The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 5
Carotid intima media thickness in adolescents with increased risk for atherosclerosis
2Division of Pediatric Endocrinology, 1Department of Pediatrics and 3Department of Radiology, Hacettepe University
Faculty of Medicine, Ankara, Turkey. E-mail: ozonalev@gmail.com
In this study, we aimed to analyze early-onset atherosclerotic changes in
adolescents with risk of cardiovascular disease in comparison to healthy
controls using carotid intima media thickness (CIMT), homocysteine and
markers of endothelial function as indicators. Children aged 10 years or
older, all pubertal, with type 1 diabetes mellitus (T1DM), obesity, or obesity
with glucose intolerance and age- and sex-matched healthy controls were
included in the study. Endothelial markers (von Willebrand factor [vWF],
tissue plasminogen activator [tPA], plasminogen activator inhibitor [PAI]-1),
CIMT, homocysteine, folic acid, and vitamin B12 levels were measured in all
subjects. Mean CIMT of the obese subjects were significantly higher than
that of lean diabetic children and healthy controls (p=0.024). There was an
independent relationship between CIMT and homocysteine level (b=0.76,
p<0.0001). Further, homocysteine was negatively correlated with vitamin B12
(r=-0.20, p<0.001) and folic acid (r=-0.44, p<0.001). Homocysteine is an
independent risk factor for early atherosclerosis in adolescents, which may
be controlled by supplementation with vitamin B12 and folic acid.
Keywords :
adolescents, atherosclerosis, carotid intima media thickness, endothelial
dysfunction, homocysteine.