Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children.
BACKGROUND
Autopsy studies in children have shown that atherosclerotic lesions begin to develop first in the intima of the aorta. Recent developments in ultrasound techniques have made it possible to visualize the intima-medial thickness of the abdominal aorta directly (aIMT). Therefore, we examined the feasibility of measuring aIMT in children and studied its value in distinguishing high-risk children from healthy controls compared with a more established marker of subclinical atherosclerosis, the common carotid artery intima-medial thickness (cIMT).


RESULTS
IMTs were measured using high-resolution (13 MHz) ultrasound in 88 children (aged 11+/-2 years); 16 had hypercholesterolemia (LDL cholesterol, 5.1+/-1.2 mmol/L), 44 had type 1 diabetes (mean duration, 4.4+/-3.1 years; LDL cholesterol, 2.3+/-0.7 mmol/L), and 28 were healthy (controls; LDL cholesterol, 2.5+/-0.8 mmol/L). High-risk children had significantly increased aIMTs and cIMTs (both P<0.001) compared with controls. In controls, aIMT was similar to cIMT (P=NS), but aIMT was higher than cIMT in the children with hypercholesterolemia and diabetes (both P<0.01). Both markers showed excellent and approximately equal between-observer (<4%) and between-subject variation (<5%).


CONCLUSIONS
Children with hypercholesterolemia and diabetes show increased IMTs compared with healthy controls, with a relatively greater increase in the aIMT than in the cIMT. Because atherosclerosis begins first in the intima of the aorta, these data suggest that the aIMT might provide the best currently available noninvasive marker of preclinical atherosclerosis in children.
Järvisalo
M J
MJ
Department of Clinical Physiology, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.
Jartti
L
L
Näntö-Salonen
K
K
Irjala
K
K
Rönnemaa
T
T
Hartiala
J J
JJ
Celermajer
D S
DS
Raitakari
O T
OT
D000293:Adolescent; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D001161:Arteriosclerosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood; D006938:Hyperlipoproteinemia Type II / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods
D002784:Cholesterol; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D008055:Lipids; D014280:Triglycerides