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OBJECTIVE: The purpose of this study was to examine the association between adiposity measures, ultrasound image quality, and preclinical markers of atherosclerosis in young adults. METHODS: B-mode ultrasound was used to obtain common carotid intima-media thickness and common carotid artery distensibility of 2265 and 1313 adults aged 24 to 39 years in two population-based studies: the Cardiovascular Risk in Young Finns and Childhood Determinants of Adult Health studies. Qualitative assessments of ultrasound image quality were obtained from each study (scored as 1, excellent; 2, average; and 3, poor) based on the ability to detect arterial interfaces and the amount of noise present in the image. RESULTS: Increased adiposity was associated with significantly increased odds (all P < .05) of average or poor carotid ultrasound image quality. Reduced image quality was associated with lower intima-media thickness in Young Finns (regression coefficient = -0.029; P = .01) and higher intima-media thickness in Childhood Determinants of Adult Health (regression coefficient = 0.013; P = .03) and lower distensibility levels in both studies (Young Finns, β = -.494; P < .01; Childhood Determinants of Adult Health: β = -.195; P < .01). We observed no differences (bias) in the association between adiposity measures and carotid intima-media thickness by image quality, but there was some evidence suggesting that the association between adiposity measures and carotid distensibility differed by image quality. CONCLUSIONS: Adiposity affects ultrasound image quality and has the potential to bias associations between adiposity and preclinical markers of atherosclerosis. Studies examining adiposity and ultrasound-derived measures of atherosclerosis should consider taking steps during the design and analysis phase to adequately account for variations in image quality to avoid any potential bias.

Type

Journal article

Journal

J Ultrasound Med

Publication Date

03/2011

Volume

30

Pages

363 - 369

Keywords

Adipose Tissue, Adiposity, Adult, Artifacts, Carotid Arteries, Carotid Artery Diseases, Carotid Intima-Media Thickness, Female, Humans, Male, Reproducibility of Results, Sensitivity and Specificity, Ultrasonography, Young Adult