By Charlene Laino
NEW ORLEANS -- November 12, 2008 --- The vascular age of children who are obese or who have unfavourable lipid profiles is more typical of normal-weight 45-year-old than of a normal-weight child, researchers reported here at the American Heart Association's (AHA) Scientific Sessions.
"Carotid artery ultrasound and estimation of vascular age may help clinicians to further stratify children with risk factors who are at greatest risk for heart disease and need intensive management," said investigator Geetha Raghuveer, MD, MPH, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
Dr. Raghuveer and colleagues studied 70 children and adolescents aged 6 to 19 years, with an average age of 13 years. Nearly all (89%) were white, and 49% were male.
Forty had a body mass index (BMI) above the 95th percentile for their age, 59 had total cholesterol levels >170 mg/dL, 51 had low-density lipoprotein cholesterol levels >110 mg/dL, 17 had high-density lipoprotein levels <35 mg/dL, and 43 children had triglyceride levels >100 mg/dL.
Using carotid artery ultrasound with a high-resolution probe, carotid artery intima-media thickness (CIMT) was calculated from multiple frames of the far wall of the common carotid artery, 2 cm proximal to the bifurcation, using semi-automated edge-detection software.
Average CIMT was 0.45 mm, which is more typical of an adult in his mid-40s, Dr. Raghuveer said in a presentation on November 11.
Then, the researchers gauged each child's vascular age by comparing his CIMT to CIMT percentile tables published for a 45-year-old race- and sex-matched population.
"There are no population-based norms for children, so we plotted against this published standard for 45-year-olds. We defined advanced vascular age as any child above the 25th percentile for race- and gender-matched adults," she explained.
Using this definition, 75% of the children had advanced vascular ages, Dr. Raghuveer said.
High triglyceride levels (>100 mg/dL) proved to the strongest risk factor for advanced vascular age. Of the 43 children with advanced vascular age, 38 had high triglyceride levels and 14 had triglyceride levels <100 mg/dL (P = .00).
BMI above the 95th percentile was also a strong predictor of advanced vascular age. Of children with advanced vascular age, 26 had a BMI above this cut-off and 4 had lower BMIs (P = .01).
"Determining vascular age using carotid intima-media thickness may help to assess the burden of atherosclerosis," Dr. Raghuveer said.
Because children "don't have as much hardening, or calcification, in their arteries, I'm optimistic we can improve the vessel walls and blood flow in adults through lifestyle and pharmaceutical interventions," she said.
[Presentation title: Advanced "Vascular Age" in Children with Dyslipidemia. Abstract 6077]
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