Relationship between blood lipid profile and carotid intima media thickness in adolescent obesity

Introduction: The World Health Organization (WHO) defines the 10-19 age as an adolescent period. Adolescence period involves physical growth, sexual development, cognitive and psychosocial maturation in the transition from childhood to adulthood. In the adolescence period, the need for calories increases with rapid growth and development. In addition, obesity is an important problem due to inadequate physical activity, inadequate eating habits, social, environmental and psychological factors. Obesity is a disease that causes a variety of health problems in children and adolescents around the world, which is increasingly common in adults. Obesity in childhood and adolescence increases the risk of atherosclerotic disease and death which is also a risk factor in the adult period. The measurements of carotid intima-media thickness (CIMT) are markers of early, preclinical atherosclerosis. Recent evidence suggests an increased CIMT in familial hypercholesterolemic children and in children with severe obesity. This study aims to investigate the relationship between blood lipid profile and CIMC in adolescents with obesity and to discuss the predictive value of preclinical atherosclerosis. Material and Methods: The study involves 108 obese patients applied to children's health and diseases outpatient, adolescent, pediatric endocrinology and pediatric cardiology clinics of our hospital, who were between the ages of 10-20 years and whose body mass index (BMI) is above 95 percentile according to age and gender. 101 healthy subjects with no chronic disease, no drug use, and whose BMI is under 85 percentile are also included in the study as the control group. Results: A total of 209 adolescents were evaluated in the study, 108 patients (66 females, 61.1 % and 42 male, 38.9 %) and 101 controls (57 femals, 56.5 %) and 44 males, 43.5 %). No statistically significant difference was found between the patients and the control group in terms of gender (p> 0.05). The mean age of patients was 12.36±2.13 years, while that of the control was 12.9±2.2 years with no significant difference (p> 0.1). The mean body weight of the obese group was 69.6±17.4 kg, while that of the control was 41.89±19.3 kg with a statistically significant difference (p <0.001). The mean height of the obese group was 153.9±11.6 cm and the mean height of the control group was 143.8±20.4 cm with a statistically significant difference (p <0.001). The mean and standard deviation of VKI values of the patients were 28.9±4.2 kg / m2, whereas this value was 18.2±2 kg / m2 in the control group with a statistically significant difference (p <0.001). ). The mean and standard deviation of % VKI % of the patients was 98.48±1.4 kg / m2, whereas that of the control group was 35.19 ±29.1 kg / m2 with a statistically significant difference (p <0.001). When the two groups were compared in terms of lipid profile; triglyceride was 120.8 (38-324) mg/dl in the patients and 88,64 (37-270) mg/dl in the controls. Thes difference was statistically significant (p <0.001). Similarly a significant difference was found between two group when HDL values are compared; 51.2 (28-85) mg/dl in the patients and 56 (26-92) mg/dl in the control (p<0.027). The difference was also statistically significant (p <0.001) when comparing LDL values in two groups; 92.0 (24,8-156,1) mg/dl in the patients vs 79,8 (17-137) mg/dl in the control. Total cholesterol was 164.3 (77-256) mg/dl in the patients and 154,1 (100-237) mg/dl in the control with a statistically significant difference (p = 0.013). The mean and standard deviation of CIMT in the patients were 0.0476±0.00985 cm, while this was 0.0141±0.079 cm in the controls with a statistically significant difference (p <0.001). However, this difference was not significant when compring the patients in terms of their sex, 0.0453±0.00904 cm in males vs 0.0438±0.00982 cm in females (p = 0.254). When both groups were evaluated in terms of their systolic and diastolic arterial blood pressures; the systolic arterial blood pressure in the obese group was 118.06 mm/Hg (100-170) and 113.4 mm/Hg (90-130) in the control with a statistically significant difference (p = 0.003). Nevertheless, the diastolic arterial lood pressure was not significantly different when comparing two groups; 75.94 mm/Hg (60-100) in the patients vs 75.26 mm/Hg (60-100) in controls (p= 0.574). It was found that CIMT in the patients was significantly correlated with BMI but it was not signifiicanly correlated with the age, triglyceride (mg/dl), HDL (mg/dl), LDL (mg/dl), total cholesterol, TA/S (mm/Hg) and TA/D (mm/Hg). Conclusion: Although there is no relationship between lipid profile and CIMT in obese adolescents, it is important to measure CIMT in order to determine an earlier dedection of preclinical atarosclerosis and to take necessary prevention, even if lipid profile is normal in patients with high BMI in terms of preclinical atarosclerosis and defined as obese due to clinical atherosclerosis. Key Words: Adolescent, Obesity, CIMT, hiperlipidemi, Atherosclerosis, Risk Factors