Carotid Intima-Media Thickness (CIMT) and Visceral Adiposity as a Benchmark for Cardiovascular Profile in Rural Versus Urban African Children and Adolescents

Background: While cardiovascular diseases (CVD) manifest in adulthood, vascular changes may begin in childhood. Early markers of CVD, such as carotid intima-media thickness (CIMT), have not been well studied in children in the African setting. The potential influence of environmental and genetic factors on the CIMT of African children is not well understood. Objective: This study assessed the cardiovascular risk profiles of Ghanaian children and adolescents in rural and urban settings using carotid intima-media thickness (CIMT) and ultrasound-measured adiposity. Methods: A cross-sectional study was conducted involving 343 asymptomatic, healthy school children (10–16 years) from the Ashanti region of Ghana. Participants were recruited from one urban and one rural school. Data collected included height, weight, blood pressure, and ultrasound measurements of CIMT, subcutaneous, preperitoneal, and Visceral fat. Results: The mean CIMT for the cohort was 0.60 ± 0.07 mm. Urban children had significantly higher BMI (p < 0.001), subcutaneous fat (p = 0.005), and preperitoneal fat (p < 0.001) compared to rural children, yet there was no significant difference in CIMT between the two sites (p = 0.497). Multiple linear regression revealed that peritoneal fat thickness (p = 0.029) and male gender (p < 0.001) were significant predictors of CIMT, whereas BMI and blood pressure were not. Conclusions: Ghanaian children exhibit elevated CIMT values compared to Western pediatric cohorts despite having lower BMI and normal blood pressure. The significant correlation between peritoneal (visceral) adiposity and CIMT suggests that fat distribution is a more sensitive indicator of early vascular remodeling than BMI in this population. This highlights the need for population-specific screening strategies that move beyond BMI.