Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents.
OBJECTIVE
Sonographic evaluation of arterial wall morphology and elasticity is increasingly accepted as a non-invasive tool in cardiovascular assessment. Several studies suggest that intima-media thickness (IMT) and arterial elasticity indices may sensitively reflect different vasculopathic processes in children. However, normative values and the impact of adolescent growth are largely unknown.


METHODS
We assessed the IMT of the common carotid (cIMT) and femoral arteries (fIMT), carotid elasticity indices and interacting anthropometric factors in 247 healthy subjects aged 10-20 years.


RESULTS
cIMT, fIMT, incremental elastic modulus (Einc) and circumferential wall stress (CWS) were positively, and distensibility coefficient (DC) inversely, correlated with age, height, body mass index (BMI), systolic blood pressure (BP) and brachial pulse pressure (r = 0.56 to -0.45, P < 0.05 to 0.0001). DC (r = -0.29, P < 0.0001) and stiffness index beta (r = 0.25, P < 0.0001), but not Einc, were significantly associated with cIMT independently of age. All vascular parameters showed non-Gaussian distributions. Excessively high IMT was associated with BMI and pulse pressure above the 90th percentile, and elevated Einc with high-normal BMI. Multivariate analysis identified independent positive effects of standardized BMI and brachial pulse pressure on normalized cIMT, negative effects of systolic BP and cIMT on DC, a positive effect of cIMT on stiffness, and positive effects of systolic BP and BMI on Einc and CWS.


CONCLUSIONS
Morphological and functional measures of large arteries should be normalized to take account of changes during adolescence and skewed distributions. Relative body mass, systolic blood pressure and/or pulse pressure are determinants of IMT and elasticity.
Jourdan
Claudia
C
Department of Pediatric Radiology, Children's Hospital, University of Heidelberg, Im Neuenheimer Feld 153, 69120 Heidelberg, Germany.
Wühl
Elke
E
Litwin
Mieczyslaw
M
Fahr
Katrin
K
Trelewicz
Justyna
J
Jobs
Katarzyna
K
Schenk
Jens-Peter
JP
Grenda
Ryszard
R
Mehls
Otto
O
Tröger
Jochen
J
Schaefer
Franz
F
D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001794:Blood Pressure; D015992:Body Mass Index; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000502:physiology*; D003187:Compliance; D004548:Elasticity; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000502:physiology*; D006801:Humans; D015999:Multivariate Analysis; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography