Carotid Artery Thickening, Stiffness Found in Obese Children as Young as 7

BUFFALO, N.Y. -- Obese children as young as 7 show signs of thickening and stiffness of the carotid arteries, a signal that they are headed for premature heart disease, a study conducted in Southern Italy has shown.

"You can see vascular changes already this early in really obese children," said Maurizio Trevisan, M.D., interim dean of the School of Public Health and Health Professions at the University at Buffalo and senior author on the study.

"We know that obesity in childhood increases the risk of atherosclerosis and death in adulthood," he added. "It is important for parents of obese children to help their children control their weight and get early treatment for these obesity-associated risk factors."

Results of the study appear in the October issue of Diabetes Care. Archangelo Iannuzzi, M.D., of Cava de' Tirreni Hospital in Salerno, Italy, is first author.

The research was conducted in the outpatient clinic of the Department of Pediatrics at A. Cardarelli Hospital in Naples, Italy. Study participants were 100 children selected consecutively from patients who came to the clinic to be evaluated for overweight or obesity, and 47 children of normal weight.

The children were between the ages of 6 and 14. None had been previously diagnosed with diabetes, insulin resistance, high cholesterol or high blood pressure, and none of their parents had a history of cardiovascular disease. Obesity was defined as having a body mass index (BMI) greater than 95 percent of children of the same age, based on values established by the U.S. Centers for Disease Control and Prevention. The BMI is a number representing the relationship of weight to height.

Researchers collected fasting blood samples from all the children to assess levels of cholesterol and other blood lipids, glucose, insulin and markers of inflammation and glucose control. The also took ultrasound scans of the carotid arteries. Carotid stiffness, which contributes to high blood pressure, was calculated according to a standard formula.

The obese children also underwent an oral glucose-tolerance test, which shows how well the body responds to a glucose challenge. Researchers also calculated an index of insulin resistance.

Results showed that obese children had significantly higher insulin resistance than children of normal weight. They also had significantly higher blood pressure, cholesterol and other blood lipids, glucose, insulin, and C-reactive protein (a marker of arterial inflammation, which contributes to arterial damage).

Obese children also had more carotid arterial thickness and stiffness than the normal weight children. "In adults, arterial thickening has been shown to be a precursor of arterial narrowing and to predict clinical coronary artery disease," said Trevisan.

The study recommends that obesity should be regarded as a disease with vascular implications, even at this young age. "The increased thickness and stiffness of the carotid artery in obese children, compared with healthy children, suggests that obesity represents a powerful determinant of early manifestations of atherosclerosis," the authors state.

Additional researchers on the study were Maria Rosario Licenziati, M.D.; Ciro Acampora, M.D.; Maria Luigia Romano, M.D., and Lucia Auriemma from A. Carderelli Hospital, Naples, Italy; Vittorio Salvatore, M.D., from Cava de' Tirreni Hospital in Salerno, and Salvatore Panico, M.D., and Paolo Rubba, M.D., from the School of Medicine, Frederico II University, Naples, Italy.