Increased intima-media thickness is not associated with stiffer arteries in children

•This study presents morphological and functional data for the same carotid segment.•We provide reference values for cIMT and distensibility parameters in boys and girls aged 7-17 years.•Increased intima-media thickness was accompanied by higher arterial compliance and lower stiffness.•Increased cIMT does not necessarily indicate subclinical atherosclerosis but may be a functional adaptation of the vessel.

ObjectiveSubclinical atherosclerosis can be assessed via sonographic measurement of intima-media thickness and carotid artery distensibility, both may already be pathologically altered in childhood. Therefore, the purpose of this study was to provide reference percentiles and investigate possible associations between alterations of intima-media thickness and distensibility.MethodsCarotid intima-media thickness and distensibility was measured via B- and M-mode ultrasound. Distensibility was defined by arterial compliance, elastic modulus, stiffness parameter β, and local pulse wave velocity β. Age- and height-dependent reference values were calculated separately for boys and girls among 690 (intima-media thickness) and 870 (distensibility) non-obese children aged 7-17 years.ResultsIntima-media thickness and distensibility did not increase significantly with age or differ between boys and girls. Systolic blood pressure and body mass index were independent predictors of intima-media thickness, while an increased systolic blood pressure or pulse pressure was associated with stiffer arteries. Increased intima-media thickness was accompanied by higher arterial compliance and lower stiffness.ConclusionUsing this healthy cohort, we describe a functional and non-pathological arterial adaptation wherein an increase in intima-media thickness is not associated with stiffer arteries.