Expression of subclinical atherosclerosis for different cardiovascular risk factors in young populations

Introduction: Carotid intima-media thickness (cIMT) is considered an early marker for atherosclerosis, hut there are few studies on the expression of this marker in younger populations. Objectives: To evaluate cIMT in younger patients (aged 30-50 years) and its expression according to cardiovascular risk factors. Methods: We analyzed individuals admitted for an invasive cardiac procedure. Normal cIMT was defined as <0.90 mm, thickened as 0.90-1.50 mm and atherosclerotic plaque as >1.50 mm. Lipid profile, anthropometric parameters, fasting blood glucose and estimated GFR were also determined. Results: A total of 106 patients were included (59% male), with a mean age of 43 5 years, 36% with hypertension, 22% smokers, 32% with known hyperlipidemia, 16% with diabetes, 39% under statin therapy and 40% with metabolic syndrome (AHA/NHLBI definition). Mean cIMT was 0.69 +/- 0.26 mm, and was normal in 74% of the patients, thickened in 20% and with atherosclerotic plaques in 6%. cIMT correlated directly with age (r=0.26, p=0.007), log fasting glucose (r=0.21, p=0.04), and log triglycerides (r=0.24, p=0.017), and tended to correlate with the number of components of metabolic syndrome (r=0.17, p=0.08). However, on multivariate analysis, only age remained as an independent predictor (r=0.29, p=0.005). Diabetic patients had greater cIMT (0.81 +/- 0.22 vs. 0.67 +/- 0.26 mm, p=0.039) and there was a trend for greater cIMT in those with metabolic syndrome (0.75 +/- 0.29 vs. 0.66 +/- 0.23 mm, p=0.09). There were no differences for the other risk factors. A higher number of risk factors in a single patient showed a trend for increased cIMT (p=0.083) Conclusions: Age is the only independent determinant of cIMT in a young population. Diabetic patients have greater cIMT and a trend was seen in those with metabolic syndrome, possibly influenced by its relation with diabetes, one of the components of the metabolic syndrome.