Elevated Serum Concentrations of Remnant Cholesterol Associate with Increased Carotid Intima-Media Thickness in Children and Adolescents

Objective To evaluate the relationship between remnant cholesterol and carotid intima-media thickness (cIMT), a surrogate marker for atherosclerosis, in children and adolescents. Study design Anthropometric, laboratory, liver and carotid ultrasonographic data were obtained from 767 youths (594, overweight/obese; 173, normal weight). Fasting RC was calculated from the standard lipid profile. cIMT >= 0.56 mm (corresponding to the 90th percentile of values observed in normal-weight children) was chosen to define elevated cIMT. Logistic regression analysis was used to estimate the risk of elevated cIMT according to tertiles of RC levels. Results In the entire cohort, the mean concentration of RC was 17.9±10.3 mg/dl and mean cIMT value was 0.51±0.8 mm. Remnant cholesterol significantly correlated with age, sex, body mass index (BMI), waist circumference, blood pressure, lipids, liver enzymes, and insulin resistance (HOMA-IR). cIMT value increased progressively with rising RC tertiles (Pfor trend<0.001). Compared with subjects in the lowest RC tertile, those in the middle and highest RC tertiles had a 2.3- and 2.4-fold increased risk of elevated cIMT, independently of age, sex, pubertal stage, BMI and apolipoprotein B (all Padj<=0.003). When the effects of overweight/obesity on the association between RC and cIMT were determined, normal-weight as well as overweight/obese subjects in the highest RC tertile had a 3.8- and 2.3-fold increased risk to have elevated cIMT compared with the respective study groups in the lowest tertile, after adjustment for conventional risk factors (Padj=0.038 and Padj=0.003, respectively). Conclusion. In youths elevated levels of remnant cholesterol might represent a marker of early atherosclerotic damage.