Abstract P372: Inflammation is an Independent Predictor of Carotid Intima Media Thickness Progression in Early Young Adulthood
Inflammatory conditions, including obesity, insulin-resistance, and hypertension, are associated with increased carotid intima media thickness (cIMT). Whether inflammation is an independent factor in promoting progression of cIMT from adolescence to young adulthood is not known. We sought to determine if higher levels of inflammation over time played a role in explaining increase in cIMT in addition to the contribution of increasing age. We measured anthropometrics, BP, fasting lipids, glucose, insulin, HbA1c, high sensitivity C-reactive protein (CRP), and cIMT in 154 adolescents and young adults at baseline (mean age 17.4 +/-3.3 years, 39% male, 58% non-Caucasian, 30% T2DM) and after 4 years of follow-up. Carotid US images were acquired of the far wall of the distal common (CCA), bifurcation (Bulb), and proximal internal (ICA) carotid arteries using high resolution ultrasound. Mean values for baseline and follow-up were compared by paired t-tests. Significant changes were found from baseline to follow-up in age, BMI, BP, TG, HDL, LDL, CRP, insulin, and CCA cIMT. Stepwise regression models were constructed to determine whether CRP was an independent determinant of cIMT at follow-up. The initial model included baseline cIMT, age, sex, race, BMI z-score, mean CRP, CRP change, and BP z-scores, TG, LDL, and glucose at each visit. CRP change was an independent determinant of follow-up bulb cIMT. The final ANCOVA model was: Bulb change = -0.420 - 0.33 * log bulb baseline + 0.0053 * CRP change + 0.0060 * age baseline + 0.040 * male + 0.00062* LDL baseline + 0.00066 * LDL_change (all factors p<0.05, model R2 =0.41, p<0.0001). We conclude that CRP is an independent cardiovascular risk factor for cIMT progression in our population of young adults, independent of age. Chronic, systemic inflammation may lead to early development of atherosclerosis in the carotid bifurcation. Early intervention is needed to reduce inflammation and the incidence of early cardiovascular disease.
- © 2013 by American Heart Association, Inc.