Abstract 12089: Do Obese and Diabetic Adolescents Have Greater Increase in Carotid Thickness Over Time?
Increased carotid intima media thickness (IMT) is associated with CV events in adults. CV risk factors (CVRFs) are associated with higher IMT in adolescents in cross-sectional studies but longitudinal data defining normal rate of increase with age or whether progression is accelerated by CVRFs are lacking. We examined IMT in the common, bulb and internal carotid arteries, and collected CVRFs in 226 adolescents at baseline and 4.6 years later (initial age 16.9 yr, 37% Caucasian, 40% male, 40% Lean (L=91), 32% Obese (O=72), 28% T2DM (T=63), matched by age, race, sex). Changes from baseline to follow-up were evaluated by paired t-tests for all and by group. ANOVA were performed to determine differences in rate of change of IMT among groups. General linear models were constructed to determine significant predictors of follow-up IMT. The full model contained age, race, sex, group, baseline IMT, baseline and change in age, BMI z-score (z), SBPz , DBPz , HR, CRP, LDL, HDL, TG, glucose, insulin and HbA1c. At baseline and follow-up there was a graded increase in CV risk factors from L to O to T. At follow-up, L had the greatest increase in BMI, SBP, and LDL though they remained normal. All groups increased in DBP equally. T had the greatest increase in fasting glucose and HbA1c. Common IMT tended to increase in O and T. Bulb and Internal IMT increased significantly in T with a trend for O. The slope of increase in carotid IMT was steeper in O and T vs L (p≤0.04). Major determinant of follow-up IMT for all 3 sites were baseline age and IMT; with the addition of BMIz at baseline and DBPz change for common (R2=0.44); sex (worse in males), group (less progression in L), LDL at baseline and change in glucose for bulb (R2=0.37); and sex, SBPz at baseline, DBPz change and CRP at baseline for internal (R2=0.47). We conclude that progression of carotid IMT is accelerated in obese and diabetic adolescents and young adults. This accelerated aging is related to CVRFs, demonstrating a need for early intervention in high risk youth.
- © 2013 by American Heart Association, Inc.