Carotid intima media thickness in obese children: is there an association with hyperlipidemia?

BACKGROUND: We aimed to evaluate the association between hyperlipidemia and carotid intima media thickness in obese children, compared to non-obese ones. METHODS: Two hundred (110 girls, 90 boys) children aged between 6 and 15 years participated in this study. The obese group included 53 girls, 47 boys whose body mass indices (BMI) above 95th percentile, the control group included 57 girls, 43 boys who had normal weight. Fasting total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) levels were measured. Carotid intima media thickness (cIMT) was performed with neck ultrasound. RESULTS: The median thickness of right, left and mean carotis intima media were statistically higher in the study group, compared to the control group. The mean cholesterol, triglyceride, HDL-C, LDL-C levels of the study group were statistically higher, compared to the control group. There was no relationship between BMI and left carotis intima media thickness, but there was statistically significant relationship between BMI and right, mean cIMTs in the study group. There was no correlation between serum lipid levels and cIMTs in the study group. The mean atherogenic index of the study group was statistically higher, compared to the control group. There was no statistical correlation between atherogenic index and cIMTs in both of the groups. CONCLUSIONS: We observed that obese children had higher carotis intima media thicknesses. Carotis intima media thickness related to obesity can play an important role in future pre-atherosclerotic changes. Large population based studies are required to confirm this associaton.

Diffusion weighted imaging and estimation of prognosis using apparent diffusion coefficient measurements in ischemic stroke.

OBJECTIVE: Estimation of the prognosis of infarction by using diffusion weighted imaging (DWI) and quantitative apparent diffusion coefficient (ADC) measurements. METHODS: 23 patients having acute stroke symptoms with verified infarction in magnetic resonance imaging (MRI) were included in this study. Their MRI studies were performed between 6 and 12h after the onset of their symptoms and were repeated on the fifth day. The infarction volumes were calculated by using DWI and the patients were divided into two groups as the ones having an expansion in the infarction area (group 1, n=16) and the others having no expansion in the infarction area (group 2, n=7). Quantitative ADC values were estimated. The groups were compared in terms of the ADC values on ADC maps obtained from DWI, performed during the between 6 and 12h from the onset of the symptoms, referring to the core of the infarction (ADC(IC)), ischemic penumbra (ADC(P)) and the nonischemic parenchymal tissue (ADC(N)). P values<0.05 were accepted to be statistically significant. RESULTS: During the between 6 and 12h mean infarction volume calculated by DWI was 23.3cm(3) for group 1 patients (ranging from 1.1 to 68.6) and this was found to be 40.3cm(3) (ranging from 1.8 to 91.5) on the fifth day. For the group 2 patients these values were found to be 42.1cm(3) (ranging from 1 to 94.7) and 41.9 (ranging from 1 to 94.7) for the same intervals respectively. A significant statistical result was failed to be demonstrated between the mean ADC(IC) and ADC(N) values (p=0.350 and p=0.229 respectively). However the comparison of the ADC(P) values between the groups was found to be highly significant (p<0.001). When the differences between the ADC(P) and ADC(IC) and ADC(N) and ADC(P) were compared the results proved to be statistically significant (p=0.038 and p<0.001 respectively). CONCLUSIONS: We believe that ADC results that would be obtained from the core and the penumbra of the infarction area will be beneficial in the estimation of the infarction prognosis and in the planning of a treatment protocol.