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Alchourron E, Dubois J, Cloutier G, Stein N, Farhat Z, Roy-Cardinal MH, Moretti JB, Lapierre C, El Jalbout R. Non-Invasive Vascular Elastography as a One-Step Imaging Technique to Evaluate Early Vascular Changes in Children Compared to B-Mode-Based Intima-Media Thickness Technique : A Validation Study Using Inter- and Intra-Rater Reliability. Can Assoc Radiol J 2022; 74:422-431. [PMID: 36263774 DOI: 10.1177/08465371221134055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Childhood obesity is linked to higher adult mortality and morbidity from atherosclerosis. It is primordial to detect at-risk children earlier-on to prevent disease progression. Carotid intima-media thickness (IMT) is a subclinical radiological marker for early atherosclerosis. B-mode ultrasound is a known technique to assess IMT, but no gold standard technique exists in children. Non-invasive vascular elastography (NIVE) using speckle statistics is an innovative alternative to evaluate IMT and adds by providing translation, strain and shear strain measurements. Validation studies for both techniques lack in children. Purpose: Validate the reproducibility of the 2 techniques in Canadian children. Methods: We conducted a prospective study where anthropometry, blood pressure, IMT and elastography were measured. Six operators obtained 2 measurements for both carotid arteries using both techniques, for a total of 720 measurements. Inter- and intra-class correlation coefficients (ICC) were calculated for each measurement technique and elastography parameters. Results: 30 participants (13.0 ± 1.26 years, 17 girls) were recruited. Twelve were overweight. No significant difference was found in mean IMT between weight groups for either technique (P = .15 and P = .60). We found excellent inter- (ICC = .98 [95% Confidence Interval (CI): .97; .99]) and intra- (ICC = .90-.93) operator reliability for the B-mode technique, and good inter (ICC = .70 [95% CI: .47; .85]) and intra- (ICC = .71-.91) operator reliability for the NIVE-based technique. Poor reliability was found between techniques (ICC = .30 [95% CI: -.31; .65). For elastography parameters, translation was the most reliable (ICC = .94-.95). Conclusion: IMT measurement is reproducible in children but not between techniques. NIVE gives the advantage of evaluating elastography.
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Affiliation(s)
- Emilie Alchourron
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Faculty of Medecine, Université de Montréal, Montreal, Quebec, Canada
| | - Josée Dubois
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Medical Imaging Department, Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, 177460University of Montreal Hospital Research Center, Montreal, Quebec, Canada
| | - Nina Stein
- Pediatric Radiology, 103398McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Ziad Farhat
- Pediatric Radiology, 3682IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Marie-Hélène Roy-Cardinal
- Laboratory of Biorheology and Medical Ultrasonics, 177460University of Montreal Hospital Research Center, Montreal, Quebec, Canada
| | - Jean-Baptiste Moretti
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Faculty of Medecine, Université de Montréal, Montreal, Quebec, Canada
| | - Chantale Lapierre
- Medical Imaging Department, Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Ramy El Jalbout
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Medical Imaging Department, Sainte-Justine University Hospital, Montreal, Quebec, Canada
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El Jalbout R, Levy E, Pastore Y, Jantchou P, Lapierre C, Dubois J. Current applications for measuring pediatric intima-media thickness. Pediatr Radiol 2022; 52:1627-1638. [PMID: 35013786 DOI: 10.1007/s00247-021-05241-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/20/2021] [Accepted: 10/31/2021] [Indexed: 10/19/2022]
Abstract
Intima-media thickness is a known subclinical radiologic marker of the early manifestations of atherosclerotic disease. It is the thickness of the vessel wall, most often the carotid artery. Intima-media thickness is measured on conventional US manually or automatically. Other measurement techniques include radiofrequency US. Because there is variation in its measurement, especially in children, several recommendations have been set to increase the measurement's validity and comparability among studies. Despite these recommendations, several pitfalls should be avoided, and quality control should be performed to avoid erroneous interpretation. This article summarizes current literature in relation to the clinical applications for intima-media thickness measurement in children with known risk factors such as obesity, liver steatosis, hypercholesterolemia, diabetes, hypertension, systemic inflammatory diseases, cancer survival, kidney and liver transplant, and sickle cell disease or beta thalassemia major. Most potential indications for intima-media thickness measurement remain in the research domain and should be interpreted combined with other markers. The objective of diagnosing an increased intima-media thickness is to start a multidisciplinary treatment approach to prevent disease progression and its sequelae in adulthood.
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Affiliation(s)
- Ramy El Jalbout
- Department of Radiology, Sainte-Justine Hospital and Research Center, University of Montreal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
| | - Emile Levy
- Department of Gastroenterology, Sainte-Justine Hospital and Research Center, University of Montreal, 3175 Chemin de la Côte Sainte-Catherine, QC, H3T 1C5, Montreal, Canada
| | - Yves Pastore
- Department of Hematology/Oncology, Sainte-Justine Hospital and Research Center, University of Montreal, 3175 Chemin de la Côte Sainte-Catherine, QC, H3T 1C5, Montreal, Canada
| | - Prevost Jantchou
- Department of Gastroenterology, Sainte-Justine Hospital and Research Center, University of Montreal, 3175 Chemin de la Côte Sainte-Catherine, QC, H3T 1C5, Montreal, Canada
| | - Chantale Lapierre
- Department of Radiology, Sainte-Justine Hospital and Research Center, University of Montreal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Josée Dubois
- Department of Radiology, Sainte-Justine Hospital and Research Center, University of Montreal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
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Büschges J, Schaffrath Rosario A, Schienkiewitz A, Königstein K, Sarganas G, Schmidt-Trucksäss A, Neuhauser H. Vascular aging in the young: New carotid stiffness centiles and association with general and abdominal obesity – The KIGGS cohort. Atherosclerosis 2022; 355:60-67. [DOI: 10.1016/j.atherosclerosis.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/07/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
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Monasso GS, Silva CCV, Santos S, Goncalvez R, Gaillard R, Felix JF, Jaddoe VWV. Infant weight growth patterns, childhood BMI, and arterial health at age 10 years. Obesity (Silver Spring) 2022; 30:770-778. [PMID: 35142077 PMCID: PMC9302666 DOI: 10.1002/oby.23376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/26/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Associations of obesity with cardiovascular disease may originate in childhood. This study examined critical periods for BMI in relation to arterial health at school age. METHODS Among 4,731 children from a prospective cohort study, associations of infant peak weight velocity, both age and BMI at adiposity peak, and BMI trajectories with carotid artery intima-media thickness and carotid artery distensibility at 10 years were examined. RESULTS A 1-standard deviation score (SDS) higher peak weight velocity and BMI at adiposity peak were associated with higher intima-media thickness (0.10 SDS; 95% CI: 0.06 to 0.13 and 0.08 SDS; 95% CI: 0.05 to 0.12) and lower distensibility (-0.07 SDS; 95% CI: -0.10 to -0.03 and -0.07 SDS; 95% CI: -0.11 to -0.03) at 10 years. For distensibility, current BMI explained these associations. Children within the highest BMI tertile at ages 2 and 10 years had the lowest distensibility (p < 0.05), but similar intima-media thickness, compared with children constantly within the middle tertile. CONCLUSIONS Infant weight growth patterns and childhood BMI are associated with subtle differences in carotid intima-media thickness and carotid distensibility at school age. For distensibility, current BMI seems critical. Follow-up is needed to determine whether these associations lead to adult cardiovascular disease.
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Affiliation(s)
- Giulietta S. Monasso
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Carolina C. V. Silva
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Susana Santos
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Romy Goncalvez
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of Obstetrics and GynaecologyErasmus University Medical CenterRotterdamthe Netherlands
| | - Romy Gaillard
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Janine F. Felix
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
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Causative Mechanisms of Childhood and Adolescent Obesity Leading to Adult Cardiometabolic Disease: A Literature Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112311565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The past few decades have shown a worrisome increase in the prevalence of obesity and its related illnesses. This increasing burden has a noteworthy impact on overall worldwide mortality and morbidity, with significant economic implications as well. The same trend is apparent regarding pediatric obesity. This is a particularly concerning aspect when considering the well-established link between cardiovascular disease and obesity, and the fact that childhood obesity frequently leads to adult obesity. Moreover, most obese adults have a history of excess weight starting in childhood. In addition, given the cumulative character of both time and severity of exposure to obesity as a risk factor for associated diseases, the repercussions of obesity prevalence and related morbidity could be exponential in time. The purpose of this review is to outline key aspects regarding the current knowledge on childhood and adolescent obesity as a cardiometabolic risk factor, as well as the most common etiological pathways involved in the development of weight excess and associated cardiovascular and metabolic diseases.
