Nutrición Hospitalaria (Feb 2012)
Grosor de la íntima-media de la arteria carótida en adolescentes obesos y su relación con el síndrome metabólico Intima-media thickness in obese adolescents and their relation with metabolic syndrome
Abstract
Introducción: Los adolescentes obesos presentan mayor riesgo cardiovascular (RCV). La medición del grosor de la intima-media (GIM) arterial detecta tempranamente el compromiso vascular. Objetivo: Evaluar si los adolescentes obesos tienen mayor compromiso vascular medido por GIM que los adolescentes no obesos, y si este es mayor en aquellos con síndrome metabólico (SM). Metodología: Grupo estudio (GE), niños obesos, IMC/edad > p95, con y sin SM y grupo control, IMC/edad p10-85, sin patología nutricional ni endocrina. Se midieron concentraciones séricas de lípidos, prueba tolerancia oral a glucosa con insulinemia y ecografía de arteria carótida. Para evaluar diferencia entre grupos se utilizaron pruebas estadísticas paramétricas y no paramétricas. Resultados: Se evaluaron 45 adolescentes obesos (20 mujeres), 19 con SM, edad 13 (9-16) años y 18 controles (14 mujeres), edad 13 (11-16) años. GIM del bulbo carotideo y de la arteria carótida interna (ACI) fueron significativamente mayores en GE que grupo control (0,54 vs 0,34; 0,34 vs 0,25, p Introduction: Obese adolescents have higher cardiovascular risk (CVR). Intima-media thickness (IMT) detects early arterial vascular compromise. Objective: To evaluate whether obese adolescents have higher vascular compromise measured by IMT than nonobese adolescents, and if this is greater in those with metabolic syndrome (MS). Method: The study group (SG), obese children (BMI/age > p95), with and without MS and control group (CG), non-obese (BMI/age p10-85) and non nutritional or endocrine disease. We measured serum lipids, oral glucose tolerance test with insulin and carotid artery ultrasound. To evaluate the differences between test groups we used parametric and nonparametric statistics. Results: We evaluated 45 obese adolescents (20 women), 19 with MS, age 13 (9-16) years and 18 controls (14 women), aged 13 (11-16) years. IMT of carotid bulb and internal carotid artery (ICA) were significantly higher in SG than CG (0.54 vs. 0.34, 0.34 vs. 0.25, p < 0.05). There was no difference between obese groups. IMT of ICA and bulb correlated positively with BMIz (r = 0.3 and 0.6, p < 0.05) and with waist circumference (CC) (r = 0.3 and 0.55, p < 0, 05). IMT of ICA was positively correlated with fasting insulin, HOMA and systolic blood pressure. In multivariate analysis only BMI and CC were associated independently to IMT. Conclusion: Obesity is an early risk factor for cardiovascular damage measured by IMT and IMT of ICA demonstrated a higher correlation with cardiovascular risk factors.
