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Regression of Carotid Intima Media Thickness after One Year of Atorvastatin Intervention in Dyslipidemic Obese Teenagers, a Randomized Controlled Pilot Study

Abstract

Reem AL Khalifah, Marc Girard and Laurent Legault

Objective: Metabolic syndrome in obese teenagers may contribute to future cardiovascular disease (CVD). We designed a pilot study to evaluate the effect on carotid intima media thickness (cIMT) of Atorvastatin treatment over one year in dyslipidemic obese adolescents (DLP) with metabolic syndrome markers.

Methods: We conducted a randomized double blinded control study. Adolescents 14-18 years old were recruited; 16 DLP were randomized to either 10 mg Atorvastatin or placebo. Both groups had cIMT measurements on the left and right side before and one year after the intervention. These measurements were compared to those of teenagers with familial hypercholesterolemia (FH).

Results: The average left cIMT of the DLP group was 0.582 ± 0.073 mm, and the right, 0.536 ± 0.071 mm, this compared well with measurements from FH individuals, 0.569 ± 0.947 mm and 0.548 ± 0.913 mm (right and left respectively, p=0.49). For the DLP group, the average left cIMT decreased only in the statin group to 0.509 ± 0.041 mm (p=0.04) but not on the right side 0.555 ± 0.062 (p=0.5). On average cIMT decreased by 10% in Atorvastatin treated individuals and increased by 1.6% in placebo treated ones. CIMT correlated best with the diastolic pressure but not with any of the lipid values.

Conclusion: To our knowledge this is the first pilot study that showed cIMT regression in dyslipidemic obese teenagers with features of metabolic syndrome after Atorvastatin therapy over one year. However, future long term studies should look at long term CVD risk reduction.