Impact of Body Mass Index on Changes in Common Carotid Artery Wall Thickness (original) (raw)
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Journal of Ultrasound in Medicine, 2018
ObjectivesStudies have shown that common carotid intima media thickness (CIMT) measured by B‐mode sonography increases with body mass index (BMI) among subjects with cardiovascular diseases in different populations. However, association of body fat and subclinical atherosclerosis in the absence of these cardiovascular diseases is understudied. We aimed to evaluate the correlation between BMI and CIMT in a healthy adult population of black African ancestry.MethodsThis is a cross‐sectional prospective study in 300 consecutive apparently healthy subjects aged 18 to 70 years without history of hypertension, dyslipidemia, diabetes mellitus, and renal disease. Subjects' common carotid artery intima media thickness was measured with a 7.5‐MHz linear ultrasound transducer at a point 10 mm proximal to the carotid bulb. All subjects' biodata, medical history, anthropometric (weight and height from which BMI was calculated), laboratory (fasting lipid profile and blood glucose), and CIM...
OBJECTIVE: Although obese children are at increased risk for coronary heart disease in later life, it is not clear if this association results from the persistence of childhood obesity into adulthood. We examined the relation of adiposity at various ages to the carotid intima-media thickness (IMT) at age 35 y. DESIGN: Prior to the determination of IMT by B-mode ultrasound, subjects (203 men, 310 women) had, on average, six measurements of body mass index (BMI) and triceps skinfold thickness (TSF) between the ages of 4 and 35 y. Mixed regression models for longitudinal data were used to assess the relation of these characteristics to adult IMT. RESULTS: Overall, adult IMT was associated with levels of both BMI and TSF (Po0.001), with the magnitudes of the associations with childhood adiposity comparable to those with adult levels of BMI and TSF. Furthermore, adult obesity modified the association between childhood adiposity and IMT: high IMT levels were seen only among overweight (BMI Z95th percentile) children who became obese (BMI Z30 kg/m 2 ) adults (Po0.01 for linear trend). In contrast, IMT levels were not elevated among (1) overweight children who were not obese in adulthood, or among (2) thinner children who became obese adults. CONCLUSIONS: These results emphasize the adverse, cumulative effects of childhood-onset obesity that persists into adulthood. Since many overweight children become obese adults, the prevention of childhood obesity should be emphasized.
Body Composition and Common Carotid Artery Remodeling in a Healthy Population
The Journal of Clinical Endocrinology & Metabolism, 2008
Context: An independent association between obesity and preclinical carotid atherosclerosis has been demonstrated, however, the pathophysiological links were not clearly established. Body composition (BC) influences systemic hemodynamics and may participate in the remodeling of common carotid artery (CCA), independently of risk factors. Objective: This study evaluated the association between CCA structure and BC in a large population of healthy subjects. Design: This was a cross-sectional study. Settings: The study was conducted at 19 European centers. Subjects: The study included 627 healthy subjects (252 men, age 30-60 yr, body mass index 17-40 kg/m 2). Main Outcome Measures: CCA luminal diameter and intima-media thickness were measured on digitized ultrasound images. Acoustic properties of CCA wall were evaluated by digital densitometric analysis and described in terms of mean gray level. BC was assessed by electrical bioimpedance. Insulin sensitivity (euglycemic hyperinsulinemic clamp) and plasma adiponectin levels were measured. Associations between CCA structure, age, BC, and metabolic and atherosclerotic risk factors were analyzed by multivariate regression models. Results: Independent factors affecting CCA diameter were fat-free mass and waist girth (standardized r ϭ 0.44 and 0.12; P Ͻ 0.01 and Ͻ 0.0001; R 2 ϭ 0.35); independent correlates of intima-media thickness were age, CCA diameter, systolic blood pressure, and low-density lipoprotein-cholesterol (standardized r ϭ 0.39, 0.25, 0.10, and 0.14; P Ͻ 0.005-0.0001; R 2 ϭ 0.40). The mean gray level of carotid wall was independently associated with age and waist girth (standardized r ϭ 0.23 and 0.12; P Ͻ 0.0001 and ϭ 0.001; R 2 ϭ 0.30). Conclusions: Findings of this cross-sectional study suggest that BC modulates CCA diameter, and may induce adaptive changes in carotid wall thickness, independently of metabolic and atherosclerotic factors. Central adiposity modifies the acoustic properties of carotid wall.
Journal of physiological anthropology, 2013
Previous studies have reported an inverse association between height and risk of cardiovascular disease. However, evidence is limited for the association between risk of atherosclerosis and height. Further, although the association between atherosclerosis and body mass index (BMI) is reportedly positive, there have been no reports of studies on associations between height and atherosclerosis in relation to BMI. We conducted a cross-sectional study of Japanese men aged 30 to 89 years undergoing general health check-ups. Of the 1,337 men, 312 were diagnosed with carotid atherosclerosis (carotid intima-media thickness (CIMT) ≥ 1.1 mm), but no significant association was found between height and carotid atherosclerosis for the entire study group. Stratification by BMI status of those analytical findings disclosed a significant inverse association between height and carotid atherosclerosis among overweight (BMI ≥ 25 kg/m(2)) but not among non-overweight (BMI < 25 kg/m(2)) men. The cla...