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Yazarlı E, Ünsal Saç R, Şimşek B, Engiz Ö, Dallar Bilge Y, Alioğlu B. The relation between increased carotid intima-media thickness with fibrin monomers in obese children. Int J Clin Pract 2021; 75:e14199. [PMID: 33794044 DOI: 10.1111/ijcp.14199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 11/26/2022] Open
Abstract
AIM This study aimed to investigate the association between carotid intima-media changes that play a part in the atherosclerotic process in childhood obesity and fibrin monomers as an important indicator of fibrin plaque. METHODS This is a cross-sectional study of obese children and non-obese healthy control subjects. Height, weight, body mass index, waist/hip ratio, systolic/diastolic blood pressures were recorded, in addition, biochemistry, haemogram, fibrin monomers and d-dimer were measured in both groups. Right and left common carotid intima-media thicknesses were measured by ultrasonography and mean carotid intima-media thickness was calculated. RESULTS Obese children (n = 89, 46.1% girls, median age: 12.6 ± 2.3 years) and healthy control group (n = 40, 52.5% girls, median age: 13.2 ± 2.2 years) were comparable in terms of gender, age and puberty stage. Mean carotid intima-media thickness was higher in obese children than the healthy control group (P = .002). There was no difference between the two groups in terms of fibrin monomers and d-dimer levels. In obese children, there was a weak negative correlation between mean carotid intima-media thickness and fibrin monomers (P = .030, r = -0.233). CONCLUSION In obese children, mean carotid intima-media thickness was determined higher, as an early indicator of atherosclerosis. We want to emphasise that obese children are at risk for cardiovascular disease and should be evaluated in terms of atherosclerosis. This study investigates the relation between increased carotid intima-media thickness and fibrin monomers, in children, the first time in Literature.
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Affiliation(s)
- Esra Yazarlı
- Department of Pediatrics, Faculty of Medicine Hatay Mustafa Kemal University, Hatay, Turkey
| | - Rukiye Ünsal Saç
- Department of Pediatrics, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Betül Şimşek
- Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Özlem Engiz
- Department of Pediatric Endocrinology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Yıldız Dallar Bilge
- Department of Pediatrics, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Bülent Alioğlu
- Department of Pediatric Hematology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
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Abstract
Obese heart failure with preserved ejection fraction (HFpEF) is a distinct HFpEF phenotype. Sodium retention, high circulating neurohormone levels, alterations in energy substrate metabolism, group 3 pulmonary hypertension, pericardial restraint, and systemic inflammation are central pathophysiologic mechanisms. Confirming the diagnosis may be challenging and high suspicion is required. Reduction of visceral adipose tissue, via caloric restriction and/or bariatric surgery, may improve outcomes in obese HFpEF patients. Furthermore, mineralocorticoid receptor inhibition, neprilysin inhibition, and sodium-glucose cotransporter 2 inhibition can ameliorate the effects of adiposity on the cardiovascular system, allowing for promising new treatment targets for the obese HFpEF phenotype.
