Abstract 10095: Progression of Carotid Thickness in Adolescents and Young Adults: Determinants of Accelerated Aging in Youth
In adults, accumulation of CV risk factors increases carotid intima-media thickness (IMT) and carotid stiffness and accelerates progression of IMT. The rate of progression of carotid IMT and stiffness in adolescents and young adults is not known, nor has the effect of CV risk factors on progression been documented. We examined carotid IMT and stiffness (beta stiffness index=Beta; Incremental elastic modulus=Einc; Peterson elastic modulus=PEM; Young’s elastic modulus=YEM), BMI, BP, CRP, fasting lipids, and HbA1c in 124 subjects age 10-22 years at baseline. Measures were repeated after 4 years of follow-up (mean age 22.1 + 3.3, 49% male, 33% Caucasian, 1/3 T2DM) to elucidate determinants of accelerated aging. Mean values between baseline and follow-up were evaluated by t-tests. General linear models were constructed to determine significant predictors of follow-up measures. The full model contained age, race (Caucasian/African-American), sex, presence of T2DM, baseline IMT or stiffness measure, baseline and difference in age, BMIz, SBPz , DBPz , CRP, LDL, HDL, TG and HbA1c. There was no significant increase in BMIz, SBPz, TG or HbA1c over 4 years of follow-up. DBP, LDL and CRP rose; HDL fell (p<0.04). There was no increase in common carotid IMT, a trend toward increase in bulb IMT and significant increase in internal IMT (0.024 mm, p<0.01). The rate of increase was greater in subjects with obesity and T2DM. All carotid stiffness measures increased (all p<0.002). Major determinants of follow-up internal carotid IMT were baseline IMT, sex, age, SBPz and CRP at baseline (R2=0.44). For stiffness, determinants were baseline stiffness, BMIz change and LDL at baseline with CRP added for Beta (R2 ranged 0.36-0.47). We conclude that IMT and carotid stiffness increase in adolescents and young adults and accelerated aging occurs with adverse levels of CV risk factors especially BMI, BP, LDL and CRP.
- © 2012 by American Heart Association, Inc.