Increased Carotid Intima-Media Thickness and Stiffness in Obese Children

Obesity in childhood increases the risk of atherosclerotic disease and death in adulthood (1). A dramatic increase in overweight among children and adolescents during the past 2 decades has been documented (2). Moreover, overweight children and adolescents have an increased risk of adult obesity (3). A clustering of factors typical of the insulin resistance syndrome has been identified in 5- to 10-year-old overweight/obese African-American children (4) and in preadolescent obese children (5). The pediatric obesity epidemic accounts for most new diagnoses of type 2 diabetes, a disease once virtually confined to adulthood, in adolescence (6). High-resolution B-mode ultrasound measurements of carotid intima-media thickness (IMT) and stiffness are markers of early, preclinical atherosclerosis. Previous observations show significantly increased IMT in familial hypercholesterolemic children (7,8) and in children with type 1 diabetes (9) and hypertension (10). Recent evidence suggests an increased arterial stiffness in familial hypercholesterolemic children (11) and in children with severe obesity (12). However, in the study by Tounian et al. (12) there was no evidence of statistically significant differences in carotid IMT between severely obese children and control subjects; moreover, there was no subgroup analyses for boys versus girls. The present study aimed to verify whether obesity …