The Interconnection between Carotid Intima–Media Thickness and Obesity: Anthropometric, Clinical and Biochemical Correlations

Abstract

Background and Objectives: Carotid intima–media thickness (CIMT) and obesity are considered independent determinants of cardio- and cerebrovascular events. The aim of our study was to investigate the effect of obesity on CIMT and to define which traditional cardiovascular risk factors correlate the most with CIMT values in patients with obesity. Materials and Methods: Anthropometric measurements were collected for the whole study group, as well as body composition and blood pressure data, and biochemical blood analyses were also performed. Results: Although our study group was significantly older according to vascular compared with chronological age, the mean CIMT values were lower when compared with the reference values. We found a statistically significant correlation of CIMT with chronological and vascular age, systolic blood pressure, fasting glucose, total cholesterol and triglyceride levels, waist-to-hip ratio, waist circumference, body muscle mass and skeletal muscle mass index. Atherosclerotic Cardiovascular Disease (ASCVD) risk assessment and SCORE (Systematic COronary Risk Evaluation) showed significant positive correlations, but there was only a weak correlation of ASCVD with CIMT. Conclusions: To deduce, since no diagnostic tool currently includes body weight as an individual risk factor, further trials are highly needed to determine if SCORE, SCORE2, ASCVD risk assessment or CIMT would be the most accurate and relevant diagnostic tool for prediction of risk for future CV events in patients with obesity.

Does the Efficacy of Semaglutide Treatment Differ between Low-Risk and High-Risk Subgroups of Patients with Type 2 Diabetes and Obesity Based on SCORE2, SCORE2-Diabetes, and ASCVD Calculations?

“…The standard principles of T2D and obesity care (assessments and follow-up, e.g., methodology and principles and cut-offs for measurements for all studied anthropometric and biochemical parameters as well for blood pressure measurement) within the Croatian Referral Center for Obesity Treatment (which is also EASO collaborating center for obesity management), which are the same methodology principles applied here, were recently extensively presented and published elsewhere [18]. SCORE2/SCORE-OP, SCORE2-Diabetes and ASCVD cardiovascular risk categories were calculated for each patient as per standardized and validated principles published by the European Society of Cardiology [extensively presented in Refs.…”

Comment on Bažadona et al. The Interconnection between Carotid Intima–Media Thickness and Obesity: Anthropometric, Clinical and Biochemical Correlations. Medicina 2023, 59, 1512

“…Bažadona et al [ 1 ] measured only in one section, i.e., the distal wall of the CCA. A further critical aspect that Bažadona et al [ 1 ] did not specify is if the CIMT measurement was synchronized with the cardiac cycle as proposed by the “Mannheim Consensus paper” [ 2 ]; CIMT varies during cardiac cycle, with CIMT reduction occurring during systole, given systolic lumen vessel expansion and CIMT increase occurring during diastole [ 17 ]. Therefore, the reduced CIMT reported by Bažadona et al [ 1 ] could, if no synchronization occurred, be in part due to measurements occurring accidentally during the systolic cardiac phase.…”

“…The authors speculated as possible reasons for their findings “that we excluded patients with previous myocardial infarction, stroke, or TIA; additionally, hypertension and diabetes were diagnosed and treated in a timely manner so the impact of these risk factors on CIMT was smaller. The fact that the thickness of CIMT did not depend on the duration of hypertension and diabetes supports this explanation” [ 1 ].…”

“…The authors measured the CIMT according to the Mannheim consensus CIMT measurement protocol [ 2 ], namely in longitudinal view on the far wall of the common carotid artery (CCA), using an automated edge detection software. Bažadona et al reported “that our study group, although obese and significantly older according to SCORE (Systematic COronary Risk Evaluation) had lower mean CIMT values compared with the reference values…When the CIMT of each patient was matched with its reference value, our adipose cohort had CIMT values as thin as the non-adipose, healthy population” [ 1 ]. The authors speculated as possible reasons for their findings “that we excluded patients with previous myocardial infarction, stroke, or TIA; additionally, hypertension and diabetes were diagnosed and treated in a timely manner so the impact of these risk factors on CIMT was smaller.…”

“…In a recently published paper in Medicina , Bažadona et al reported on the relationship between carotid intima–media thickness (CIMT) and obesity [ 1 ]. The authors measured the CIMT according to the Mannheim consensus CIMT measurement protocol [ 2 ], namely in longitudinal view on the far wall of the common carotid artery (CCA), using an automated edge detection software.…”