et al.. Carotid artery intima-media thickness and distensibility in children and adolescents: Reference values and role of body dimensions. Hypertension. 2013; 62:550-556.
• [20]Geerts CC, Evelein AM, Bots ML, van der Ent CK, Grobbee DE, Uiterwaal CS. Body fat distribution and early arterial changes in healthy 5-year-old children. Ann Med. 2012; 44:350-359.
• [21]Jourdan C, Wühl E, Litwin M, Fahr K, Trelewicz J, Jobs K et al.. Normative values for intima–media thickness and distensibility of large arteries in healthy adolescents. J Hypertens. 2005; 23:1707-1715.
• [22]Kollias A, Psilopatis I, Karagiaouri E, Glaraki M, Grammatikos E, Grammatikos EE et al.. Adiposity, blood pressure, and carotid intima-media thickness in greek adolescents. Obesity (Silver Spring). 2013; 21:1013-1017.
• [23]Lamotte C, Iliescu C, Beghin L, Salleron J, Gonzalez-Gross M, Marcos A et al.. Association of socioeconomic status, truncal fat and sICAM-1 with carotid intima-media thickness in adolescents: the HELENA study. Atherosclerosis. 2013; 228:460-465.
• [24]Melo X, Santa-Clara H, Pimenta NM, Carrolo M, Martins SS, Minderico CS et al.. Body composition phenotypes and carotid intima-media thickness in 11-13-year-old children. Eur J Pediatr. 2014; 173:345-352.
• [25]Osiniri I, Sitjar C, Soriano-Rodriguez P, Prats-Puig A, Casas-Satre C, Mayol L et al.. Carotid intima-media thickness at 7 years of age: relationship to C-reactive protein rather than adiposity. J Pediatr. 2012; 160:276-280.
• [26]Sass C, Herbeth B, Chapet O, Siest G, Visvikis S, Zannad F. Intima–media thickness and diameter of carotid and femoral arteries in children, adolescents and adults from the Stanislas cohort: effect of age, sex, anthropometry and blood pressure. J Hypertens. 1998; 16:1593-1602.
• [27]Weghuber D, Zelzer S, Stelzer I, Paulmichl K, Kammerhofer D, Schnedl W et al.. High risk vs“metabolically healthyo” phenotype in juvenile obesity - Neck subcutaneous adipose tissue and serum uric acid are clinically relevant. Exp Clin Endocrinol Diabetes. 2013; 121:384-390.
• [28]Whincup PH, Nightingale CM, Rapala A, Joysurry D, Prescott M, Donald AE et al.. Ethnic differences in carotid intimal medial thickness and carotid-femoral pulse wave velocity are present in UK children. Heart. 2011; 97:A41.
• [29]Croymans DM, Sanchez A, Barth JD, Roberts CK. Carotid intima-media thickness, dietary intake, and cardiovascular phenotypes in adolescents: relation to metabolic syndrome. Metab Clin Exp. 2010; 59:533-539.
• [30]Dawson JD, Sonka M, Blecha MB, Lin W, Davis PH. Risk factors associated with aortic and carotid intima-media thickness in adolescents and young AdultsThe Muscatine offspring study. J Am Coll Cardiol. 2009; 53:2273-2279.
• [31]Mittelman SD, Gilsanz P, Mo AO, Wood J, Dorey F, Gilsanz V. Adiposity predicts carotid intima-media thickness in healthy children and adolescents. J Pediatr. 2010; 156:592-597.
• [32]Urbina EM, Kimball TR, McCoy CE, Khoury PR, Daniels SR, Dolan LM. Youth with obesity and obesity-related type 2 diabetes mellitus demonstrate abnormalities in carotid structure and function. Circulation. 2009; 119:2913-2919.
• [33]Elkiran O, Yilmaz E, Koc M, Kamanli A, Ustundag B, Ilhan N. The association between intima media thickness, central obesity and diastolic blood pressure in obese and owerweight children: a cross-sectional school-based study. Int J Cardiol. 2013; 165:528-532.
• [34]Ozguven I, Ersoy B, Ozguven A, Ozkol M, Onur E. Factors affecting carotid intima media thickness predicts early atherosclerosis in overweight and obese adolescents. Obesity Res Clin Pract. 2010; 4:e41-e48.
• [35]Arnaiz P, Acevedo M, Barja S, Aglony M, Guzman B, Cassis B et al.. Adiponectin levels, cardiometabolic risk factors and markers of subclinical atherosclerosis in children. Int J Cardiol. 2010; 138:138-144.
• [36]Pandit D, Kinare A, Chiplonkar S, Khadilkar A, Khadilkar V. Carotid arterial stiffness in overweight and obese Indian children. J Pediatr Endocrinol Metab. 2011; 24:97-102.
• [37]Lim SM, Kim HC, Lee HS, Lee JY, Suh M, Ahn SV. Association between blood pressure and carotid intima-media thickness. J Pediatr. 2009; 154:667-671.
• [38]Fraser GE. Diet, life expectancy, and chronic disease: studies of seventh-Day adventists and other vegetarians. Oxford University Press, New York; 2003.
• [39]McGill HC, McMahan CA, Herderick EE, Malcom GT, Tracy RE, Strong JP. Origin of atherosclerosis in childhood and adolescence. Am J Clin Nutr. 2000; 72:1307S-1315S.
• [40]Scuteri A, Najjar SS, Muller DC, Andres R, Hougaku H, Metter EJ et al.. Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness. J Am Coll Cardiol. 2004; 43:1388-1395.
• [41]Reis JP, Loria CM, Lewis CE, Powell-Wiley TM, Wei GS, Carr JJ et al.. Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery calcification in middle age. JAMA. 2013; 310:280-8.
• [42]Urbina E. Noninvasive assessment of target organ injury in children with the metabolic syndrome. J Cardiometab Syndr. 2006; 1:277-281.
• [43]Giannini C, de Giorgis T, Scarinci A, Cataldo I, Marcovecchio ML, Chiarelli F et al.. Increased carotid intima-media thickness in pre-pubertal children with constitutional leanness and severe obesity: the speculative role of insulin sensitivity, oxidant status, and chronic inflammation. Eur. 2009; 161:73-80.
• [44]Iannuzzi A, Licenziati MR, Acampora C, Salvatore V, Auriemma L, Romano ML et al.. Increased carotid intima-media thickness and stiffness in obese children. Diabetes Care. 2004; 27:2506-2508.