Adiposity, Blood Pressure, and Carotid Intima-Media Thickness in Greek Adolescents

Objective: In children and adolescents with cardiovascular risk factors, the assessment of subclinical target-organ damage is of paramount importance. This study investigated factors associated with carotid intima-media thickness (cIMT) in adolescents. Design and Methods: A cross-sectional study was performed in 448 apparently healthy adolescents recruited from schools (mean age 14 +/- 2.2 years, 211 boys), which involved cIMT measurements (common carotid artery) and assessment of lipid profile, glucose, and blood pressure (BP). Results: The prevalence of overweight/obesity was 28.1%/12.7% and of BP >= 95th percentile 19.6%. Left cIMT was correlated with age (r = 0.10), waist circumference (WC) (0.15), and BP (0.21/0.13, systolic/diastolic) (all P < 0.05). Right cIMT was correlated with waist to hip ratio (WHR) (0.10), whereas the mean of left and right cIMT was correlated with WC (0.12), WHR (0.12), and systolic BP (0.14) (all P < 0.05). After the age of 13 years, boys tended to have higher cIMT than girls, which was significant in the 13-15 years subgroup (P < 0.05). In stepwise multivariate analysis (independent variables: age, gender, WC, WHR, body mass index z-score, lipid parameters, glucose, BP), left cIMT was independently associated with systolic BP; right cIMT with WHR; mean left and right cIMT with WC. Adolescents with BP >= 90th percentile had higher left cIMT than those < 90th percentile (0.63 +/- 0.09 vs. 0.61 +/- 0.09 mm respectively, P < 0.05). Conclusion: Central adiposity and systolic BP appear to be independently associated with increased cIMT values in apparently healthy adolescents. Left side cIMT appears to be superior to right side measurements in terms of association with cardiovascular risk factors.