Increased Carotid Intima-Media Thickness and Stiffness in Obese Children

O besity in childhood increases therisk of atherosclerotic disease anddeath in adulthood (1). A dramatic increase in overweight among children and adolescents during the past 2 decades has been documented (2). Moreover, overweight children and adolescents have an increased risk of adult obesity (3). A clustering of factors typical of the insulin resistance syndrome has been identified in 5- to 10-year-old overweight/obese Af-rican-American children (4) and in pre-adolescent obese children (5). The pediatric obesity epidemic accounts for most new diagnoses of type 2 diabetes, a disease once virtually confined to adult-hood, in adolescence (6). High-resolution B-mode ultrasound measurements of carotid intima-media thickness (IMT) and stiffness are markers of early, preclinical atherosclerosis. Pre-vious observations show significantly increased IMT in familial hypercholester-olemic children (7,8) and in children with type 1 diabetes (9) and hypertension (10). Recent evidence suggests an increased ar-terial stiffness in familial hypercholester-olemic children (11) and in children with severe obesity (12). However, in the study by Tounian et al. (12) there was no evidence of statisti-cally significant differences in carotid IMT between severely obese children and con-trol subjects; moreover, there was no sub-group analyses for boys versus girls. The present study aimed to verify whether obesity in childhood may cause prema-ture vascular alterations in both sexes.