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. 2016 May 12;5(5):e002941.
doi: 10.1161/JAHA.115.002941.

Relation Between Adolescent Cardiovascular Risk Factors and Carotid Intima-Media Echogenicity in Healthy Young Adults: The Atherosclerosis Risk in Young Adults (ARYA) Study

Anouk L M Eikendal  1 , Karlijn A Groenewegen  2 , Michiel L Bots  2 , Sanne A E Peters  3 , Cuno S P M Uiterwaal  2 , Hester M den Ruijter  4
Affiliations

Relation Between Adolescent Cardiovascular Risk Factors and Carotid Intima-Media Echogenicity in Healthy Young Adults: The Atherosclerosis Risk in Young Adults (ARYA) Study

Anouk L M Eikendal et al. J Am Heart Assoc. .

Abstract

Background: Echogenicity is an ultrasound measure that reflects arterial wall composition. In adult populations, lower carotid intima-media echogenicity relates to an unfavorable cardiovascular risk burden yet appears to reflect a different aspect of arterial wall remodeling than carotid intima-media thickness (CIMT). Since studies on carotid intima-media echogenicity earlier in life are lacking, we investigated associations between adolescent cardiovascular risk factors and young adulthood carotid intima-media echogenicity and compared this to CIMT.

Methods and results: In 736 participants of the Atherosclerosis Risk in Young Adults study, information on adolescent anthropometrics, puberty stage, and systolic blood pressure (SBP) was available. In young adulthood, demographics, anthropometrics, and fasting plasma samples were collected. Common CIMT and echogenicity, quantified as gray-scale median (GSM), were evaluated using B-mode ultrasonography. Lower and higher GSM values, respectively, represented lower and higher echogenicity. Associations of adolescent body mass index and SBP with young adulthood GSM and CIMT were evaluated using linear regression analysis. Mean age was 13.5 years in adolescence and 28.4 years in young adulthood (difference: 14.9 years). After full adjustment, adolescent body mass index related to GSM (β=-1.62/SD; 95% CI: -2.79, -0.46; P=0.006), independent of CIMT. Adolescent SBP did not relate to GSM. Moreover, adolescent body mass index (β=8.06 μm/SD [95% CI: 4.12, 11.99], P<0.001) and SBP (β=4.69 μm/SD [95% CI: 0.84, 8.54], P=0.02) related to CIMT.

Conclusions: Adolescent body mass index related to GSM and CIMT in young adulthood; SBP only related to CIMT. Hence, carotid intima-media echogenicity appears to be involved in arterial wall remodeling, yet may mimic a different facet of this process than CIMT.

Keywords: adolescence; cardiovascular disease risk factors; risk factor; vascular biology; vascular remodeling; young adult.

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Figures

Figure 1
Figure 1
Example of higher and lower carotid intima‐media echogenicity. Example of ultrasound images obtained in the ARYA study illustrating the differences in carotid intima‐media echogenicity using identical gain‐settings (60 dB). The left image shows a higher carotid intima‐media echogenicity that, accordingly, has a higher GSM value and appears light on the ultrasound image. Contrarily, the right image displays a lower carotid intima‐media echogenicity (more echolucent carotid intima‐media) that, accordingly, has a low GSM value and appears dark on the ultrasound image. The blue lines represent the regions of interest of both images. ARYA indicates Atherosclerosis Risk in Young Adults Study; GSM, gray‐scale median.
See this image and copyright information in PMC

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