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.