Association Between Body Mass Index, Skinfolds Thickness, Blood Pressure, and Decreased Carotid Artery Wall Strain on Vascular Elastography in Children

Introduction: Childhood obesity is a risk factor for cardiovascular disease. Intima-media thickness (IMT) and non-invasive vascular elastography (NIVE) are techniques that can be used to assess subclinical carotid atherosclerosis in children. Intima-media thickness has been found to be linked to cardiovascular risk factors, but the specific factors that affect development of early atherosclerosis in children need further study. The purpose of this study was to evaluate which adiposity markers predict increased IMT or arterial stiffness in children. Methods: A prospective observational study was conducted between October 2020 and February 2023. Anthropometric, demographic, and socioeconomic data were acquired. Common carotid IMT and NIVE parameters were measured by ultrasound and compared. Multiple linear regressions were performed to measure relationships between variables. Results: Ninety-two children were recruited. Mean age was 13.2 ± 1.14 years old, 56.5% were girls. Thirty-nine percent had a body mass index (BMI) over the 85th percentile for their age and sex, therefore overweight or obese. The NIVE-based cumulated axial strain (CAS) had strong predictive value for adiposity in children and was significantly lower in the overweight/obese group (P < .001), suggesting higher arterial stiffness. The NIVE-based IMT divided by the carotid diameter was significantly lower in the overweight group (P = .014) and in boys (P = .024). Cumulated axial translation (CAT), cumulated lateral translation (CLT), and cumulated shear strain magnitude (C |ShS|) were also significantly predicted by adiposity measurements. No significant differences were found between weight groups for IMT measurements. Discussion: Non-invasive vascular elastography-based IMT/diameter measurement is decreased in overweight/obese children and strongly predicted (25.0%) by waist circumference. Overweight and obese children are more likely to have lower CAS measurements therefore reduced artery compliance which may be used as a surrogate marker for subclinical atherosclerosis. Conclusion: Non-invasive vascular elastography parameters might be better tools than IMT to stratify cardiovascular risk, specifically adiposity markers, in children.