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A study on carotid artery intima–media thickness and metabolic risk factors in overweight and obese Indian children

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Abstract

Introduction

Carotid intima–media thickness (CIMT) serves as an early marker of atherosclerosis. Data on obesity-related risk factors and their association with carotid intima–media thickness among overweight and obese children are lacking.

Objectives

To compare CIMT of overweight and obese children with CIMT of normal BMI children. To compare various anthropometric and metabolic risk factors associated with increased CIMT among overweight and obese children.

Methods

A descriptive study in a paediatric department of a tertiary care hospital including 50 age-matched normal BMI children and 50 overweight and obese children. Anthropometric data, blood pressure, CIMT (by B-mode ultrasonography), fasting blood sugar, fasting Insulin, fasting lipid profile, TSH, and FT4 were collected. HOMA-IR and fasting glucose–insulin ratio (FGIR) were calculated for insulin resistance. Cutoff for high CIMT was derived using ROC curve analysis.

Results

Overweight and obese children had higher mean CIMT than normal BMI children (0.5 ± 0.1 mm vs 0.34 ± 0.05 mm, respectively, P < 0.001). ROC analysis revealed 0.45 mm as the cutoff for high CIMT. Among overweight and obese children, 31 children (62%) had high CIMT. Among metabolic risk factors for increased CIMT, only FGIR was observed to be significant. Compared to overweight and obese children with normal CIMT, those with higher CIMT had low FGIR value (5.2 ± 2.2 mm vs 6.9 ± 2.6 mm, respectively, P < 0.05).

Conclusion

Overweight and obese children had significantly higher CIMT than controls. Even among overweight and obese children, those with increased CIMT had low FGIR (implying insulin resistance) compared to those with normal CIMT.

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References

  1. Strauss RS. Childhood obesity and self-esteem. Pediatrics. 2000;105:e15.

    Article  CAS  Google Scholar 

  2. Polak JF, Szklo M, O’Leary DH. Associations of coronary heart disease with common carotid artery near and far wall intima-media thickness: the Multi-Ethnic Study of Atherosclerosis. J Am Soc Echocardiogr. 2015;28:1114–21.

    Article  Google Scholar 

  3. Burke GL, Evans GW, Riley WA, Sharrett AR, Howard G, Barnes RW, Rosamond W, Crow RS, Rautaharju PM, Heiss G. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. Stroke. 1995;26:386–91.

    Article  CAS  Google Scholar 

  4. Aminbakhsh A, Mancini GJ. Carotid intima–media thickness measurements: what defines an abnormality? A systematic review. Clin Invest Med. 1999;22:149.

    CAS  PubMed  Google Scholar 

  5. Raitakari OT, Juonala M, Viikari JS. Obesity in childhood and vascular changes in adulthood: insights into the Cardiovascular Risk in Young Finns Study. Int J Obes. 2005;29:S101–4.

    Article  Google Scholar 

  6. Park MH, Skow Á, De Matteis S, Kessel AS, Saxena S, Viner RM, Kinra S. Adiposity and carotid-intima media thickness in children and adolescents: a systematic review. BMC Pediatrics. 2015;15:161.

    Article  Google Scholar 

  7. Simsek E, Balta H, Balta Z, Dallar Y. Childhood obesity-related cardiovascular risk factors and carotid intima-media thickness. Turk J Pediatr. 2010;52:602.

    PubMed  Google Scholar 

  8. Khadilkar V, Yadav S, Agrawal K, Tamboli S, Banerjee M, Cherian A, Goyal JP, Khadilkar A, Kumaravel V, Mohan V, Narayanappa D, Ray I, Yewale V. Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children. Indian Pediatr. 2015;52:47–55.

    Article  Google Scholar 

  9. Khadilkar A, Ekbote V, Chiplonkar S, Khadilkar V, Kajale N, Kulkarni S, Parthasarathy L, Arya A, Bhattacharya A, Agarwal S. Waist circumference percentiles in 2–18 year old indian children. J Pediatr. 2014;164(1358–1362):e2.

    Google Scholar 

  10. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44:291–303.

    Article  CAS  Google Scholar 

  11. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in boys. Arch Dis Child. 1970;45:13–23.

    Article  CAS  Google Scholar 

  12. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents Full report. 2012. Available from: https://www.nhlbi.nih.gov/files/docs/guidelines/peds_guidelines_full.pdf. Cited 10 Apr 2019.

  13. IDF consensus definition of metabolic syndrome in children and adolescents. Belgium: International diabetes federation; 2007. Available from: https://www.idf.org/e-library/consensus-statements/61-idf-consensus-definition-of-metabolic-syndrome-in-children-and-adolescents. Cited 10 Apr 2019.

  14. Kendall D, Vail A, Amin R, Barrett T, Dimitri P, Ivison F, Kibirige M, Mathew V, McGovern A, Stirling H, Tetlow L, Wales J, Wright N, Clayton P, Hall C. Metformin in obese children and adolescents: The MOCA Trial. J Clin Endocrinol Metab. 2013;98:322–9.

