Flow-mediated arterial dilatation and carotid intimal media thickness as early biomarkers of the risk of atherosclerosis in obese adolescents with metabolic syndrome: a cross-sectional study

Background The increasing rates of teenage obesity and metabolic syndrome globally strain public health systems, notably due to heightened risks of cardiovascular diseases such as atherosclerosis. Early biomarkers like Flow-Mediated Arterial Dilatation (FMAD) and Carotid Intimal Media Thickness (CIMT) show potential in identifying high-risk individuals and enabling proactive interventions. Our study aims to analyze the relationship between FMAD, CIMT, and atherosclerosis risk in obese adolescents with metabolic syndrome. Materials and Methods A cross-sectional study compares CIMT and FMAD in obese adolescents, excluding those with smoking, alcohol consumption, dyslipidemia, hormone medication use, or endocrine diseases. Mean ± SD represented normal continuous data, while median (quartiles 1–3) represented non-normal data. Chi-Square analyzed categorical data proportions, with the independent-T test for normal variables and the Mann-Whitney test for non-normal ones. Results A total of 72 adolescents (51 obese and 21 with normal weight) were included in this study. There were no significant differences in age, sex, or height between the two groups; however, the obese group had significantly higher body weight, BMI, body fat, waist circumference, and blood pressure (p < 0.001). FMAD values were lower and CIMT values were higher in the obese group (p < 0.05). FMAD showed a negative correlation with BMI, while CIMT correlated positively with BMI and waist circumference. Metabolically, the obese group had higher fasting glucose, triglyceride, and insulin levels, along with lower HDL levels (p < 0.05). Based on endothelial function, HDL levels were significantly lower in participants with FMAD < 7.1% (p = 0.023). Overall, adolescent obesity was associated with impaired endothelial function, increased arterial thickness, and an atherogenic metabolic profile. Conclusion A negative correlation was found between FMAD and BMI, and a positive correlation between CIMT with BMI and waist circumference, indicating that obesity is associated with reduced endothelial function and carotid artery thickening. The relationship between FMAD and CIMT was not significant, suggesting that endothelial dysfunction may precede structural arterial changes.