Impaired glucose tolerance strongly linked to intima-media thickness in children and adolescents
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Carotid intima-media thickness (IMT), a measure of early cardiovascular changes, predicts later atherosclerotic disease, and is as a convenient surrogate of cardiovascular risk in young populations, in which direct longitudinal observation is unpractical and unrealistic. The study aimed to investigate whether different definitions of the metabolic syndrome for children and adolescents were linked to IMT. A total of 264 Caucasian overweight children and adolescents aged 7-16 years participated in the study. Weight status, waist circumference, fasting glucose levels, glucose levels at 2 h after glucose tolerance testing and blood pressure had an impact on IMT, but lipids, fasting insulin and insulin resistance index had no influence. Linear regression analysis revealed a significant association between IMT and the definitions of the metabolic syndrome by Viner (P=0.019) and Weiss (P<0.001), but not between IMT and the other definitions. For IMT equal or above the upper quartile (≥0.7 mm), impaired glucose tolerance had a positive predictive value of 96%, the positive predictive value of the proposed definitions of metabolic syndrome for IMT ≥0.7 mm being <50%. Based on these findings, the authors conclude that impaired glucose tolerance demonstrated the strongest association to high IMT, far superior to any proposed metabolic syndrome definition, and suggest that overweight children should be screened for impaired glucose tolerance, as this condition demonstrates the strongest association to IMT.
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