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CLINICAL RESEARCH: CARDIOVASCULAR RISK

Risk Factors Associated With Aortic and Carotid Intima-Media Thickness in Adolescents and Young Adults

The Muscatine Offspring Study

Jeffrey D. Dawson, ScD^_*,_*, Milan Sonka, PhD, Mary Beth Blecha, RVT, Wenjiao Lin, MS^_*, and Patricia H. Davis, MD

^_* Department of Biostatistics, University of Iowa, Iowa City, Iowa
Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa
Department of Neurology, University of Iowa, Iowa City, Iowa
Center for Health Policy Research, University of California–Los Angeles, Los Angeles, California

Manuscript received December 17, 2008; revised manuscript received February 9, 2009, accepted March 3, 2009.

^_* Reprint requests and correspondence: Dr. Jeffrey D. Dawson, Department of Biostatistics, University of Iowa, 200 Hawkins Drive, C-22 GH, Iowa City, Iowa 52242 (Email: jeffrey-dawson{at}uiowa.edu).

Objectives: This study sought to determine whether cardiovascular risk factors are associated with aortic intima-media thickness (aIMT) and carotid intima-media thickness (cIMT) in adolescents and young adults.

Background: Atherosclerotic lesions begin developing in youth, first in the distal abdominal aorta and later in the carotid arteries. Knowledge of how risk factors relate to aIMT and cIMT may help in the design of early interventions to prevent cardiovascular disease.

Methods: Participants were 635 members of the Muscatine Offspring cohort. The mean aIMT and cIMT were measured using an automated reading program.

Results: The mean (SD) values of aIMT and cIMT were 0.63 (0.14) and 0.49 (0.04) mm, respectively. In adolescents (age 11 to 17 years), aIMT was associated with triglycerides, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist/hip ratio, after adjusting for age, sex, and height. In young adults (age 18 to 34 years), aIMT was associated with those same 5 risk factors, plus high-density lipoprotein cholesterol and pulse pressure. In adolescents, cIMT was associated with SBP, pulse pressure, heart rate, BMI, and waist/hip ratio. In young adults, cIMT was associated with total cholesterol, low-density lipoprotein cholesterol, triglycerides, SBP, DBP, BMI, waist/hip ratio, and glycosylated hemoglobin. In both age groups, aIMT and cIMT were significantly correlated with the Pathobiological Determinants of Atherosclerosis in Youth coronary artery risk score.

Conclusions: Both aIMT and cIMT are associated with cardiovascular risk factors. Using aIMT in adolescents gives information beyond that obtained from cIMT alone. Measurement of aIMT and cIMT may help identify those at risk for premature cardiovascular disease.

Key Words: atherosclerosis • ultrasound • pre-clinical disease • abdominal aorta • IMT

Abbreviations and Acronyms   aIMT = aortic intima-media thickness   BMI = body mass index   cIMT = carotid intima-media thickness   DBP = diastolic blood pressure   HbA1C = glycosylated hemoglobin   HDL-C = high-density lipoprotein cholesterol   IMT = intima-media thickness   LDL-C = low-density lipoprotein cholesterol   MI = myocardial infarction   SBP = systolic blood pressure

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