Department of Pediatrics and Endocrinology, Warsaw Medical University, Waraw, Poland.
Department of Pediatric Radiology, Warsaw Medical University, Waraw, Poland.
Adv Exp Med Biol. 2017;1021:63-72. doi: 10.1007/5584_2017_29.
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.
儿童和青少年肥胖会导致代谢和血液动力学并发症的患病率增加，这可能会损害内皮功能和结构。高分辨率 B 型超声内膜中层厚度（IMT）测量是评估动脉粥样硬化早期临床前阶段的有用工具。本研究的目的是评估肥胖儿童的颈动脉 IMT 及其与胰岛素抵抗和其他传统代谢综合征成分的关系。该研究纳入了 80 名肥胖儿童，年龄为 5.3-17.9 岁，对照组为 31 名儿童。肥胖使用国际肥胖工作组（IOTF）标准定义。代谢综合征使用 2007 年国际糖尿病联合会（IDF）标准定义。评估了每位患者的人体测量学测量、血液参数和颈动脉 IMT。计算了胰岛素抵抗指数。我们发现，患有代谢综合征的儿童的 IMT 明显高于不符合综合征标准的儿童（0.62±0.09 毫米对 0.55±0.18 毫米，p=0.03）和对照组（0.62±0.09 毫米对 0.52±0.14 毫米，p=0.02）。在多元线性回归分析中，IMT 与收缩压相关（p=0.005）。结果并未显示 IMT 与胰岛素抵抗之间存在关联。我们得出结论，腹部肥胖和代谢综合征伴随的成分导致颈动脉 IMT 增加。增强的收缩压在改变颈动脉 IMT 方面起着主要作用。
