Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.190003
Jornal Vascular Brasileiro
Original Article

Avaliação ultrassonográfica do complexo médio-intimal das carótidas comuns em crianças eutróficas e portadoras de sobrepeso/obesidade

Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children

Jorge Garcia; Augusto César Garcia Saab Benedeti; Simone Helena Caixe; Francisco Mauad Filho; Carlos Alberto Nogueira-de-Almeida

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Resumo

Resumo: Contexto: A obesidade é uma epidemia global, inclusive entre as crianças. Diante desse perfil, torna-se necessário identificar precocemente alterações cardiovasculares presentes em crianças com sobrepeso/obesidade. A ultrassonografia no modo B das carótidas comuns avalia, com precisão e em tempo real, as alterações precoces na medição da espessura do complexo médio-intimal (CMI), podendo detectar o início do processo de aterosclerose.

Objetivos: O presente estudo comparou a espessura do CMI entre crianças escolares com e sem sobrepeso/obesidade.

Métodos: Foram incluídas 59 crianças de ambos os sexos, entre 7 e 10 anos de idade, oriundas de centros de saúde de São Paulo. As crianças foram caracterizadas de acordo com o escore z do índice de massa corporal (IMC) em dois grupos, com e sem sobrepeso/obesidade. Os grupos foram comparados em relação à espessura do CMI.

Resultados: Os grupos foram homogêneos em idade e sexo. A medida média do CMI no grupo com sobrepeso/obesidade foi de 0,49 (± 0,07) mm; no grupo não sobrepeso/obeso, foi de 0,41 (± 0,05) mm (p < 0,01). Essas diferenças se mantiveram quando os grupos com e sem sobrepeso/obesidade foram comparados separadamente por sexo e pelos lados direito e esquerdo. O coeficiente de correlação entre a medida do CMI e o escore z do IMC foi de 0,61 (intervalo de confiança de 95% = 0,42-0,75). Dentro do mesmo estado nutricional, não houve diferença entre os gêneros, nem entre os lados direito e esquerdo.

Conclusões: A espessura do CMI de crianças com sobrepeso/obesidade foi maior e diretamente proporcional ao escore z do IMC, denotando maior risco cardiovascular nesse grupo.

Palavras-chave

ultrassonografia, carótida comum, obesidade, complexo médio-intimal

Abstract

Abstract: Background: Obesity is a global epidemic, including among children. It is therefore necessary to identify cardiovascular changes in overweight/obese children as early as possible. Mode B ultrasonography of the common carotids can be used to precisely evaluate in real time early changes in the thickness of the intima-media complex (IMC), which can detect onset of the atherosclerosis process.

Objectives: This study compared IMC thickness between schoolchildren with and without overweight/obesity.

Methods: A sample of 59 children of both sexes, aged 7 to 10 years, were recruited from health centers in São Paulo, Brazil. Children were classified by z scores for body mass index (BMI) into two groups, with or without overweight/obesity. These groups were then compared in terms of IMC thickness.

Results: The groups were homogenous for age and sex. The mean IMC measurement in the group with overweight/obesity was 0.49 mm (± 0.07), whereas in the group free from overweight/obesity it was 0.41 (± 0.05) mm (p < 0.01). These differences were maintained when groups with and without overweight/obesity were compared separately by sex and for right and left sides. The coefficient for the correlation between IMC measurement and BMI z score was 0.61 (95% confidence interval = 0.42-0.75). Within the same nutritional status group, there were no differences between sexes or between right and left sides.

Conclusions: Intima-media thickness was greater among children with overweight/obesity and was directly proportional to BMI z score, denoting increased cardiovascular risk in this group.
 

Keywords

ultrasonography, common carotid, obesity, intima-media complex

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