Background: Adults with Obesity (O) or Type 2 Diabetes (T2DM) are at higher risk for stroke and myocardial infarction. Increased carotid intima-media thickness (cIMT) and stiffness are associated
with these adverse outcomes. We compared carotid arteries in youth who were lean (L), O or T2DM.
Methods and Results: Carotid ultrasound for cIMT, Young’s Elastic Modulus (YEM) and Beta
Stiffness Index (Beta), anthropometric, laboratory, and BP were measured in 182 L, 136 O, and 128 T2DM
youth; 10-24 years. Mean differences were evaluated by ANOVA. Independent determinates of cIMT,
YEM and Beta were determined with General Linear Models. CV risk factors worsened from L to O to
T2DM. T2DM had greater cIMT than lean and O for the common carotid and bulb. For the internal, both
O and T2DM were thicker than L. The carotid arteries were stiffer O and T2DM as compared to L.
Determinates of cIMT were Group, Group*age interaction, gender, SBP for common (r2 =0.17); age, race,
and SBP for bulb (r2 =0.16); age, race, gender, SBP and total cholesterol for the internal (r2 =0.21). Age,
SBP and DBP were determinates of all measures of carotid stiffness with gender adding to YEM
(r2=0.23); BMI z score, Group and Group*age interaction contributing to Beta (r2 =0.31, all p<0.0001).
Conclusion: Youth with Obesity and T2DM diabetes have abnormalities in carotid thickness and
stiffness only partially explained by traditional CV risk factors. These vascular changes should alert
health care practitioners to address CV risk factors early to prevent an increase in the incidence of stroke
and myocardial infarction.