Is Obesity a Risk Factor for Carotid Atherosclerotic Disease?—Opportunistic Review

Abstract

Obesity is a risk factor for coronary atherosclerosis. However, the influence of adipose tissue in carotid atherosclerosis is not completely understood. No systematic review/meta-analysis was previously performed to understand if obesity is a risk factor for carotid atherosclerosis. This paper aims to provide an opportunistic review of the association between obesity and carotid atherosclerosis and define the role of the different adipose tissue depots in the characteristics of carotid stenosis. The databases PubMed and Cochrane Library were searched on 15–27 April and 19 May 2021. A total of 1750 articles published between 1985 and 2019 were identified, 64 were preselected, and 38 papers (35,339 subjects) were included in the final review. The most frequent methods used to determine obesity were anthropometric measures. Carotid plaque was mostly characterized by ultrasound. Overall obesity and visceral fat were not associated with the presence of carotid plaque when evaluated separately. Waist-hip ratio, however, was a significant anthropometric measure associated with the prevalence of carotid plaques. As it reflected the ratio of visceral and subcutaneous adipose tissue, the balance between these depots could impact the prevalence of carotid plaques.

Metabolically Obese Normal-Weight Phenotype as a Risk Factor for High Blood Pressure: A Five-Year Cohort

“…This research shows the importance of detecting the MONW phenotype in individuals from the general population due to their risk of HBP intervening early in their lifestyle. The mechanisms to explain the association of MONW and hypertension go beyond the increase in fat linked to the increase in BMI, chronic diseases could be further related to the accumulation of intraorganic fat, which can induce the development of hypertension through various mechanisms that lead to chronic systemic inflammation and oxidative stress in obesity such as hyperactivation of the sympathetic nervous system, increased action of the renin angiotensin aldosterone system, changes in the structure and function of the left ventricle [21], chronic vascular inflammation [28], insulin resistance [29] and consequent endothelial dysfunction [10,30].…”

Nicotine dependence and visceral adiposity as risk factors for the development and severity of carotid artery stenosis

“…In the present study, BMI and WC were significantly associated with CAS severity. Ferreira et al [ 8 ] also reported a link between obesity and other carotid atherosclerotic plaque characteristics, showing that carotid plaque instability was linked to overall obesity and an increase in fat mass. Similarly, Salari et al [ 36 ] found that moderate to severe atherosclerosis affected 62% of the adult population of northern Iran and was correlated with obesity indices.…”

“…The extent and severity of coronary artery plaques and the incidence of major adverse cardiac events are inversely correlated with increased abdominal fat tissue/subcutaneous fat tissue ratio [ 3 , 6 ]. Nevertheless, the impact of obesity on carotid atherosclerosis disease is still under observation [ 7 ], and there is limited research on the effect of adipose tissue on carotid artery atherosclerosis and the risk of stenosis [ 8 ]. Smoking has long been recognized as a major contributor to clinical CVD and is associated with the development of atherosclerosis [ 9 ].…”

Association of Frailty Syndrome and Sarcopenia With Subclinical Atherosclerosis in Older Patients

“…showed that there was no association of overall obesity or visceral obesity with the presence of carotid plaque [20,21]. Research by Kim Tae Nyun et al showed the ratio of muscle to fat to be associated with arterial stiffness [22].…”