Carotid Intima-Media Thickness in Healthy Young Adults: A Review of Vascular-Metabolic Associations and the Evidence Gap in the UAE Population

Abstract

Background and Purpose: Carotid intima-media thickness (CIMT), measured by B-mode ultrasound, is a validated marker of subclinical atherosclerosis and early cardiovascular risk. While widely studied in middle-aged and high-risk groups, its determinants in young, apparently healthy adults remain underexplored particularly within the UAE, where lifestyle and metabolic risk factors are increasingly prevalent. This review aimed to synthesize global evidence on CIMT in healthy young adults, evaluate its associations with traditional and metabolic biomarkers, and identify research gaps relevant to the UAE population.

Methods: A systematic search of PubMed, Scopus, and Google Scholar up to September 2025 identified studies including adults aged 18–35 years without established cardiovascular disease that reported CIMT measured by ultrasound. Data were extracted for study design, participant characteristics, and associations with traditional or metabolic risk factors. Correlation and regression findings were narratively synthesized. For our ongoing UAE-based cross-sectional study, statistical analysis will include descriptive statistics, Pearson or Spearman correlation, and multivariable linear regression to assess associations between CIMT and predictors such as BMI, blood pressure, CRP, glucose, and lipid profile. Statistical significance will be set at p<0.05.

Results: Thirty-six studies (n=10,000) met inclusion criteria, with only a few conducted in the UAE or Gulf region. Increased CIMT was consistently associated with higher BMI, systolic blood pressure, glucose, and CRP levels, while greater physical activity and favorable lipid profiles correlated with lower CIMT.

Conclusions: Subclinical vascular changes are detectable even among healthy young adults and are closely linked to modifiable metabolic and lifestyle factors. The forthcoming cross-sectional study in Ras Al Khaimah aims to address the regional evidence gap and provide baseline data for early cardiovascular prevention across the UAE population.