title: Calf circumference is inversely associated with carotid plaques.
abstract: OBJECTIVE
  The association of carotid atherosclerosis with body composition and fat distribution is poorly understood. We aimed to test the cross-sectional association of carotid plaques and common carotid artery intima-media thickness with calf circumference (CC), representing peripheral fat and lean mass, and with waist circumference and waist-to-hip ratio, 2 markers of abdominal obesity.
  
  
  METHODS
  The study was performed on 6265 subjects aged >or=65 years recruited prospectively from the electoral rolls of 3 French cities. Ultrasound examination and anthropometric measures were performed according to a standardized protocol.
  
  
  RESULTS
  Carotid plaques were less frequent with increasing CC, the ORs for the second, third, and fourth quartile of CC compared with the first quartile being 0.98 (95% CI, 0.84 to 1.15), 0.85 (95% CI, 0.72 to 1.01), and 0.71 (95% CI,:0.58 to 0.86; P for trend=0.0002), respectively, independently of age, gender, body mass index, and other vascular risk factors. There was an opposite and multiplicative effect of CC and waist-to-hip ratio on the frequency of carotid plaques (55.1% of individuals in the fourth waist-to-hip ratio quartile and the first CC quartile had carotid plaques, against 31.8% in the first waist-to-hip ratio and the fourth CC quartile). Mean common carotid artery intima-media thickness was larger with increasing waist circumference, waist-to-hip ratio, and CC, but the association with CC disappeared after adjusting for body mass index.
  
  
  CONCLUSIONS
  The present study shows, for the first time, an inverse relationship between carotid plaques and CC. Although this needs to be confirmed in other populations, it may suggest an antiatherogenic effect of large CC.
authors.affiliation: Inserm, U744, Lille, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Debette
authors.forename: Nathalie
authors.initials: N
authors.lastname: Leone
authors.forename: Dominique
authors.initials: D
authors.lastname: Courbon
authors.forename: Jérôme
authors.initials: J
authors.lastname: Gariépy
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.forename: Annick
authors.initials: A
authors.lastname: Alpérovitch
authors.forename: Pierre
authors.initials: P
authors.lastname: Ducimetière
authors.forename: Philippe
authors.initials: P
authors.lastname: Amouyel
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Zureik
mesh_terms: D000368:Aged; D000886:Anthropometry; D001823:Body Composition; D050218:Body Fat Distribution; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000473:pathology*; D017536:Carotid Artery, Common / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007866:Leg / Q000033:anatomy & histology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D049629:Waist-Hip Ratio