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

Objective Structural 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. Methods Carotid 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. Results Carotid 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). Conclusions Carotid 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.