Carotid Artery Wall Echogenicity Measured by Gray Scale Median of the Intima‐Media Complex From Childhood to Young Adulthood

Abstract

Background Echogenicity of the carotid arterial wall, measured by gray scale median of the intima‐media complex (IM‐GSM), is a novel subclinical atherosclerosis marker with lower values indicating greater lipid deposition. Our longitudinal study investigated IM‐GSM from childhood to adulthood and its associated risk factors. Methods and Results A total of 240 participants from the Southern California CHS (Children's Health Study) underwent carotid artery ultrasounds in 2008 (mean age±SD): (11.2±0.6 years), and again around 2022 (24.2±1.6 years) to assess IM‐GSM, carotid artery intima‐media thickness, and carotid artery distensibility. Questionnaires and anthropometric and blood pressure measurements were completed by participants at both times. Mean and SD of IM‐GSM were 108.2±24.6 in childhood and 75.6±15.8 in adulthood. Each 1‐year increase in age was associated with −2.52 change in IM‐GSM (95% CI, −2.76 to −2.27). Childhood and adulthood IM‐GSMs were highly correlated (β=0.13 [95% CI, 0.05–0.22]). In childhood, Hispanic ethnicity, lower parental education levels and prenatal father smoking were significantly associated with lower IM‐GSM. In adulthood, higher systolic blood pressure, carotid artery intima‐media thickness, hypertension, and lower distensibility were significantly associated with lower IM‐GSM. Weight status exhibited a consistent association with both childhood and adulthood IM‐GSM. During the transition from childhood to adulthood, individuals who shifted from normal weight to overweight/obese or normal blood pressure to hypertension or experienced an increase in carotid artery intima‐media thickness displayed lower levels of IM‐GSM in adulthood. Conclusions IM‐GSM decreases with age. Maintaining healthy weight and blood pressure levels in children could potentially aid in preventing subclinical atherosclerosis.