Few studies have determined whether greater carotid artery intima-media thickness (IMT) in asymptomatic individuals is associated prospectively with increased risk of coronary heart disease (CHD). In the Atherosclerosis Risk in Communities Study, carotid IMT, an index of generalized atherosclerosis, was defined as the mean of IMT measurements at six sites of the carotid arteries using B-mode ultrasound. The authors assessed its relation to CHD incidence over 4-7 years of follow-up (1987-1993) in four US communities (Forsyth County, North Carolina; Jackson, Mississippi; Minneapolis, Minnesota; and Washington County, Maryland) from samples of 7,289 women and 5,552 men aged 45-64 years who were free of clinical CHD at baseline. There were 96 incident events for women and 194 for men. In sex-specific Cox proportional hazards models adjusted only for age, race, and center, the hazard rate ratio comparing extreme mean IMT (>1 mm) to not extreme (<1 mm) was 5.07 for women (95% confidence interval 3.08-8.36) and 1.85 for men (95% confidence interval 1.28-2.69). The relation was graded (monotonic), and models with cubic splines indicated significant nonlinearity. The strength of the association was reduced by including major CHD risk factors, but remained elevated at higher IMT. Up to 1 mm mean IMT, women had lower adjusted annual event rates than did men, but above 1 mm their event rate was closer to that of men. Thus, mean carotid IMT is a noninvasive predictor of future CHD incidence. Am J Epidemiol 1997; 146:483-94. carotid arteries; coronary disease; incidence; risk factors; ultrasonography
Stroke, 1994
We tested the hypothesis that body mass, waist-to-hip circumference ratio, physical inactivity, diabetes, hyperglycemia, and fasting insulin are each positively associated with asymptomatic carotid artery wall thickness. Average intimal-medial carotid wall thickness (an indicator of atherosclerosis) was measured noninvasively by B-mode ultrasonography in cross-sectional samples of 45- to 64-year-old adults, both blacks and whites, free of symptomatic cardiovascular disease, in four US communities. Sample mean carotid wall thickness was approximately 0.7 mm in women (n = 7956) and 0.8 mm in men (n = 6474). Body mass, waist-to-hip ratio, work physical activity, diabetes, and fasting insulin were associated (P < .05) with carotid wall thickness in the hypothesized direction. Adjusted for age, race, smoking, body mass index, artery depth, and Atherosclerosis Risk in Communities field center, mean wall thickness was greater by 0.02 mm in women and 0.03 mm in men for a 0.07-unit (one S...
American Journal of Cardiology, 2011
Carotid intima-media thickness (CIMT) progression is predictive of future cardiovascular events in middle-age and older adults. However, information is scant on segment-specific CIMT progression by race (black vs white) and gender and its predictors during short-term follow-up in asymptomatic young adults. B-mode ultrasound images of the far walls of both carotid arteries were obtained in 842 subjects aged 24 to 43 years and enrolled in the Bogalusa Heart Study (70% whites and 42% men). The CIMT and cardiometabolic risk variables were measured at baseline and after an average of 2.4 years. The mean CIMT progression rates/year adjusted for age, race, and gender were greatest at the bulb, followed by the internal and common carotid segments (p <0.0001). In a multivariate logistic model, age, mean arterial pressure, and high-density lipoprotein cholesterol were significantly associated with common CIMT progression. Smoking, age, insulin resistance index, and mean arterial pressure were significantly associated with bulb CIMT progression; and the waist/height ratio, smoking, age, and mean arterial pressure were significantly associated with internal CIMT progression, independent of the baseline CIMT and traditional cardiometabolic risk variables, including adiponectin, C-reactive protein, and intercellular adhesion molecules. In addition, the status of progression was associated with a greater prevalence of metabolic syndrome (common and internal CIMT, p <0.05; bulb CIMT, p <0.0001) and diabetes (bulb CIMT only, p <0.001). In conclusion, in younger adults, the magnitude of progression of CIMT within a short period varied in a segment-specific manner, regardless of race or gender, and was predictable using modifiable traditional risk factors. This could have implications for preventive and interventional cardiology. Published by Elsevier Inc. (Am J Cardiol 2011; 107:114-119) Most studies of longitudinal carotid intima-media thickness (CIMT) changes have been performed on middle-age and older age adults. 1,2-6 These observations have involved certain carotid artery segments individually or combined. 1,2-4,7 However, information is scant regarding the segments of CIMT progression and their relations to risk factor variables in apparently healthy younger adults. The relations have varied among specific segments within the carotid artery, and these need to be examined. The present analysis studied specific segments and risk factors in a biracial (black vs white) population. 8 Methods The prospective study cohort was derived from the 2 cross-sectional surveys conducted in Bogalusa, Louisiana, a biracial community. In the 2001 to 2002 survey, 1,143 participants (mean Ϯ SD age 36.4 Ϯ 4.4 years; 70% white;
Age-and gender-associated determinants of carotid intima-media thickness: A community-based study
2012
Few population-based studies have assessed the risk factors of and gender differences in intimamedia thickness (IMT) at the common carotid artery (CCA) for different age groups. Objective: Factors determining age and gender differences in IMT were studied in ethnic Chinese participants of the Chin-Shan Community Cardiovascular Cohort in Taiwan. Methods: From July 1994 through August 1996, the CCA-IMT of 1203 men and 1487 women aged 35 years or more was measured using high-resolution B-mode carotid ultrasound. Cardiovascular risk factors were recorded for each subject. Results: The CCA-IMT consistently increased with age and was more in men than in women. For participants aged 55 years or more, women showed a more rapid increase in systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL) than men. The gender difference in CCA-IMT became insignificant after 75 years of age. The major determinants of CCA-IMT in addition to age and gender were body mass index at 35-44 years of age, LDL in both genders and SBP in women at 45-54 years old, SBP at 55-64 and 65-74 years old, and women with left ventricular hypertrophy, hypertension with medication, and high LDL levels at 65-74 years old after multivariate linear regression analysis. For those aged over 75 years, SBP was an important determinant of CCA-IMT. Conclusions: The CCA-IMT increases with age and its determinants are associated with age and gender. The rapid increase in cardiovascular risk factors in women after 55 years of age attenuates the female advantage in CCA-IMT.