Subclinical Atherosclerosis in Latino Youth: Progression of Carotid Intima-Media Thickness and Its Relationship to Cardiometabolic Risk Factors

• Published in: The Journal of pediatrics 2011-06, Vol.158 (6), p.935-940
• Main Authors: Toledo-Corral, Claudia M., PhD, MS, MPH, Davis, Jaimie N., PhD, RD, Alderete, Tanya L., BA, Weigensberg, Marc J., MD, Ayala, Christina T., MPH, Li, Yanjie, MD, Hodis, Howard N., MD, Goran, Michael I., PhD
• Format: Article
• Language: English
• Subjects: Adolescent; adolescents; at-risk population; atherosclerosis; Atherosclerosis (general aspects, experimental research); Atherosclerosis - diagnosis; Atherosclerosis - epidemiology; Biological and medical sciences; blood; Blood and lymphatic vessels; body composition; Body Mass Index; Cardiology. Vascular system; Cardiovascular Diseases - metabolism; carotid arteries; Cholesterol, HDL - metabolism; Cholesterol, LDL - metabolism; dual-energy X-ray absorptiometry; fasting; Female; General aspects; glucose; glucose tolerance tests; Hispanic Americans; Humans; insulin; Latinos; low density lipoprotein cholesterol; magnetic resonance imaging; Male; Medical sciences; metabolic syndrome; Overweight; Pediatrics; Risk; Risk Factors; Tunica Intima - pathology; Tunica Media - pathology; ultrasonics; youth
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2010.12.008

Objective To assess carotid artery intima-media thickness (CIMT) change over 2 years in overweight Latino adolescents and examine its relationship to cardiometabolic risk. Study design Seventy-two healthy overweight male and female Latino adolescents (mean age, 14.5 ± 1.7 years; mean body mass index, 31.5 ± 6.9 kg/m2 ) were evaluated at baseline and 2 years later for CIMT by high-resolution B-mode ultrasound, the metabolic syndrome and its features, body composition by dual-energy x-ray absorptiometry and magnetic resonance imaging, glucose/insulin measures by fasting blood, and oral and intravenous glucose tolerance tests. Results Baseline CIMT did not differ from 2-year follow-up; however, 38 participants increased CIMT (0.017 ± 0.003 mm; +2.8%) and 34 decreased or remained the same (−0.019 ± 0.002 mm; −3.1%). ANCOVA analyses showed that participants with CIMT progression had higher baseline low-density lipoprotein (LDL)-cholesterol and total cholesterol (91.3 ± 3.4 and 150.3 ± 3.9 mg/dL) compared with those with CIMT non-progression (78.1 ± 3.6 and 135.6 ± 4.2 mg/dL, P < .05), independent of sex, baseline CIMT, age, and height. In multivariate regression, LDL-cholesterol was the sole predictor of CIMT progression, but the effect was small (odds of CIMT progression increased by 3% for each 1 mg/dL higher baseline LDL-cholesterol; 95% CI, 1.004 to 1.006, P = .03). Conclusions These results indicate a high variability in the magnitude of CIMT change in growing overweight Latino youth and support the use of LDL-cholesterol to assess subclinical atherosclerosis risk in this population.