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Affiliation(s)
- Efstratios Koutroumpakis
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center, 6431 Fannin Street, MSB 1.220, Houston, TX 77030, USA
| | - Ramanjit Kaur
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center, 6431 Fannin Street, MSB 1.220, Houston, TX 77030, USA
| | - Heinrich Taegtmeyer
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center, 6431 Fannin Street, MSB 1.220, Houston, TX 77030, USA
| | - Anita Deswal
- Department of Cardiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
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8
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Widjaja NA, Irawan R, Prihaningtyas RA, Ardiana M, Hanindita MH. Carotid intima-media thickness, hypertension, and dyslipidemia in obese adolescents. Pan Afr Med J 2019; 34:134. [PMID: 33708303 PMCID: PMC7906559 DOI: 10.11604/pamj.2019.34.134.18309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 10/30/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction Obesity is a global health problem with growing prevalence in developing countries. Obesity causes chronic inflammation due to imbalances between pro- and anti-inflammatory cytokines. This causes metabolic complications such as dyslipidemia, hypertension, and cardiovascular disorder. Carotid intima-media thickness (CIMT) is a predictor of atherosclerosis which could be measured easily and non-invasively. Early detection of cardiovascular diseases in obese adolescents at risk is hoped to improve outcomes. Methods This is a cross-sectional study on obese adolescents aged 13-16 year old at Pediatric Clinic of Dr. Soetomo General Hospital. Obesity is defined as Body mass index higher than 95th percentiles according to CDC (2000). Dyslipidemia is diagnosed when either an increase in cholesterol, LDL, triglyceride or a decrease in HDL level is found, as recommended by NCPE and American Academy of Pediatrics. Hypertension is defined as an increase of blood pressure > P95 according to age and gender. The differences of CIMT based on dyslipidemia, hypertension, and gender were analyzed with Wilcoxon Mann Whitney with significant p value (p < 0,005). Results This study included 59 obese adolescents, consisting of 32 (54.2%) male adolescents and 35 (59.3%) female adolescents. Dyslipidemia was found on 38 (64.4%) adolescents and hypertension was found on 35 (59.3%) adolescents. No difference of CIMT was found between obese adolescents with and without dyslipidemia and with and without hypertension based on gender (p > 0.05). Conclusion No difference of CIMT based on gender between adolescents aged below 18. The high number of dyslipidemia and hypertension in obese adolescents need an early detection of cardiovascular complication.
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Affiliation(s)
- Nur Aisiyah Widjaja
- Child Health Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.,Medical Doctoral Program Student, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Roedi Irawan
- Child Health Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Rendi Aji Prihaningtyas
- Child Health Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Meity Ardiana
- Cardiology and Vascular Medicine Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Meta Herdiana Hanindita
- Child Health Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
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Sönmez HE, Canpolat N, Ağbaş A, Taşdemir M, Ekmekçi ÖB, Alikaşifoğlu M, Sever L, Çalışkan S. The Relationship between the Waist Circumference and Increased Carotid Intima Thickness in Obese Children. Child Obes 2019; 15:468-475. [PMID: 31246513 DOI: 10.1089/chi.2019.0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: This study aimed to evaluate the cardiometabolic risk factors in normotensive obese and hypertensive obese (HT-obese) children by comparison of anthropomorphic measurements, fat distribution, carotid artery intima-media thickness (CIMT), and inflammatory markers. Methods: Fifty-three obese patients 10-18 years of age with a BMI-for-age/gender >95th percentile and 20 age- and gender-matched healthy volunteers enrolled in the study. Obese patients were divided into two groups according to the presence of hypertension (HT), as follows: HT-obese subgroup (n = 30) and nonhypertensive obese (non-HT-obese) subgroup (n = 23). Results: Weight standard deviation score (SDS), BMI-SDS, waist circumference (WC) SDS, and the fat tissue z-score were significantly higher (p < 0.001 for all) in the obese patients than the control groups. Obese patients had higher 24-hour systolic blood pressure (SBP) SDS and leptin, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 levels. Furthermore, CIMT and CIMT-SDS were significantly higher in them. HT-obese patients (n = 30) had significantly higher WC-SDS and lower serum leptin and adiponectin levels than those of non-HT-obese group (n = 23). Finally, an association between increased CIMT-SDS and WC-SDS (β = 0.399, p = 0.002) and 24-hour SBP-SDS (β = 0.272, p = 0.009) was shown. Conclusions: Association between increased WC and HT implies the importance of central obesity in atherosclerosis. We concluded that WC measurement could be used to define risk groups since it is related to cardiometabolic complications.
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Affiliation(s)
- Hafize Emine Sönmez
- Department of Pediatrics, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Mehmet Taşdemir
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Özlem Balcı Ekmekçi
- Department of Biochemistry, and Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Müjgan Alikaşifoğlu
- Department of Adolescence, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Lale Sever
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Salim Çalışkan
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
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Carotid Intima-Media Thickness and Metabolic Syndrome Components in Obese Children and Adolescents. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1021:63-72. [PMID: 28456929 DOI: 10.1007/5584_2017_29] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Obesity in children and adolescents contributes to increased prevalence of metabolic and hemodynamic complications, which may impair endothelial function and structure. A high resolution B-mode ultrasound measurement of intima-media thickness (IMT) is a useful tool to assess early, preclinical stage of atherosclerosis. The objective of this study was to evaluate the carotid artery IMT in obese children and its association with insulin resistance and other traditional metabolic syndrome components. The study entailed 80 obese children, aged 5.3-17.9 year and a control group of 31 children. Obesity was defined using the International Obesity Task Force (IOTF) criteria. Metabolic syndrome was defined using the International Diabetes Federation (IDF) criteria of 2007. Each patient's anthropometric measurements, blood parameters, and the carotid IMT were evaluated. Insulin resistance indices were calculated. We found that children with metabolic syndrome had a significantly increased IMT compared to children who did not meet the syndrome criteria (0.62 ± 0.09 mm vs. 0.55 ± 0.18 mm, p = 0.03) and compared to control group (0.62 ± 0.09 vs. 0.52 ± 0.14, p = 0.02). In a multivariable linear regression analysis, IMT correlated with systolic blood pressure (p = 0.005). The results did not show an association between IMT and insulin resistance. We conclude that abdominal obesity and the accompanying components of metabolic syndrome lead to increased carotid IMT. The enhanced systolic blood pressure plays a major role in changing the carotid IMT.
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El Jalbout R, Cloutier G, Roy-Cardinal MH, Henderson M, Levy E, Lapierre C, Soulez G, Dubois J. The value of non-invasive vascular elastography (NIVE) in detecting early vascular changes in overweight and obese children. Eur Radiol 2019; 29:3854-3861. [DOI: 10.1007/s00330-019-06051-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/03/2019] [Accepted: 01/30/2019] [Indexed: 10/27/2022]
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12
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Fujiwara H, Nakajima H, Inoue F, Kosaka K, Asano H, Yoshii K. Arterial stiffness in junior high school students: Longitudinal observations. Pediatr Int 2018; 60:127-135. [PMID: 29230906 DOI: 10.1111/ped.13475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/15/2017] [Accepted: 11/30/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Early atherosclerotic change is found even in childhood, and there is an urgent need to clarify the factors causing childhood atherosclerosis and take preventive measures. Early detection of the contributing risk factors is crucial to facilitate preventive measures. Pulse wave velocity (PWV) is a widely used technique for the assessment of atherosclerosis in children. METHODS Lifestyle questionnaire, brachio-ankle PWV (baPWV) and anthropometric data were obtained from junior high school students in an urban area of Japan between 2006 and 2008, from seventh to ninth grades. RESULTS Mean baPWV increased from 867.4 ± 99.5 m/s to 944.5 ± 117.5 m/s in boys, and from 864.0 ± 99.5 m/s to 923.0 ± 101.3 m/s in girls. Obese students had higher baPWV than non-obese students in both genders across each grade. On logistic regression analysis of ninth grade student data, high baPWV was dependent on systolic blood pressure (SBP), time watching television (TV) and symptoms of depression and anxiety, whereas low baPWV was dependent on time playing video games, light exercise, sleep and indoor play, as well as good friendship and motivation. CONCLUSION Systolic blood pressure, time watching TV, and symptoms of depression and anxiety may contribute to arterial stiffness and be related to obesity in junior high school students.
