title: The association of obesity and obesity-related conditions with carotid extra-medial thickness in children and adolescents.
abstract: BACKGROUND
  Carotid extra-medial thickness (EMT) and carotid intima-media thickness (cIMT) provide information concerning vascular changes.
  
  
  OBJECTIVE
  In this study, we aimed to evaluate the association between carotid EMT and obesity and its metabolic complications in children.
  
  
  METHODS
  The study included 38 obese subjects and 30 age-matched and sex-matched healthy controls aged between 7 and 17 years. For all subjects, complete blood count, fasting blood glucose, serum insulin, aspartate aminotransferase, alanine aminotransferase, HDL cholesterol, total cholesterol and triglyceride levels were measured. The carotid EMT and cIMT were measured by an expert radiologist in all patients.
  
  
  RESULTS
  Body mass index (BMI) (28.8 ± 3 vs. 18.1 ± 2.2, p < 0.001), total cholesterol (167.9 ± 34.8 mg dL-1vs. 150.5 ± 28.1 mg dL-1, p = 0.029), homeostatic model assessment of insulin resistance (HOMA-IR) (4.3 vs. 1.7, p < 0.001), cIMT (0.51 ± 0.08 mm vs. 0.45 ± 0.06 mm, p < 0.001) and carotid EMT (0.74 ± 0.11 mm vs. 0.64 ± 0.1 mm, p < 0.001) were significantly higher in obese subjects than in controls, while HDL cholesterol (41.6 ± 6.5 mg dL-1vs. 49.5 ± 7.5 mg dL-1, p < 0.001) was lower in obesity group. Among the obese subjects, the HOMA-IR values (4.7 vs. 3.6, p = 0.027), cIMT (0.54 ± 0.07 mm vs. 0.49 ± 0.07 mm, p = 0.039) and carotid EMT (0.79 ± 0.1 mm vs. 0.7 ± 0.1 mm, p = 0.013) were significantly higher in post-pubertal children compared with prepubertal children. BMI, cut-off values of HOMA-IR and cIMT were significantly associated with increased carotid EMT (p < 0.001, p = 0.023 and p < 0.001, respectively). The only independent risk factor affecting carotid EMT was BMI (p < 0.001).
  
  
  CONCLUSIONS
  We have found that carotid EMT is associated with cIMT, obesity and insulin resistance and the assessment of carotid EMT may provide additional information concerning early vascular disease.
authors.affiliation: Department of Pediatrics, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Bekdas
authors.affiliation: Department of Pediatrics, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Kaya
authors.affiliation: Department of Radiology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Dagistan
authors.affiliation: Department of Pediatrics, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: S B
authors.initials: SB
authors.lastname: Goksugur
authors.affiliation: Department of Pediatrics, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Demircioglu
authors.affiliation: Department of Pediatrics, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Erkocoglu
authors.affiliation: Department of Pediatrics, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-3802-0336
authors.initials: M
authors.lastname: Dilek
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D002339:Carotid Arteries / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D063766:Pediatric Obesity / Q000503:physiopathology*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids
keywords: carotid extra-medial thickness; carotid intima-media thickness; child; obesity