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Early-life markers of atherosclerosis using aortic and carotid intima-media thickness: an assessment of methods to account for child size

McCloskey, Kate, Vuillermin, Peter, Carlin, John B., Skilton, Michael R., Raitakari, Olli, Jachno, Kim, Cheung, Michael, Burgner, David P. and Ponsonby, Anne-Louise 2015, Early-life markers of atherosclerosis using aortic and carotid intima-media thickness: an assessment of methods to account for child size, Journal of vascular ultrasound, vol. 39, no. 3, pp. 119-126.

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Title Early-life markers of atherosclerosis using aortic and carotid intima-media thickness: an assessment of methods to account for child size
Author(s) McCloskey, Kate
Vuillermin, Peter
Carlin, John B.
Skilton, Michael R.
Raitakari, Olli
Jachno, Kim
Cheung, Michael
Burgner, David P.
Ponsonby, Anne-Louise
Journal name Journal of vascular ultrasound
Volume number 39
Issue number 3
Start page 119
End page 126
Total pages 8
Publisher Society for Vascular Ultrasound
Place of publication Lanham, Md.
Publication date 2015-09
ISSN 1544-3167
Summary Background.—Distinguishing pathological from physiological relationships between vessel size and aortic intima-media thickness (aIMT) is an important challenge, especially in growing children. We examined the relationship between childhood vessel diameter and aIMT and assessed common analytic approaches used to address this relationship.Methods.—We analyzed aIMT in two population-derived cohorts; 6-week-old infants and 19-year-olds. We simulated datasets in which we assumed a simple physiological relationship between vessel diameter and aIMT, and then superimposed possible pathological effects on aIMT; (a) intrauterine growth retardation, (b) macrosomia and (c) both intrauterine growth retardation and macrosomia. Using simulated datasets and cohorts, we evaluated analytic strategies including those in which the relationship between vessel diameter and aIMT was (a) ignored, (b) adjusted for by dividing aIMT by weight, or (c) adjusted for using varying regression techniques.Results.—aIMT was found to increase in proportion to vessel diameter in both cohorts (138 μm/mm at 6 weeks and 52 μm/mm at 19 years of age). Simply dividing aIMT by weight produced negative associations with weight across all datasets. By contrast, adjusting for vessel diameter as a covariate enabled accurate distinction of the direction of the association between aIMT and weight in all simulated datasets. These results were replicated in the cohort studies for both aIMT and carotid intima-media thickness.Conclusion.—There is a physiological relationship between vessel diameter and aIMT. Simply dividing aIMT by weight may lead to incorrect assumptions regarding the relationship between weight and aIMT. However, the physiological relationship is appropriately estimated by including vessel diameter as a covariate in regression.
Language eng
Field of Research 1103 Clinical Sciences
Socio Economic Objective 920501 Child Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Society for Vascular Ultrasound
Persistent URL http://hdl.handle.net/10536/DRO/DU:30084678

Document type: Journal Article
Collection: School of Medicine
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