INTIMA-MEDIA THICKNESS OF THE CAROTID ARTERIES IS AFFECTED BY PUBERTAL MATURATION IN HEALTHY ADOLESCENTS

ABSTRACT Objective: To contribute to the assessment of normal parameters of carotid intima-media thickness (CIMT) in healthy adolescents. Methods: A cross-sectional study was conducted through clinical, laboratory and ultrasound evaluation in 61 healthy adolescents. The inclusion criteria consisted of being in good health. The exclusion criteria were: presence or history of any chronic disease; being obese or overweight according to the World Health Organization (WHO) established criterion; continuous use of medication; or presenting a febrile condition or requiring medication within 48-hours prior to assessment. The pubertal stages were evaluated using the Tanner criteria. The high-resolution B-mode ultrasound examinations were performed according to the recommendations of the Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Results: Adolescents were 14±2.6 years old, 62.3% female, 19 (31%) at early puberty (Tanner II and III), and 38 (62%) at late puberty (Tanner IV and V). They presented normal clinical and laboratorial parameters. CIMT values were 0.46±0.04 to 0.55±0.04 mm on the right and 0.48±0.02 to 0.53±0.04 mm on the left, according to pubertal maturation. CIMT values increased significantly on the right and left sides, according to pubertal stage (p&lt;0.001 and p=0.016), and maximum internal diameters of the common carotid artery (p&lt;0.025 and p&lt;0.003). It was higher in males compared to females. Conclusions: An increase in CIMT in the healthy adolescents group, according to both age, and the degree of pubertal maturation should be considered when evaluating adolescents in diagnostic procedures.摘要 研究目的：本研究旨在为健康青少年颈动脉内膜中层厚度（carotid intima-media thickness, CIMT）正常参考值的评估提供数据支撑。 研究方法：本研究采用横断面研究设计，纳入61名健康青少年并开展临床、实验室及超声检查。纳入标准为身体健康；排除标准包括：存在任意慢性疾病或相关病史；符合世界卫生组织（World Health Organization, WHO）制定的肥胖或超重判定标准；长期服用药物；评估前48小时内存在发热症状或需服用药物。采用Tanner分期标准评估受试者的青春期发育阶段。高分辨率B型超声检查严格遵循美国超声心动图学会颈动脉内膜中层厚度工作组发布的共识声明中的操作规范进行。 研究结果：受试青少年年龄为14±2.6岁，女性占比62.3%；其中19例（31%）处于青春期早期（Tanner II、III期），38例（62%）处于青春期晚期（Tanner IV、V期）。所有受试者的临床及实验室指标均处于正常范围。按青春期发育阶段分组，受试者右侧CIMT为0.46±0.04 mm至0.55±0.04 mm，左侧为0.48±0.02 mm至0.53±0.04 mm。双侧颈动脉内膜中层厚度均随青春期分期升高而显著增加（右侧p<0.001，左侧p=0.016），颈总动脉最大内径亦呈现相同变化趋势（右侧p<0.025，左侧p<0.003）；且男性受试者的CIMT水平显著高于女性。 研究结论：在对青少年开展诊断性检查时，应考虑健康青少年的颈动脉内膜中层厚度会随年龄及青春期发育程度升高而增加这一特征。