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Affiliation(s)
- Hiroshi Fujiwara
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kamigyo, Japan
| | - Hisakazu Nakajima
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kamigyo, Japan
| | - Fumio Inoue
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kamigyo, Japan.,Department of Education, Kyoto University of Education, Fukakusa, Fushimi, Kyoto, Japan
| | - Kitaro Kosaka
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kamigyo, Japan
| | - Hiroaki Asano
- School of Nursing, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kamigyo, Japan
| | - Kengo Yoshii
- Department of Mathematics and Statistics in Medical Sciences, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kamigyo, Japan
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13
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El Jalbout R, Cloutier G, Cardinal MHR, Henderson M, Lapierre C, Soulez G, Dubois J. Carotid artery intima-media thickness measurement in children with normal and increased body mass index: a comparison of three techniques. Pediatr Radiol 2018; 48:1073-1079. [PMID: 29744621 PMCID: PMC6061475 DOI: 10.1007/s00247-018-4144-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/01/2018] [Accepted: 04/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Common carotid artery intima-media thickness is a marker of subclinical atherosclerosis. In children, increased intima-media thickness is associated with obesity and the risk of cardiovascular events in adulthood. OBJECTIVE To compare intima-media thickness measurements using B-mode ultrasound, radiofrequency (RF) echo tracking, and RF speckle probability distribution in children with normal and increased body mass index (BMI). MATERIALS AND METHODS We prospectively measured intima-media thickness in 120 children randomly selected from two groups of a longitudinal cohort: normal BMI and increased BMI, defined by BMI ≥85th percentile for age and gender. We followed Mannheim recommendations. We used M'Ath-Std for automated B-mode imaging, M-line processing of RF signal amplitude for RF echo tracking, and RF signal segmentation and averaging using probability distributions defining image speckle. Statistical analysis included Wilcoxon and Mann-Whitney tests, and Pearson correlation coefficient and intra-class correlation coefficient (ICC). RESULTS Children were 10-13 years old (mean: 11.7 years); 61% were boys. The mean age was 11.4 years (range: 10.0-13.1 years) for the normal BMI group and 12.0 years (range: 10.1-13.5 years) for the increased BMI group. The normal BMI group included 58% boys and the increased BMI group 63% boys. RF echo tracking method was successful in 79 children as opposed to 114 for the B-mode method and all 120 for the probability distribution method. Techniques were weakly correlated: ICC=0.34 (95% confidence interval [CI]: 0.27-0.39). Intima-media thickness was significantly higher in the increased BMI than normal BMI group using the RF techniques and borderline for the B-mode technique. Mean differences between weight groups were: B-mode, 0.02 mm (95% CI: 0.00 to 0.04), P=0.05; RF echo tracking, 0.03 mm (95% CI: 0.01 to 0.05), P=0.01; and RF speckle probability distribution, 0.03 mm (95% CI: 0.01 to 0.05), P=0.002. CONCLUSION Though techniques are not interchangeable, all showed increased intima-media thickness in children with increased BMI. RF echo tracking method had the lowest success rate at calculating intima-media thickness. For patient follow-up and cohort comparisons, the same technique should be used throughout.
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Affiliation(s)
- Ramy El Jalbout
- Department of Medical Imaging, University of Montreal, Sainte-Justine University Health Center, 3175 Cote-Sainte-Catherine Road, Montreal, Quebec, H3T 1C5, Canada.
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Marie-Hélène Roy Cardinal
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Mélanie Henderson
- Department of Pediatrics, University of Montreal, Sainte-Justine University Health Center, Montreal, Quebec, Canada
| | - Chantale Lapierre
- Department of Medical Imaging, University of Montreal, Sainte-Justine University Health Center, 3175 Cote-Sainte-Catherine Road, Montreal, Quebec, H3T 1C5 Canada
| | - Gilles Soulez
- Department of Radiology, University of Montreal Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Josée Dubois
- Department of Medical Imaging, University of Montreal, Sainte-Justine University Health Center, 3175 Cote-Sainte-Catherine Road, Montreal, Quebec, H3T 1C5 Canada
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14
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Aroor AR, Jia G, Sowers JR. Cellular mechanisms underlying obesity-induced arterial stiffness. Am J Physiol Regul Integr Comp Physiol 2017; 314:R387-R398. [PMID: 29167167 DOI: 10.1152/ajpregu.00235.2016] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Obesity is an emerging pandemic driven by consumption of a diet rich in fat and highly refined carbohydrates (a Western diet) and a sedentary lifestyle in both children and adults. There is mounting evidence that arterial stiffness in obesity is an independent and strong predictor of cardiovascular disease (CVD), cognitive functional decline, and chronic kidney disease. Cardiovascular stiffness is a precursor to atherosclerosis, systolic hypertension, cardiac diastolic dysfunction, and impairment of coronary and cerebral flow. Moreover, premenopausal women lose the CVD protection normally afforded to them in the setting of obesity, insulin resistance, and diabetes, and this loss of CVD protection is inextricably linked to an increased propensity for arterial stiffness. Stiffness of endothelial and vascular smooth muscle cells, extracellular matrix remodeling, perivascular adipose tissue inflammation, and immune cell dysfunction contribute to the development of arterial stiffness in obesity. Enhanced endothelial cortical stiffness decreases endothelial generation of nitric oxide, and increased oxidative stress promotes destruction of nitric oxide. Our research over the past 5 years has underscored an important role of increased aldosterone and vascular mineralocorticoid receptor activation in driving development of cardiovascular stiffness, especially in females consuming a Western diet. In this review the cellular mechanisms of obesity-associated arterial stiffness are highlighted.
