Fatty streak

A fatty streak is the first grossly visible (visible to the naked eye) lesion in the development of atherosclerosis. It appears as an irregular yellow-white discoloration on the luminal surface of an artery. It consists of aggregates of foam cells, which are lipoprotein-loaded macrophages,^[1] located in the intima, the innermost layer of the artery, beneath the endothelial cells that layer the lumina through which blood flows. Fatty streaks may also include T cells, aggregated platelets, and smooth muscle cells. Although fatty streaks can develop into atheromas (atheromatous plaques), not all are destined to become advanced lesions.^[2]

Progression of atherosclerosis

Epidemiology

Almost all children older than 10 in developed countries have aortic fatty streaks, with coronary fatty streaks beginning in adolescence.^[3][4][5]

In 1953, a study was published that forever changed the understanding of the development of heart disease. The study examined the results of 300 autopsies performed on U.S. soldiers who had died in the Korean War. Despite the fact that the average age of the soldiers was just 22 years old, 77% of them had visible signs of coronary atherosclerosis. This study showed that heart disease could affect people at a young age and was not just a problem for older individuals.^[6][7][8]

In 1992, a report had shown that microscopic fatty streaks were noticed in the left anterior descending artery in over 50% of children aged 10–14. And 8% had more notable accumulations of extracellular lipid.^[9]

In a 2005 study carried out between 1985–1995, it was found that around 87% of aortas and 30% of coronary arteries in age group 5–14 years had fatty streaks.^[10]

See also

• Endothelial dysfunction

References

1. Guyton, Arthur C.; Hall, John E. (2006). Textbook of Medical Physiology (11th ed.). Philadelphia: Elsevier Saunders. p. 849. ISBN 978-0-7216-0240-0.
2. Kumar, Vinay; Abbas, Abul K.; Aster, Jon C.; Turner, Jerrold R.; Perkins, James A.; Robbins, Stanley L.; Cotran, Ramzi S., eds. (2021). Robbins & Cotran Pathologic Basis of Disease (10th ed.). Philadelphia, PA: Elsevier. p. 499. ISBN 978-0-323-53113-9.
3. Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 348-351 ISBN 978-1-4160-2973-1
4. Strong, J. P.; McGill, H. C. (1969-05-06). "The pediatric aspects of atherosclerosis". Journal of Atherosclerosis Research. 9 (3): 251–265. doi:10.1016/S0368-1319(69)80020-7. ISSN 0368-1319. PMID 5346899.
5. Zieske, Arthur W.; Malcom, Gray T.; Strong, Jack P. (January 2002). "Natural History and Risk Factors of Atherosclerosis in Children and Youth: The Pday Study". Pediatric Pathology & Molecular Medicine. 21 (2): 213–237. doi:10.1080/pdp.21.2.213.237. ISSN 1522-7952. S2CID 218896145.
6. Enos, William F. (1953-07-18). "Coronary Disease Among United States Soldiers Killed in Action in Korea". Journal of the American Medical Association. 152 (12): 1090. doi:10.1001/jama.1953.03690120006002. ISSN 0002-9955.
7. "Stopping Heart Disease in Childhood". NutritionFacts.org. Retrieved 2022-12-08.
8. Wilson, Don P. (2000), Feingold, Kenneth R.; Anawalt, Bradley; Boyce, Alison; Chrousos, George (eds.), "Is Atherosclerosis a Pediatric Disease?", Endotext, South Dartmouth (MA): MDText.com, Inc., PMID 27809437, retrieved 2022-12-08
9. Strong, Jack P.; Malcom, Gray T.; Newman, William P.; Oalmann, Margaret C. (June 1992). "Early Lesions of Atherosclerosis in Childhood and Youth: Natural History and Risk Factors". Journal of the American College of Nutrition. 11 (sup1): 51S–54S. doi:10.1080/07315724.1992.10737984. ISSN 0731-5724.
10. Mendis, Shanthi; Nordet, P.; Fernandez-Britto, J.E.; Sternby, N. (2005-03-01). "Atherosclerosis in children and young adults: An overview of the World Health Organization and International Society and Federation of Cardiology study on Pathobiological Determinants of Atherosclerosis in Youth study (1985–1995)". Global Heart. 1 (1): 3. doi:10.1016/j.precon.2005.02.010. ISSN 2211-8179.