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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:649.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Increased Aortic Intima-Media Thickness in 11-Year-Old Healthy Children With Persistent Chlamydia pneumoniae Seropositivity

Iina Volanen; Mikko J. Järvisalo; Raija Vainionpää; Martti Arffman; Katariina Kallio; Susanna Anglé; Tapani Rönnemaa; Jorma Viikari; Jukka Marniemi; Olli T. Raitakari; Olli Simell

From the Research Centre of Applied and Preventive Cardiovascular Medicine (I.V., M.J.J., M.A., K.K., S.A.), the Departments of Pediatrics (I.V., K.K., O.S.), Clinical Physiology (M.J.J., O.T.R.), Virology (R.V.), and Medicine (T.R., J.V.), University of Turku; the Department of Health and Functional Capacity (J.M.), National Public Health Institute, Turku; and the Department of Internal Medicine (M.J.J.), Satakunta Central Hospital, Pori, Finland.

Correspondence to Iina Volanen, MD, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland. E-mail iina.volanen{at}utu.fi

Objective— The relationship between Chlamydia pneumoniae (Cpn) infection and arterial measures of preclinical atherosclerosis has remained controversial. Because atherogenesis begins in early life, we examined whether carotid and aortic intima-media thickness (IMT) and brachial artery endothelial function are associated with Cpn seropositivity in children.

Methods and Results— Cpn-specific IgG and IgA antibodies were assessed by enzyme immunoassay in 199 healthy children followed-up annually from 7 to 11 years of age. Carotid (cIMT) and aortic IMT (aIMT), and brachial artery flow-mediated dilatation (FMD) were measured in 137 of the 199 children at the age of 11 years using high-resolution ultrasound. Children with persistent IgG and/or IgA seropositivity to Cpn had significantly increased aIMT compared with seronegative children (IgG45 and IgA12 enzyme immunounits) or children with transient Cpn seropositivity (seronegative, 0.496 [0.054]; transient, 0.494 [0.061]; and persistent, 0.532 [0.086] mm; P<0.05 for trend). This trend was not explained by traditional atherosclerotic risk factors or pubertal stage. cIMT and FMD were not associated with Cpn seropositivity.

Conclusions— Eleven-year-old children with persistent Cpn seropositivity show increased aIMT but not cIMT, suggesting that Cpn may affect the aortic wall, the site where the earliest atherosclerotic lesions are known to occur, in otherwise healthy children.

We assessed whether the arterial intima-media thickness (IMT) and endothelial function, 2 measures of preclinical atherosclerosis, are related to Chlamydia pneumoniae (Cpn) seropositivity in healthy children. Eleven-year-old children with persistent Cpn seropositivity showed increased aortic IMT, suggesting that Cpn might contribute to the development of early atherosclerosis.

Key Words: antibodies • atherosclerosis • infection • pediatrics • ultrasound

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