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Affiliation(s)
- Annayya R Aroor
- Diabetes and Cardiovascular Center, University of Missouri Columbia School of Medicine , Columbia, Missouri.,Harry S Truman Memorial Veterans Hospital , Columbia, Missouri
| | - Guanghong Jia
- Diabetes and Cardiovascular Center, University of Missouri Columbia School of Medicine , Columbia, Missouri.,Harry S Truman Memorial Veterans Hospital , Columbia, Missouri
| | - James R Sowers
- Diabetes and Cardiovascular Center, University of Missouri Columbia School of Medicine , Columbia, Missouri.,Departments of Medical Pharmacology and Physiology, University of Missouri Columbia School of Medicine , Columbia, Missouri.,Harry S Truman Memorial Veterans Hospital , Columbia, Missouri.,Dalton Cardiovascular Center Columbia , Columbia, Missouri
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15
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Parmeggiani L, Salandin M, Egger F, Lupi F, Primerano M, Radetti G. A thicker intima-media carotid wall was found in a cohort of children with recent onset migraine. Acta Paediatr 2016; 105:e577-e581. [PMID: 27686570 DOI: 10.1111/apa.13611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 09/06/2016] [Accepted: 09/26/2016] [Indexed: 01/22/2023]
Abstract
AIM Migraine affects approximately 10-20% of the general population, including children and adolescents, and an association between migraine and increased risks for cardiovascular disease and stroke have been reported in adult patients. This study aimed to address the lack of data on children with migraine. METHODS This study comprised 30 children and adolescents (16 male) with migraine. We evaluated their biochemical profile, glucose homeostasis, vascular function by flow-mediated dilatation and arterial structure by carotid intima-media thickness (cIMT). A group of 32 age, sex and auxologically matched children (17 male) served as controls. RESULTS The group of children with migraine had a normal biochemical profile and glucose homeostasis, but presented with significantly thicker cIMT than the control group (0.48 ± 0.07 mm versus 0.45 ± 0.04, p < 0.05). CONCLUSION We observed a significantly thicker cIMT in children with migraine compared with the controls. The brief time interval between the onset of the disease and the time of the study makes it unlikely that repetitive migraine attacks could be responsible for the thickening of the cIMT. Thus, it may be speculated that primitive vascular function abnormalities were wholly or partly responsible for the development of migraine in this paediatric cohort.
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Affiliation(s)
- Lucio Parmeggiani
- Department of Neuropediatrics; Regional Hospital of Bolzano; Bolzano Italy
| | - Michela Salandin
- Department of Neuropediatrics; Regional Hospital of Bolzano; Bolzano Italy
| | - Flavio Egger
- Department Internal Medicine; Regional Hospital of Bolzano; Bolzano Italy
| | - Fiorenzo Lupi
- Department of Pediatrics; Regional Hospital of Bolzano; Bolzano Italy
| | - Marco Primerano
- Hospital Pharmacy; Regional Hospital of Bolzano; Bolzano Italy
| | - Giorgio Radetti
- Department of Pediatrics; Regional Hospital of Bolzano; Bolzano Italy
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