Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T07:10:51.170Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of the carotid artery intima-media complex through ultrasonography and the relationship with Pathobiological Determinants of Atherosclerosis in Youth

Published online by Cambridge University Press:  11 November 2015

Thacira D. A. Ramos ,
Tatianne M. E. Dantas ,
Mônica O. S. Simões ,
Danielle F. Carvalho  and
Carla C. M. Medeiros
Thacira D. A. Ramos*
Affiliation:
State University of Paraiba, Postgraduate Master in Public Health, Campina Grande/PB, Brazil
Tatianne M. E. Dantas
Affiliation:
State University of Paraiba, Postgraduate Master in Public Health, Campina Grande/PB, Brazil
Mônica O. S. Simões
Affiliation:
State University of Paraiba, Postgraduate Master in Public Health, Campina Grande/PB, Brazil
Danielle F. Carvalho
Affiliation:
State University of Paraiba, Postgraduate Master in Public Health, Campina Grande/PB, Brazil
Carla C. M. Medeiros
Affiliation:
State University of Paraiba, Postgraduate Master in Public Health, Campina Grande/PB, Brazil
*
Correspondence to: T. D. A. Ramos, Rua Nilo Peçanha, 851 apartamento 901, Prata, Cidade: Campina Grande/Paraíba, País 58400-515, Brazil. Tel: +55 (83) 98840-5101; E-mail: thaciradantas@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To evaluate the presence of carotid thickening and its relationship with the Pathobiological Determinants of Atherosclerosis in Youth score.

Methods

We carried out a cross-sectional study involving 512 brazilian adolescents. Variables such as sex, body mass index, concentrations of non-high-density lipoprotein and high-density lipoprotein cholesterol, blood pressure, blood glucose and glycated haemoglobin A1c levels that make up the score, and carotid thickening through the intima-media complex measured by ultrasound were evaluated. We adopted two cut-off points to evaluate carotid thickening, being considered altered for those higher or equal to the z-score 2+ and ⩾75th percentile. The association was assessed using the χ2 test and univariate and multivariate logistic regression analyses.

Results

High cardiovascular risk was present in 10.2% of the adolescents; carotid thickness was present in 4.3% determined by the z-score 2+ and in 25.0% determined by the 75th percentile. When measured by the z-score, carotid thickening was associated with high systolic blood pressure (p=0.024), high-non-high density lipoprotein cholesterol (p=0.039), and high cardiovascular risk assessed by the score and by the 75th percentile, with body mass index >30 (p=0.005). In the multivariate analysis, high cardiovascular risk was found to be independently associated with the presence of carotid thickness evaluated by the z-score, with risk four times greater (p=0.010) of presenting with this condition compared with individuals with low risk, and this fact was not observed when factors were analysed alone.

Conclusion

The presence of high cardiovascular risk in adolescents assessed by the Pathobiological Determinants of Atherosclerosis in Youth score was associated with marked thickening of the carotid artery in healthy adolescents.

