Long-Term Trajectories of BMI Predict Carotid Stiffness and Plaque Volume in Type 2 Diabetes Older Adults: a Cohort Study.

Abstract

Background: High body mass index (BMI) is a risk factor for type 2 diabetes and cardiovascular disease. However, its relationships with indices of carotid stiffness and plaque volume are unclear. We investigated associations of long-term measurements of BMI with indices of carotid stiffness and atherosclerosis among non-demented diabetes patients from the Israel Diabetes and Cognitive Decline (IDCD) study. Methods: Carotid ultrasound indices [carotid intima media thickness (cIMT), distensibility, elastography and plaque volume] were assessed in N=471 participants. Mean BMI across all MHS diabetes registry measurements and trajectories of BMI were calculated. BMI was categorized into three trajectory groups representing: a relatively stable normal weight (n=185, 44%), overweight trajectory (n=188, 44.8%) and a trajectory of obesity (n=47, 11.2%). Linear and logistic regressions estimated associations of carotid indices with mean BMI and BMI trajectories. Results: Compared to the normal weight trajectory, an obesity trajectory was associated with carotid distensibility (β=-3.078, p=0.037), cIMT (β=0.095, p=0.004), and carotid elastography (β=0.181, p=0.004) but not with plaque volume (β=0.066, p=0.858). Compared with the normal weight trajectory, an obesity trajectory was associated with increased odds for impaired carotid distensibility (OR=2.790, p=0.033), impaired cIMT (OR=5.277, p=0.001) and large carotid plaque volume (OR=8.456, p=0.013) but not with carotid elastography (OR=1.956, p=0.140). Mean BMI was linearly associated with Distensibility (β=-0.275, p=0.005) and cIMT (β=0.005, p=0.026).Conclusions: Long-term measurements of adiposity are associated with indices of carotid stiffness and plaque volume among older type 2 diabetes adults.

The Impact of Dietary Diversity, Lifestyle, and Blood Lipids on Carotid Atherosclerosis: A Cross-Sectional Study

“…A higher BMI was significantly associated with the risk of CAS, which was similar to previous studies [21,22]. A cohort study found that obesity is associated with the carotid atherosclerosis index and plaque volume in older adults with type 2 diabetes [22]. Both ex-smokers and current smokers had an increased risk of CAS in our study.…”

“…Increasing attention is being paid to the importance of lifestyle factors in the prevention of atherosclerosis [20]. A higher BMI was significantly associated with the risk of CAS, which was similar to previous studies [21,22]. A cohort study found that obesity is associated with the carotid atherosclerosis index and plaque volume in older adults with type 2 diabetes [22].…”

Clinical significance and influencing factors of carotid pulse wave velocity in patients with diabetic microangiopathy

“…Carotid tensile stress is related to its elasticity, 23 and Claudio et al 24 found that Carotid endothelial shear stress reduction is an independent predictor of atherosclerosis. In addition, in a previous study, 25 increased TG levels and decreased HDL‐C levels were related to arteriosclerosis. Further, adipose tissue‐derived inflammatory factors—resistin, vaspin, and visfatin—were associated with the pathogenesis of carotid atherosclerosis, including initial activation of endothelial cells.…”