Carotid extra-medial thickness in childhood: Early life effects on the arterial adventitia

ObjectiveStructural modification of the arterial adventitia may be an early event in atherosclerosis. Carotid extra-medial thickness is a new measure of arterial adventitial thickness. We examined the association of cardiovascular risk factors with extra-medial thickness, in childhood.MethodsCarotid extra-medial thickness was assessed by high-resolution ultrasound in 389 non-diabetic children aged 8-years. A non-fasting blood sample was collected from 314 participants. Associations of gender, age, lipoproteins, blood pressure, BMI z-score, waist:height ratio and parental history of early vascular disease, with extra-medial thickness were examined.ResultsCarotid extra-medial thickness was lower in girls (r = −.163, P = .001) and directly associated with systolic (r = .128, P = .009), diastolic blood pressure (r = .130, P = .009), and height (r = .170, P = .0006). These associations remained after adjustment for carotid intima-media thickness. In multivariable analysis including carotid intima-media thickness, only gender and height were significantly associated with carotid extra-medial thickness. In gender-stratified analysis, the strongest associations with extra-medial thickness were BMI z-score (r = .181, P = .01), height (r = .210, P = .003) and diastolic blood pressure (r = .167, P = .02) for boys; and systolic blood pressure (r = .153, P = .03) and parental history of premature cardiovascular disease (r = .139, P = .05) for girls. The association of BMI z-score with extra-medial thickness differed by gender (P-interaction = .04).ConclusionsCarotid extra-medial thickness is independently associated with gender and height in childhood. Extra-medial thickness may provide important information concerning early arterial health, particularly related to the arterial adventitia.

► Extra-medial thickness is a noninvasive measure of arterial adventitial thickness. ► We measured carotid extra-medial thickness in 389 non-diabetic 8-year old children. ► Extra-medial thickness is associated with cardiovascular risk factors in childhood. ► The arterial adventitia may be involved in early atherosclerosis.