Carotid intima-media thickness, hypertension, and dyslipidemia in obese adolescents

Nur Aisiyah Widjaja, Roedi Irawan, Rendi Aji Prihaningtyas, Meity Ardiana, Meta Herdiana Hanindita, Nur Aisiyah Widjaja, Roedi Irawan, Rendi Aji Prihaningtyas, Meity Ardiana, Meta Herdiana Hanindita

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.

Keywords: CIMT; Obesity; adolescents; dyslipidemia; hypertension.

Conflict of interest statement

The authors declare no competing interests.

© Nur Aisiyah Widjaja et al.

References

    1. Castro AM, Macedo-de la Concha LE, Pantoja-Meléndez CA. Low-grade inflammation and its relation to obesity and chronic degenerative diseases. Revista Médica del Hospital General de México. 2017;80(2):101–105.
    1. Fang J, Zhang JP, Luo CX, Yu XM, Lv LQ. Carotid Intima-media thickness in childhood and adolescent obesity relations to abdominal obesity, high triglyceride level and insulin resistance. Int J Med Sci. 2010 Aug 18;7(5):278–83.
    1. Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. In: Engin AB, Engin A, editors. Obesity and Lipotoxicity. Cham: Springer International Publishing; 2017. pp. 1–17.
    1. Gao Z, Khoury PR, McCoy CE, Shah AS, Kimball TR, Dolan LM, et al. Adiposity has no direct effect on carotid intima-media thickness in adolescents and young adults: Use of structural equation modeling to elucidate indirect & direct pathways. Atherosclerosis. 2016 Mar;246:29–35. Epub 2015 Dec 8.
    1. Todendi PF, Possuelo LG, Klinger EI, Reuter CP, Burgos MS, Moura DJ, et al. Low-grade inflammation markers in children and adolescents: Influence of anthropometric characteristics and CRP and IL6 polymorphisms. Cytokine. 2016 Dec;88:177–183.
    1. Ayoub M, Zouaoui C, Grira N, Kochkar R, Stambouli N, Bouguerra C, et al. Correlation between Dietary Intake and Inflammatory Biomarkers in a Tunisian Obese Group. Journal of Biosciences and Medicines. 2015;03(11):108–113.
    1. Weber DR, Levitt Katz LE, Zemel BS, Gallagher PR, Murphy KM, Dumser SM, et al. Anthropometric measures of abdominal adiposity for the identification of cardiometabolic risk factors in adolescents. Diabetes Res Clin Pract. 2014 Mar;103(3):e14–7. Epub 2014 Jan 8.
    1. Staiano AE, Katzmarzyk PT. Ethnic and sex differences in body fat and visceral and subcutaneous adiposity in children and adolescents. Int J Obes (Lond) 2012 Oct;36(10):1261–9. Epub 2012 Jun 19.
    1. Going SB, Lohman TG, Cussler EC, Williams DP, Morrison JA, Horn PS. Percent body fat and chronic disease risk factors in U.S. children and youth. Am J Prev Med. 2011 Oct;41(4 Suppl 2):S77–86.
    1. Stabouli S, Kotsis V, Karagianni C, Zakopoulos N, Konstantopoulos A. Blood pressure and carotid artery intima-media thickness in children and adolescents: the role of obesity. Hellenic J Cardiol. 2012 Jan-Feb;53(1):41–7.
    1. Baroncini LAV, Sylvestre L de C, Pecoits Filho R. Assessment of Intima-Media Thickness in Healthy Children Aged 1 to 15 Years. Arq Bras Cardiol. 2016 Apr;106(4):327–32. Epub 2016 Mar 8.
    1. Weberruß H, Pirzer R, Böhm B, Dalla Pozza R, Netz H, Oberhoffer R. Intima-media thickness and arterial function in obese and non-obese children. BMC Obes. 2016 Jan 9;3:2. eCollection 2015.
    1. Böhm B, Hartmann K, Buck M, Oberhoffer R. Sex differences of carotid intima-media thickness in healthy children and adolescents. Atherosclerosis. 2009 Oct;206(2):458–63. Epub 2009 Mar 25.
    1. Le J, Zhang D, Menees S, Chen J, Raghuveer G. “Vascular Age” Is Advanced in Children With Atherosclerosis-Promoting Risk Factors. Circulation: Cardiovascular Imaging. 2010;3(1):8–14.
    1. Su T-C, Liao C-C, Chien K-L, Hsu SH-J, Sung F-C. An Overweight or Obese Status in Childhood Predicts Subclinical Atherosclerosis and Prehypertension/Hypertension in Young Adults. J Atheroscler Thromb. 2014;21(11):1170–82. Epub 2014 Jul 16.
    1. Baroncini LAV, Sylvestre L de C, Baroncini CV, Pecoits Filho R. Assessment of Carotid Intima-Media Thickness as an Early Marker Of Vascular Damage In Hypertensive Children. Arq Bras Cardiol. 2017 May;108(5):452–457. Epub 2017 Apr 20.
    1. O’Leary DH, Bots ML. Imaging of atherosclerosis: carotid intima-media thickness. Eur Heart J. 2010 Jul;31(14):1682–9. Epub 2010 Jun 11.

Source: PubMed

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