title: Association of obesity and visceral fat distribution with intima-media thickness of carotid arteries in middle-aged and older persons.
abstract: OBJECTIVE
  The association between obesity and atherosclerotic disease is controversial. We examined whether common carotid intima-media thickness (IMT), a precursor to preclinical atherosclerosis, was associated with total body fatness or the accumulation of fat mass in the abdominal region in middle-aged and older persons.
  
  
  METHODS
  Participants were consecutively enrolled from patients aged >or=50 years, and were 623 men aged 73+/-10 (mean+/-standard deviation) years and 835 women aged 76+/-10 years. Demographic data were collected and maximal preperitoneal fat thickness (PFT(max)) and carotid intima-media thickness (IMT) were evaluated on B-mode ultrasonography. Subjects were divided into 3 groups on the basis of body mass index (BMI), a marker of general obesity.
  
  
  RESULTS
  It was shown by multiple regression analysis for IMT that age, smoking status, hypertension and uric acid were significantly associated with IMT in subjects in the lowest BMI group (<20 kg/m(2)), and age, hypertension, dyslipidemia and uric acid in middle BMI group (20-22.9 kg/m(2)). Moreover, man sex, age, BMI, PFT(max), smoking status, hypertension and uric acid were significantly associated with IMT in subjects with highest BMI group (>or=23 kg/m(2)). Analysis of covariance showed that interaction between BMI and visceral obesity (f=7.202, p=0.007) was significantly associated with IMT, in addition to age, visceral obesity, smoking status, hypertension, dyslipidemia and uric acid.
  
  
  CONCLUSIONS
  The present study indicates a graded and independent association between general and visceral obesity and preclinical carotid artery changes in patients aged >or=50 years with a BMI >or=23 kg/m(2).
authors.affiliation: Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Japan. rykawamo@yahoo.co.jp
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kawamoto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohtsuka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ninomiya
authors.forename: Syunpei
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050218:Body Fat Distribution; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D008297:Male; D008875:Middle Aged; D009765:Obesity; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography