Agyei Benedict Apaw, Wiafe Yaw Amo, Donkor Andrew, Anyitey-Kokor Ijeoma Chinedum, Yahya Kataru, Sarfo Fred Stephen
Department of Medical Imaging Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana.
IMPACCT (Improving Palliative Aged and Chronic care through Clinical Research and Translation), Faculty of Health University of Technology Sydney Sydney New South Wales Australia.
Health Sci Rep. 2024 Aug 29;7(9):e70033. doi: 10.1002/hsr2.70033. eCollection 2024 Sep.
Blood pressure, body mass index (BMI), and carotid intima-media thickness (CIMT) are well-known independent predictors of cardiovascular disease especially in adulthood. However, there is insufficient evidence regarding the statistical significance of the relationship between childhood CIMT, blood pressure and BMI. This systematic review and meta-analysis was therefore conducted to ascertain the relationship.
This systematic review and meta-analysis was reported in accordance with the PRISMA statement. Three electronic databases were searched, namely EMBASE, MEDLINE and the Cochrane Library. Data were extracted independently by two review authors. Quantitative data were analyzed using Review Manager.
The meta-analysis was conducted using a random effects model and standard mean difference. The results of the meta-analysis indicated a statistically significant difference in CIMT of 0.86 (95% CI: 0.41-1.31) between normotensive versus hypertensive children. Again, overweight and moderately obese children had higher CIMT values as compared to normal weight children with a pooled standard mean difference of 0.72 (95% CI: 0.24-1.20) and 2.75 (95% CI: 0.73-4.77) respectively. The pooled standard mean difference of systolic and diastolic blood pressures was found to be 2.44 (95% CI: 1.69-3.19) and 1.28 (95% CI: 0.65-1.92) respectively between normal weight and overweight/obese children.
The meta-analysis found a significant difference in CIMT between normotensive and hypertensive children, with overweight and moderately obese children having higher CIMT values. Thus, conducting CIMT screening for obese or overweight children and children with increased blood pressure can provide valuable information about their cardiovascular disease risk.
血压、体重指数（BMI）和颈动脉内膜中层厚度（CIMT）是众所周知的心血管疾病独立预测指标，尤其在成年期。然而，关于儿童CIMT、血压和BMI之间关系的统计学意义，证据并不充分。因此，开展了这项系统评价和荟萃分析以确定它们之间的关系。
本系统评价和荟萃分析按照PRISMA声明进行报告。检索了三个电子数据库，即EMBASE、MEDLINE和Cochrane图书馆。由两位综述作者独立提取数据。使用Review Manager对定量数据进行分析。
采用随机效应模型和标准化均数差值进行荟萃分析。荟萃分析结果表明，血压正常儿童与高血压儿童之间的CIMT差异有统计学意义，差值为0.86（95%CI：0.41 - 1.31）。此外，超重和中度肥胖儿童的CIMT值高于正常体重儿童，合并标准化均数差值分别为0.72（95%CI：0.24 - 1.20）和2.75（95%CI：0.73 - 4.77）。正常体重儿童与超重/肥胖儿童之间收缩压和舒张压的合并标准化均数差值分别为2.44（95%CI：1.69 - 3.19）和1.28（95%CI：0.65 - 1.92）。
荟萃分析发现血压正常儿童与高血压儿童之间的CIMT存在显著差异，超重和中度肥胖儿童的CIMT值更高。因此，对肥胖或超重儿童以及血压升高的儿童进行CIMT筛查，可以提供有关其心血管疾病风险的有价值信息。
