on April 9, 2009
Published online before print April 9, 2009, doi: 10.1161/ATVBAHA.109.184184
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Submitted on January 9, 2009
Accepted on March 25, 2009
HDL-Cholesterol, Blood Pressure, and Asymmetric Dimethylarginine Are Significantly Associated With Arterial Wall Thickness in Children
Julian G. Ayer ;
From the Department of Cardiology (J.G.A., J.A.H., M.K.C.N., D.S.C.), Royal Prince Alfred Hospital, Sydney, Australia; the Heart Research Institute (J.G.A., S.N., M.K.C.N., D.S.C.), Sydney, Australia; the Woolcock Institute of Medical Research (W.X., G.B.M.), Sydney, Australia; the Department of Clinical Physiology (O.T.R.), University of Turku, Finland; and the Department of Medicine and Bosch Institute (J.G.A., M.K.C.N., D.S.C.), the University of Sydney, Australia.
* To whom correspondence should be addressed. E-mail: david.celermajer{at}email.cs.nsw.gov.au.
Objective—Atherosclerosis is found at autopsy in the arteries of adolescents and young adults. Arterial wall thickening may be assessed in vivo by ultrasound measurement of the carotid intima media thickness (CIMT), a marker of subclinical atherosclerosis. As the determinants of arterial wall thickness in childhood are unknown, we assessed the influence of cardiovascular risk factors on CIMT in 8-year-old children.
Methods and Results—A community-based sample of 405 children (age 8.0±0.1 years, 49% girls) had anthropometry, family history, blood pressure (BP), and CIMT measured. A blood sample was collected for HDL and non-HDL cholesterol, apolipoproteins A1 and B, high-sensitivity C-reactive protein, bilirubin, and asymmetrical dimethylarginine (ADMA, an endogenous nitric oxide inhibitor). CIMT was significantly associated with systolic BP (r=0.17, P<0.001), diastolic BP (r=0.10, P=0.04), HDL (r=-0.13, P=0.02), and ADMA (r=0.18, P=0.001). CIMT was significantly higher in children with premature parental CHD (0.63±0.07 versus 0.59±0.06 mm, P=0.03). On multivariate analysis, HDL (
coefficient=-0.02, P=0.04), ADMA ( coefficient=0.05, P<0.001), and systolic BP ( coefficient=0.001, P=0.003) were significantly and independently associated with CIMT.
Conclusions—Lower HDL-cholesterol, higher levels of ADMA, and systolic BP are significantly associated with greater arterial wall thickness in early childhood.
Key words: HDL-cholesterol • asymmetrical dimethylarginine • pediatric • intima-media thickness • blood pressure