    Article  CAS  Google Scholar 

  15. Yokoyama H, Emoto M, Fujiwara S, Motoyama K, Morioka T, Komatsu M, et al. Quantitative insulin sensitivity check index and the reciprocal index of homeostasis model assessment in normal range weight and moderately obese type 2 diabetic patients. Diabetes Care. 2003;26(8):2426–32.

    Article  CAS  Google Scholar 

  16. Singh B, Saxena A. Surrogate markers of insulin resistance: a review. World J Diabetes. 2010;1(2):36–47.

    Article  Google Scholar 

  17. Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall C, Mohler ER, Najjar SS, Rembold CM, Post WS. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr. 2008;21:93–111.

    Article  Google Scholar 

  18. Elkiran O, Yilmaz E, Koc M, Kamanli A, Ustundag B, Ilhan N. The association between intima media thickness, central obesity and diastolic blood pressure in obese and owerweight children: a cross-sectional school-based study. Int J Cardiol. 2013;165:528–32.

    Article  Google Scholar 

  19. Ozguven I, Ersoy B, Ozguven A, Ozkol M, Onur E. Factors affecting carotid intima media thickness predicts early atherosclerosis in overweight and obese adolescents. Obesity Res Clin Pract. 2010;4:e41–8.

    Article  Google Scholar 

  20. Chaubey S, Singh Vijay K, Singh P, Mittal M, Singh Abhishek K, Kushwaha KP. A study on intima- media thickness of carotid artery in children with nephrotic syndrome: a cross sectional study. J Pediatr Res. 2017;4:91–101.

    Google Scholar 

  21. Dabas A, Thomas T, Gahlot M, Gupta N, Devasenathipathy K, Khadgawat R. Carotid intima–medial thickness and glucose homeostasis in Indian obese children and adolescents. Indian J Endocrinol Metab. 2017;21:859–63.

    Article  CAS  Google Scholar 

  22. Vijayakumar M, Sabitha S, Princy K, Rajendran VR, Gopalan AV. Importance of carotid intima media thickness in childhood obesity. J Evol Med Dent Sci. 2017;6:586–91.

    Article  CAS  Google Scholar 

  23. Hacihamdioglu B, Okutan V, Yozgat Y, Yildirim D, Kocaoglu M, Lenk MK, Özcan O. Abdominal obesity is an independent risk factor for increased carotid intima-media thickness in obese children. Turk J Pediatr. 2011;53:48.

    PubMed  Google Scholar 

  24. Borda WA, Badillo FL, Suárez JC, Rey JJ. Carotid intima media thickness in obese children. Rev Colomb Radiol. 2015;26:4185–91.

    Google Scholar 

  25. Pandit D, Kinare A, Chiplonkar S, Khadilkar A, Khadilkar V. Carotid arterial stiffness in overweight and obese Indian children. J Pediatr Endocrinol Metab. 2011;24:97–102.

    Article  CAS  Google Scholar 

  26. 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;7:272–8.

    Google Scholar 

  27. Wunsch R, de Sousa G, Toschke A, Reinehr T. Intima–media thickness in obese children before and after weight loss. Pediatrics. 2006;118:2334–40.

    Article  Google Scholar 

Download references

Acknowledgements

Authors acknowledge the support and help provided by SRIHER, Chennai, India (CSP-MED/15/AUG/24/11).

Funding

No financial support was obtained for this research.

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Authors and Affiliations

  1. Department of Pediatrics, Sri Ramachandra Medical College, Porur, Chennai, 600116, India

    Vignatha Sajja & Saji James

  2. Department of Pediatrics, Division of Paediatric Endocrinology, Sri Ramachandra Medical College, G-block, 4th floor (link room), Porur, Chennai, 600116, India

    Dhivyalakshmi Jeevarathnam

  3. Department of Pediatrics, Division of Pediatric Cardiology, Sri Ramachandra Medical College, Porur, Chennai, 600116, India

    Jebaraj Rathinasamy

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  1. Vignatha Sajja
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Correspondence to Dhivyalakshmi Jeevarathnam.

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Authors do not have anything to disclose and declare no conflict of interest.

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Informed consent was not required for this study as per IRB protocol.

Human rights statement and informed consent

The study “A study on carotid artery intima–media thickness and metabolic risk factors in overweight and obese Indian children” was conducted in agreement with the Institutional Ethical Review Board of Sri Ramachandra Institute of Higher Education and Research, Chennai, India (CSP/17/June/49/2017). This study did not require an informed consent from patients.

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Sajja, V., Jeevarathnam, D., James, S. et al. A study on carotid artery intima–media thickness and metabolic risk factors in overweight and obese Indian children. Diabetol Int 11, 142–149 (2020). https://doi.org/10.1007/s13340-019-00417-6

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  • DOI: https://doi.org/10.1007/s13340-019-00417-6

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