Carotid Artery Intima-media Thickness Values in Obese or Overweight Children: a Meta-analysis

Overview

Journal Eur Radiol

Specialty Radiology

Date 2024 Dec 20

PMID 39702636

Authors

Jean-Baptiste Moretti

Alexandre Korban

Emilie Alchourron

Sylvie Gervais

Ramy El Jalbout

Affiliations

Soon will be listed here.

Abstract

Objective: Carotid artery intima-media thickness (IMT) is a non-invasive ultrasound marker of early atherosclerosis. This systematic review and meta-analysis aim to report the published differences in IMT values in children living with overweight or obesity compared to controls with normal weight.

Methods: This review was conducted according to PRISMA guidelines, including only cohorts with normal controls. Inclusion criteria were IMT measured using B-mode or radiofrequency (RF) techniques and based on the four consensuses: American Heart Association, Association for European Pediatric Cardiology, Mannheim Consensus, and American Society of Echocardiography. We used the body mass index based on the World Health Organization growth standard definitions of obesity in children. Relevant articles were extracted from PubMed, Cochrane Library, Embase, and Web of Science searched from inception to February 2024. A meta-analysis was done by a biostatistician using the R-software version 4.0.2.

Results: We obtained 15 B-mode-based and two RF echo-tracking-based IMT measurement studies. IMT is significantly increased in children living with obesity. The mean IMT was 0.041 mm, 95% confidence interval (CI): 0.052; 0.031 higher in children with overweight/obesity, using the B-mode technique, and 0.045 mm, 95% CI: 0.062; 0.029 higher in children with overweight/obesity using RF technique.

Conclusion: This meta-analysis shows that IMT is significantly increased in children with obesity compared to normal-weight children according to both techniques.

Key Points: Question IMT measured according to known consensuses is significantly increased in children living with obesity. Findings Mean IMT was 0.041 mm higher in children living with obesity using the B-mode technique and 0.045 mm using the RF technique. Clinical relevance There are different techniques to measure IMT in children. This meta-analysis, using cohorts of children living with obesity compared to normal weight controls, shows a significantly increased IMT in children living with obesity.

References

Anderson T . Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk. Can J Cardiol. 2006; 22 Suppl B:72B-80B. PMC: 2780833. DOI: 10.1016/s0828-282x(06)70990-4. View

de Groot E, Hovingh G, Wiegman A, Duriez P, Smit A, Fruchart J . Measurement of arterial wall thickness as a surrogate marker for atherosclerosis. Circulation. 2004; 109(23 Suppl 1):III33-8. DOI: 10.1161/01.CIR.0000131516.65699.ba. View

Reinehr T, Kiess W, de Sousa G, Stoffel-Wagner B, Wunsch R . Intima media thickness in childhood obesity: relations to inflammatory marker, glucose metabolism, and blood pressure. Metabolism. 2005; 55(1):113-8. DOI: 10.1016/j.metabol.2005.07.016. View

Umer A, Kelley G, Cottrell L, Giacobbi Jr P, Innes K, Lilly C . Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis. BMC Public Health. 2017; 17(1):683. PMC: 5575877. DOI: 10.1186/s12889-017-4691-z. View

Silva L, Stefanello J, Pizzi J, Timossi L, Leite N . Atherosclerosis subclinical and inflammatory markers in obese and nonobese children and adolescents. Rev Bras Epidemiol. 2013; 15(4):804-16. DOI: 10.1590/s1415-790x2012000400012. View

El Jalbout R, Cloutier G, Roy Cardinal M, Henderson M, Lapierre C, Soulez G . Carotid artery intima-media thickness measurement in children with normal and increased body mass index: a comparison of three techniques. Pediatr Radiol. 2018; 48(8):1073-1079. PMC: 6061475. DOI: 10.1007/s00247-018-4144-6. View

de Ferranti S, Steinberger J, Ameduri R, Baker A, Gooding H, Kelly A . Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association. Circulation. 2019; 139(13):e603-e634. DOI: 10.1161/CIR.0000000000000618. View

Lee E, Kim H, Bae J, Kim J, Han H, Park C . Relevance of common carotid intima-media thickness and carotid plaque as risk factors for ischemic stroke in patients with type 2 diabetes mellitus. AJNR Am J Neuroradiol. 2007; 28(5):916-9. PMC: 8134355. View

Sharma K, Blaha M, Blumenthal R, Musunuru K . Clinical and research applications of carotid intima-media thickness. Am J Cardiol. 2009; 103(9):1316-20. PMC: 2691892. DOI: 10.1016/j.amjcard.2009.01.020. View

10.

Flahault A, Fernandes R, De Meulemeester J, Ravizzoni Dartora D, Cloutier A, Gyger G . Arterial Structure and Stiffness Are Altered in Young Adults Born Preterm. Arterioscler Thromb Vasc Biol. 2020; 40(10):2548-2556. DOI: 10.1161/ATVBAHA.120.315099. View

11.

Tantawy A, Adly A, Rahman Ismail E, Abdelazeem M . Clinical Predictive Value of Cystatin C in Pediatric Sickle Cell Disease: A Marker of Disease Severity and Subclinical Cardiovascular Dysfunction. Clin Appl Thromb Hemost. 2016; 23(8):1010-1017. DOI: 10.1177/1076029616665921. View

12.

Schreuder F, Graf M, Hameleers J, Mess W, Hoeks A . Measurement of common carotid artery intima-media thickness in clinical practice: comparison of B-mode and RF-based technique. Ultraschall Med. 2009; 30(5):459-65. DOI: 10.1055/s-0028-1109187. View

13.

Urbina E, Williams R, Alpert B, Collins R, Daniels S, Hayman L . Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension. 2009; 54(5):919-50. DOI: 10.1161/HYPERTENSIONAHA.109.192639. View

14.

Dalla Pozza R, Ehringer-Schetitska D, Fritsch P, Jokinen E, Petropoulos A, Oberhoffer R . Intima media thickness measurement in children: A statement from the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology. Atherosclerosis. 2015; 238(2):380-7. DOI: 10.1016/j.atherosclerosis.2014.12.029. View

15.

Touboul P, Hennerici M, Meairs S, Adams H, Amarenco P, Bornstein N . Mannheim carotid intima-media thickness consensus (2004-2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis. 2006; 23(1):75-80. DOI: 10.1159/000097034. View

16.

Stein J, Korcarz C, Hurst R, Lonn E, Kendall C, Mohler E . 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.... J Am Soc Echocardiogr. 2008; 21(2):93-111. DOI: 10.1016/j.echo.2007.11.011. View

17.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

18.

Moretti J, Michael R, Gervais S, Alchourron E, Stein N, Farhat Z . Normal pediatric values of carotid artery intima-media thickness measured by B-mode ultrasound and radiofrequency echo tracking respecting the consensus: a systematic review. Eur Radiol. 2023; 34(1):654-661. DOI: 10.1007/s00330-023-09994-2. View

19.

Faienza M, Acquafredda A, Tesse R, Luce V, Ventura A, Maggialetti N . Risk factors for subclinical atherosclerosis in diabetic and obese children. Int J Med Sci. 2013; 10(3):338-43. PMC: 3575630. DOI: 10.7150/ijms.5181. View

20.

Karpoff L, Vinet A, Schuster I, Oudot C, Goret L, Dauzat M . Abnormal vascular reactivity at rest and exercise in obese boys. Eur J Clin Invest. 2009; 39(2):94-102. DOI: 10.1111/j.1365-2362.2008.02068.x. View