Assessment of intima-media thickness of the carotid artery and intraluminal diameter of the brachial artery as cardiovascular risk markers in Brazilian adolescents with overweight or obesity

Autor: Carlos Alberto Longui, Leonardo Zanesco, Aleksandro B Ferreira, Osmar Monte, Cristiane Kochi, Arthur Lyra, Eduardo de Faria Castro Fleury, Alessandra C R Ribeiro, Gilmar V Tostes Filho, Alexandre José Bonfitto
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Waist
Adolescent
Brachial Artery
Endocrinology
Diabetes and Metabolism
030209 endocrinology & metabolism
030204 cardiovascular system & hematology
Overweight
Carotid Intima-Media Thickness
03 medical and health sciences
0302 clinical medicine
Endocrinology
Insulin resistance
Risk Factors
Internal medicine
medicine.artery
medicine
Humans
Endothelium
Obesity
Brachial artery
Reactive hyperemia
medicine.diagnostic_test
business.industry
Glucose Tolerance Test
Intercellular Adhesion Molecule-1
medicine.disease
Lipids
Carotid Arteries
Cross-Sectional Studies
Intima-media thickness
Cardiovascular Diseases
Pediatrics
Perinatology and Child Health
Cardiology
Homeostatic model assessment
Female
Insulin Resistance
Waist Circumference
medicine.symptom
Lipid profile
business
Brazil
Zdroj: Journal of Pediatric Endocrinology and Metabolism. 33:339-345
ISSN: 2191-0251
0334-018X
DOI: 10.1515/jpem-2019-0254
Popis: Background The intima-media thickness of the carotid artery (cIMT) and endothelial dysfunction are associated with cardiovascular (CV) disease. Objectives To evaluate the correlation between cIMT, brachial intraluminal diameter and flow-mediated vasodilation on the reactive hyperemia phase in adolescents with obesity with predictors of CV risk. Methods Seventy-three pubertal patients with overweight or obesity were evaluated (45 girls) with a mean (standard deviation [SD]) age of 12.9 (2.5) years. Patients underwent anthropometric measurements and had the lipid profile, oral glucose tolerance test (oGTT) and serum intercellular adhesion molecule-1 (sICAM-1) levels analyzed. The ratios of the waist circumference (WC)/height (WHtR) and triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C), homeostatic model assessment of insulin resistance (HOMA-IR), the Matsuda index and insulin area under the curve (AUC) were calculated. All patients were evaluated for cIMT and arterial blood flow velocity of the brachial artery. Results 75.3% of the patients had high cIMT values. We found a positive correlation between WHtR and cIMT (r = 0.233; p = 0.050). There was a positive correlation between sICAM-1 and insulin AUC (r = 0.323; p = 0.012) and WHtR (r = 0.258; p = 0.047). Patients with abnormal arterial dilation had higher sICAM-1 values (p = 0.02) despite having smaller WHtR (p = 0.046). Conclusions These adolescents with obesity had high cIMT values. Insulin resistance was associated with sICAM-1. Endothelial dysfunction was positively correlated with sICAM-1. There is no consensus about what the best laboratorial approach to evaluate insulin resistance in adolescents is, and the cutoff values of each method are arbitrary. So, as we saw earlier, the association between anthropometric data (WHtR) and ultrasound findings could be useful to evaluate the CV risk of these adolescents with obesity, because of its practical, direct and low-cost value.
Databáze: OpenAIRE
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