Association of central obesity with early Carotid intima-media thickening is independent of that from other risk factors

Abstract

Aim:We investigated whether anthropometric measurements or metabolic risk factors correlated more with vascular changes associated with obesity. Methods: One hundred never smoking subjects (71 women, 29 men) without vascular events, with blood pressure (BP) o140/ 90 mm Hg, LDL cholesterol o4 mmol/l, glucose o6.2 mmol/l participated. Anthropometric measurements (body mass index (BMI), waist/hip ratio (WHR), waist circumference (WC) and Waist/height ratio WHTR) and metabolic risk factors (glucose, insulin, lipid and uric acid levels plus BP) were assessed. Subjects underwent vascular measurements (Carotid intima-media thickness (IMT) using duplex ultrasonography, vascular stiffness assessment (Augmentation Index) by applanation tonometry and brachial artery reactivity tests). Results: Risk factors were in the 'normal distribution'. BMI, WHR, WC, WHTR correlated significantly with triglyceride, HDL, LDL, insulin, glucose, uric acid and systolic BP levels (Po0.001). IMT correlated with WHTR, BMI, WC, Glucose (Po0.001), Homoeostasis Model Assessment (HOMA) and cholesterol levels (Po0.05). Only Age, WHTR or BMI were significant correlates of IMT in a multivariate analysis (Po0.01) including WHTR or BMI, with age, sex, systolic BP, HDLc and HOMA. Augmentation Index correlated with age (Po0.0001), WHTR and WC (Po0.0005) but with age only in a multivariate analysis. Brachial reactivity did not correlate with any anthropometric or metabolic parameters. Anthropometric cutoff points, (BMI X25, WC X102 cm men, X88 cm women, WHR X0.9 men, X0.8 women and WHTR X0.5 men and women) significantly differentiated normal from abnormal metabolic and vascular measurements. The WHTR ratio X0.5 was as reliable as the BMI cutoff X25 in determining metabolic and vascular abnormalities. BMI and WHTR were strongly associated with 89% agreement (Po0.0001). Conclusion: These results demonstrated that in 'healthy individuals', anthropometric parameters and metabolic risk factors correlated with each other, but anthropometric parameters were the only significant correlates of carotid IMT. A waist/height ratio X0.5 predicts both early vascular and metabolic changes. These data support a risk factor independent vasculotrophic effect of obesity.

Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program

“…Insulin resistance increases the endothelial expression of PAI-1 and cellular adhesion molecules, 33,34 suggesting that multiple mechanisms may contribute to accelerated atherosclerosis. 7,35 Thus, the decrease in PAI-1 concentration observed in this investigation may help to attenuate the monocyte migratory capacity mediated by insulin in a pro-inflammatory and atherothrombotic state.…”

A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value

“…Data analysed by odds of having the specified outcome by either cut-off or group of the specified obesity measure. In the population as a whole (65,74,75,79) and divided by sex (66,72,80) 7/7…”

“…In the population as a whole (65,74,75,79) and divided by sex (66,72,80) FPG 12/18 In the population as a whole (10,55,65,75,79) and analyses divided by ethnicity (58) , age (48) , sex (66,72,73,77) or age and sex (76) Not in whole study population (57,62,74,80) , in women, but not men (61,82) 10/16…”

“…In the population as a whole (65,75,79) and analyses divided by ethnicity (58) , age (48) , sex (66,72,73,77) or age and sex (76) Not in whole study population (57,62,74,80) , in women, but not men (61,82) 12/16 In the population as a whole (10,55,65,75) and analyses divided by ethnicity (58) , age (48) , sex (66,72,73,77,82) or age and sex (76) Not in whole study population (57,62,74) , in women but not men (61) HOMA-IR 4/4…”

Ursachen und Risikofaktoren der Arteriosklerose

“…Darüber hinaus konnte diese Korrelation nicht nur an der IntimaMedia-Dicke, sondern zusätzlich am Verkalkungsgrad der Koronararterien festgemacht werden [32]. Eine weitere Untersuchung bestätigte den Zusammenhang zwischen Adipositas und Karotis-IntimaMedia-Dicke bei 100 Probanden, die niemals geraucht hatten, keine vaskulären Krankheitserscheinungen zeigten und normale LDL-Cholesterin-und Blutzuckerwerte sowie normalen Blutdruck aufwiesen [33]. Auch eine Assoziation zwischen Hüft-und Taillenumfang als Maß für die Adipositas und Fortschreiten der Arteriosklerose ließ sich anhand von Karotis-Intima-Media-Dicken-Bestimmungen demonstrieren [34].…”