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.