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Obesity in childhood contributes to cardiovascular risk factors, such as hypertension and dyslipidaemia.1 Exposure to these cardiovascular risk factors may induce atherogenic changes in the arteries.1 Measurement of the intima-media thickness (IMT) of the common carotid artery (CCA) is an acknowledged non-invasive marker for early atherosclerotic changes and is a feasible, reliable, valid, and cost effective method.2,3 It has not yet been studied whether hypertension and dyslipidaemia are related to IMT in obese children. Therefore, we measured clinical data (age, gender, degree of overweight as standard deviation score of BMI (SDS-BMI)4), IMT, serum lipids (triglycerides and HDL, LDL, and total cholesterol), systolic (SP) and diastolic blood pressure (DP) in 46 obese children (median age 9.6 years). The control group was comprised of 16 lean age and gender matched children. IMT was measured at CCA near the bifurcation at the far wall by B-mode ultrasound using a 14 Mhz linear transducer and compared between obese and lean children by Mann-Whitney U test, since IMT was not normally distributed. IMT as dependent variable and age, gender, SDS-BMI, blood pressure, and serum lipids as independent variables were determined in a multiple linear regression analysis. Blood pressure and lipids were compared between obese children with IMT above the upper quartile of IMT and children with IMT below or equal to the upper quartile of IMT by Student’s t test for unpaired observations. Obese children showed a significant (p < 0.001) thicker intima media (median 0.06 cm) compared to the control group (median IMT 0.04 cm). In multiple linear regression analysis, IMT correlated significantly to triglycerides (p = 0.023) and systolic and diastolic blood pressure (p < 0.001). The children with IMT above the upper quartile (0.06 cm) showed significantly increased triglycerides (p = 0.038, median 142 mg/dl versus 103 mg/dl) and blood pressure (p < 0.001, median SP 137 mm Hg versus 119 mm Hg, median DP 71 mm Hg versus 60 mm Hg), while they did not differ significantly from the other children in respect of gender, age, SDS-BMI, and HDL, LDL, or total cholesterol.
Since IMT is increased in obese children, vascular changes in obesity seem to occur already in childhood. Childhood obesity may be a risk factor for developing atherosclerosis, since higher IMT of the CCA is reported to be predictive and is related to the severity and extent of coronary artery disease and strokes.5,6 Our findings suggest that hypertension and hypertriglyceridaemia, which are part of the metabolic syndrome, have the highest atherogenic potential in childhood obesity.
Competing interests: none