Keywords

Atherosclerosisadolescencecarotid arteriesintima-media
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 7 , October 2016 , pp. 1333 - 1342
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Beaglehole, R, Bonita, R, Horton, R, et al. Measuring progress on NCDs – one goal and five targets. Lancet 2012; 380: 1283–1285.CrossRefGoogle ScholarPubMed
2. McMaham, CA, Gidding, SS, Viikari, JSA, et al. Association of pathobiologic determinants of atherosclerosis in youth risk score and 15-year change in risk score with carotid artery intima-media thickness in young adults (from the Cardiovascular Risk in Young Finns Study). Am J Cardiol 2007; 100: 1124–1129.CrossRefGoogle Scholar
3. McMaham, CA, Gidding, SS, Malcom, GT, et al. Pathobiological Determinants of Atherosclerosis in Youth risk scores are associated with early and advanced atherosclerosis. Pediatrics 2006; 118: 1447–1455.CrossRefGoogle Scholar
4. Hong, YM. Atherosclerotic cardiovascular disease beginning in childhood. Korean Circ J 2010; 40: 1–9.CrossRefGoogle ScholarPubMed
5. McGill, HC Jr, McMahan, CA, Gidding, SS. Preventing heart disease in the 21st century: implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study. Circulation 2008; 117: 1216–1227.CrossRefGoogle ScholarPubMed
6. Fitch, KV, Stavrou, E, Looby, SE, Hemphill, L, Jaff, MR, Grinspoon, SK. Associations of cardiovascular risk factors with two surrogate markers of subclinical atherosclerosis: endothelial function and carotid intima media thickness. Atherosclerosis 2011; 217: 437–440.CrossRefGoogle ScholarPubMed
7. Berni, A, Giuliani, A, Tartaglia, F, et al. Effect of vascular risk factors on increase in carotid and femoral intima-media thickness. Identification of a risk scale. Atherosclerosis 2011; 216: 109–114.CrossRefGoogle ScholarPubMed
8. 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.CrossRefGoogle ScholarPubMed
9. Reinehr, T, Wunsch, R. Intima media thickness-related risk factors in childhood obesity. Int J Pediatr Obes 2011; 6: 46–52.CrossRefGoogle ScholarPubMed
10. Elkiran, O, Yilmaz, E, Koc, M, Kamanli, A, Ustandag, B, Ilhan, N. The association between intima media thickness, central obesity and diastolic blood pressure in obese and overweight children: a cross-sectional school-based study. Int J Cardiol 2013; 165: 528–532.CrossRefGoogle ScholarPubMed
11. Paul, TK, Chen, W, Srinivasan, SR, He, J, Bereson, GS. Contrast of the impact of multiple cardiovascular risk factors on the femoral and carotid intima-media thickness in asymptomatic young adults: the Bogalusa Heart Study. Atherosclerosis 2011; 216: 359–364.CrossRefGoogle ScholarPubMed
12. Jounala, M, Viikari, JSA, Kahonen, M, et al. Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study. Eur Heart J 2010; 31: 1745–1751.CrossRefGoogle Scholar
13. Morrison, KM, Dyal, L, Conner, W, et. al. Cardiovascular risk factors and non-invasive assessment of subclinical atherosclerosis in youth. Atherosclerosis 2010; 208: 501–505.CrossRefGoogle ScholarPubMed
14. Caserta, AC, Pendino, GM, Alicante, S, 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.CrossRefGoogle Scholar
15. Aguilar-Shea, AL, Gallardo-Mayo, C, Garrido-Elustondo, S, Calvo-Manuel, E, Zamorano-Gómez, JL. Carotid intima-media thickness as a screening tool in cardiovascular primary prevention. Eur J Clin Invest 2011; 41: 521–526.CrossRefGoogle ScholarPubMed
16. Engelen, L, Ferreira, I, Stehouwer, CD, et al. Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors. Eur Heart J 2013; 34: 2368–2380.CrossRefGoogle ScholarPubMed
17. ABEP – Associação Brasileira de Empresas de Pesquisa – 2012. Dados com base no Levantamento Sócio Econômico 2010 – IBOPE. Acessado em março 2012, Disponível em www.abep.org - abep@abep.org.Google Scholar
18. Sposito, AC, Caramelli, B, Fonseca, FA, et al. IV Brazilian guideline for dyslipidemia and atherosclerosis prevention: Department of Atherosclerosis of Brazilian Society of Cardiology. Arq Bras Cardiol 2007; 88 (suppl 1): 2–19.CrossRefGoogle ScholarPubMed
19. World Health Organization – WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995; 854: 1–452.Google Scholar
20. Sociedade Brasileira de Cardioligia; Sociedade. VI Diretrizes Brasileira de Hipertensão; Sociedade Brasileira de Nefrologia. VI Brazilian Guidelines on Hypertension. Arq Bras Cardiol 2010; 95: 553.Google Scholar
21. Touboul, PJ, Hennerici, MG, Meairs, S, et al. Mannheim carotid intima-media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis 2012; 34: 290–296.CrossRefGoogle Scholar
22. Stein, JH, Korcarz, CE, Hurst, RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr 2008; 21: 93–111.CrossRefGoogle Scholar
23. Prabhushankar, R, Krueger, C, Manrique, C. Membrane estrogen receptors: their role in blood pressure regulation and cardiovascular disease. Curr Hypertens Rep 2014; 16: 408.CrossRefGoogle ScholarPubMed
24. Gil, TY, Sung, CY, Shim, SS, Hong, YM. Intima-media thickness and pulse wave velocity in hypertensive adolescents. J Korean Med Sci 2008; 23: 35–40.CrossRefGoogle ScholarPubMed
25. Geetha, R. Lifetime cardiovascular risk of childhood obesity. Am J Clin Nutr 2010; 91 (Suppl): 1514S–1519S.Google Scholar
26. Pizzi, J, Silva, LR, Moser, D, Leite, N. Relationship between subclinical atherosclerosis, blood pressure, and lipid profile in obese children and adolescents: a systematic review. Arq Bras Endocrinol Metabol 2013; 57: 1–6.CrossRefGoogle ScholarPubMed
27. Barra, S, Gaeta, G, Cuomo, S, et al. Early increase of carotid intima-media thickness in children with parental history of premature myocardial infarction. Heart 2009; 95: 642–645.CrossRefGoogle ScholarPubMed
28. Juonala, M, Saarikoski, LA, Viikari, JS, et al. A longitudinal analysis on associations of adiponectin levels with metabolic syndrome and carotid intima-media thickness. The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2011; 217: 234–239.CrossRefGoogle ScholarPubMed
29. Shah, AS, Dolan, LM, Gao, Z. Clustering of risk factors: a simple method of detecting cardiovascular disease in youth. Pediatrics 2011; 127: e312-8.CrossRefGoogle ScholarPubMed
30. Dalla Pozza, R, Ehringer-Schetitska, D, Fritsch, P, Jokinen, E, Petropoulos, A, Oberhoffer, R. Intima media thickness measurement in children: a statement from the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology. Atherosclerosis 2015; 238: 380–387.CrossRefGoogle Scholar
31. Chubband, H, Simpson, JM. The use of Z-scores in paediatric cardiology. Ann Pediatr Cardiol 2012; 5: 179–184.Google Scholar
32. Simão AF, Précoma DB, Andrade JP, et al. Brazilian guidelines for cardiovascular prevention. Arq Bras Cardiol 2014; 102: 415.Google Scholar