title: Lean body mass may explain apparent racial differences in carotid intima-media thickness in obese children.
abstract: BACKGROUND
  Racial differences in carotid intima-media thickness (cIMT) have been suggested to be associated with the disproportionally high prevalence of cardiovascular disease in black adults. The objective of this study was to evaluate the effects of cardiovascular risk factors on the racial differences seen in cIMT in obese children.
  
  
  METHODS
  Obese subjects aged 4 to 21 years were recruited prospectively. Height, weight, blood pressure, fasting insulin, glucose, lipid panel, high-sensitivity C-reactive protein, and body composition by dual-energy x-ray absorptiometry were obtained. B-mode carotid imaging was analyzed by a single blinded physician.
  
  
  RESULTS
  A total of 120 subjects (46 white, 74 black) were enrolled. Black subjects exhibited greater cIMT (0.45 ± 0.03 vs 0.43 ± 0.02 cm, P < .01) and higher lean body mass index (19.3 ± 3.4 vs 17.3 ± 3.2 kg/m², P = .02) than white subjects. Simple linear regression revealed modest associations between mean cIMT and race (R = 0.52, P < .01), systolic blood pressure (R = 0.47, P < .01), and lean body mass (R = 0.51, P < .01). On multivariate regression analysis, lean body mass remained the only measure to maintain a statistically significant relationship with mean cIMT (P < .01).
  
  
  CONCLUSIONS
  Black subjects demonstrated greater cIMT than white subjects. The relationship between race and cIMT disappeared when lean body mass was accounted for. Future studies assessing the association of cardiovascular disease risk factors to cIMT in obese children should include lean body mass in the analysis.
authors: Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina. Electronic address: chowdhur@musc.edu.
authors: Shahryar M
authors: SM
authors: Chowdhury
authors: Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
authors: Melissa H
authors: MH
authors: Henshaw
authors: Asheville Cardiology Associates, Asheville, North Carolina.
authors: Brad
authors: B
authors: Friedman
authors: Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
authors: J Philip
authors: JP
authors: Saul
authors: The Ward Family Heart Center, Children's Mercy Hospital, Kansas City, Missouri.
authors: Girish S
authors: GS
authors: Shirali
authors: Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
authors: Janet
authors: J
authors: Carter
authors: Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
authors: Bryana M
authors: BM
authors: Levitan
authors: Department of Pediatrics, Division of Pediatric Epidemiology, Medical University of South Carolina, Charleston, South Carolina.
authors: Tom
authors: T
authors: Hulsey
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D015992:Body Mass Index; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013022:South Carolina / Q000453:epidemiology; D013851:Thinness / Q000000981:diagnostic imaging* / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Carotid intima-media thickness; Children; Lean body mass; Obesity; Race