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

作者：Maher V^*; O'Dowd M; Carey M; Markham C; Byrne A; Hand E; Mc Inerney D

来源：International Journal of Obesity, 2009, 33(1): 136-143.

DOI：10.1038/ijo.2008.254

• carotid artery intima-media thickness
• central obesity
• metabolic risk factors
• vasculature

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) < 140/90 mm Hg, LDL cholesterol <4 mmol/l, glucose <6.2 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 (P<0.001). IMT correlated with WHTR, BMI, WC, Glucose (P<0.001), Homoeostasis Model Assessment (HOMA) and cholesterol levels (P<0.05). Only Age, WHTR or BMI were significant correlates of IMT in a multivariate analysis (P<0.01) including WHTR or BMI, with age, sex, systolic BP, HDLc and HOMA. Augmentation Index correlated with age (P<0.0001), WHTR and WC (P<0.0005) but with age only in a multivariate analysis. Brachial reactivity did not correlate with any anthropometric or metabolic parameters. Anthropometric cutoff points, ( BMI >= 25, WC >= 102cm men, >= 88cm women, WHR >= 0.9 men, >= 0.8 women and WHTR >= 0.5 men and women) significantly differentiated normal from abnormal metabolic and vascular measurements. The WHTR ratio >= 0.5 was as reliable as the BMI cutoff >= 25 in determining metabolic and vascular abnormalities. BMI and WHTR were strongly associated with 89% agreement (P<0.0001).
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 >= 0.5 predicts both early vascular and metabolic changes. These data support a risk factor independent vasculotrophic effect of obesity.

• 出版日期2009-1