The relative impact of different measures of adiposity on markers of early atherosclerosis.
BACKGROUND
Although there are several methods available to assess adiposity, there is still controversy on the relative clinical utility of each of these methods. This study examines the relative impact of different measures of adiposity on markers of early atherosclerosis. In particular weight changes over time have been poorly assessed in this setting.


METHODS
Eighty-six healthy individuals (31 men, age 36.5+/-8.9 years) with a wide range of body-mass index (28.7+/-7.0, 18.9-57.9 kg/m2) without hypertension, diabetes or smoking were examined. In addition to waist circumference and waist-to-hip ratio self-reported weight change since adolescence was also calculated. Ultrasonography was used to measure abdominal fat layers and their ratio. Flow-mediated dilatation of the brachial artery, serum levels of intercellular adhesion molecule (sICAM-1) and mean intima-media thickness of the carotid artery were measured as markers of early atherosclerosis.


RESULTS
Stepwise multivariate regression analysis showed waist circumference and waist-to-hip ratio as the only independent predictor of flow-mediated dilatation. Waist circumference and weight change but not current body-mass index were independent predictors of intima-media thickness. These correlations were not influenced by ultrasonographically measured fat layers, C-reactive protein and basal insulin resistance. Body-mass index and weight gain were associated with sICAM-1 but not independently of basal insulin resistance and C-reactive protein.


CONCLUSIONS
Waist circumference and weight gain were the strongest predictors of early atherosclerosis in a population of apparently healthy adults. The ultrasonographically measured fat layers did not provide additional information in this population.
Stamatelopoulos
Kimon S
KS
Vascular laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece. stamatelopoulosk@yahoo.gr
Lekakis
John P
JP
Vamvakou
Georgia
G
Katsichti
Paraskevi
P
Protogerou
Athanasios
A
Revela
Ioanna
I
Karatzi
Kalliopi
K
Alevizaki
Maria
M
Zakopoulos
Nikolaos
N
Papamichael
Christos M
CM
D050153:Abdominal Fat / Q000000981:diagnostic imaging; D050154:Adiposity; D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D015415:Biomarkers / Q000032:analysis*; D001783:Blood Flow Velocity; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D012044:Regression Analysis; D017539:Tunica Intima / Q000473:pathology; D014463:Ultrasonography; D049629:Waist-Hip Ratio
D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein