Introduction: Early atherosclerosis is asymptomtic, and clinical manifestations are visible relatively late. (1-3)

Patients and Methods: To determine parameters of arterial stiffness in pediatric patients with preatherosclerosis, in cooperation with Department of Pediatric Endocrinology, we have analyzed 148 patients, 68 obese, 42 with diabetes mellitus type 1 with duration over 5 years, and 38 controls. Patients did not have clinical manifestations of atherosclerosis. The groups were formed due to well-known influence of diabetes and obesity as a risk factors for cardiovascular disease. In our study pediatric patients with diabetes mellitus type 1, obese patients and controls were screened with e-tracking ultrasound method. Novel methods for determination of arterial stiffness by ultrasound e-tracking analysis is easy, safe and reproducible allowing measurement of parameters like Beta stiffness index, pulse wave velocity (PWV), augmentation index (AI), arterial compliance (AC) and elasticity modulus (Ep). Common carotid artery is analyzed 1-2 cm from bifurcation on anterior and posterior wall of vessel. Accurate image of intima-media border is essential for analysis. By positioning the tracking gate on arterial wall we can measure deformation of artery during cardiac cycle.

Results: We found significant difference in AC (p=0.004) and intima media thickness (p=0.022) between all groups. Also, significant difference between group was found in IMT (diabetic patients vs. control, p=0.015), in IMT (diabetic vs. control, p=0.002) and in AC (diabetic patients vs. obese patients, p=0.004).

Conclusion: Arterial compliance is most sensitive parameter of early atherosclerosis. Intima-media thickness could be additional marker in detection of preatherosclerosis. Combination of functional arterial stiffness parameters with early morphological markers like IMT is useful in diagnosis and follow-up of these patients. According to our data diabetes mellitus is more significant risk factor than obesity in pediatric patients.