Carotid artery intima-media thickness in children with primary dyslipidemia

Introduction. In subjects with primary dyslipidemia, arterial
functional and morphological changes are detectable even in
the first decade of age, thus suggesting that subclinical forms of
the atherosclerotic process begin since the childhood. Carotid
artery intimal-media thickness (cIMT), as measured by B-mode
ultrasound, is a widely accepted surrogate marker of carotid and
even coronary atherosclerosis, which can be assessed without
problems even in children. This pilot study sought to compare the
cIMT values of three small groups of dyslipidemic children: the
first affected by Familial Hypercholesterolemia (FH; n=13), the
second by Familial Combined Hyperlipidemia (FCH; n=14) and
the third by Undefined Autosomal Dominant Hypercholesterolemia
(ADH; n=20), so defined for the lack of any clear characteristic
for FH or FCH.
Methods. cIMT was measured in the near and far wall of left and right common carotids (CC), bifurcations (Bif) and first proximal
centimeter of internal carotid arteries (ICA). Three scan angles
(anterior, lateral and posterior) were considered. The ultrasonic
variables selected for the statistical analyses were the mean (IMTmean)
and the maximum (IMTmax) value of cIMT detected in the
whole carotid tree. Statistical analysis were performed by SPSS
21.0 software.
Results. In the whole group (n=47; age 10.7±3.3 ys) the mean±SD
values of IMTmean and IMTmax were 0.65±0.06 mm and 0.79±
0.07 mm, respectively. IMTmean was significantly higher in FH
children than in FCH children (0.67±0.064 mm Vs. 0.63±0.033
mm; respectively. P=0.003). The IMTmax of children with FH
(0.82±0.079 mm) was significantly greater than that observed
in both FCH (0.78±0.062 mm; P=0.006) and Undefined ADH
(0.78±0.072 mm; P=0.017). No differences were observed in terms
of either IMTmean or IMTmax when FCH were compared with
Undefined ADH (both P>0.05).
Conclusions. These results confirm observations previously
reported showing that Familial Hypercholesterolemia (FH) predisposes
patients to premature atherosclerosis, with the process
which starts in early childhood.