Subclinical atherosclerosis and metabolic risk: role of body mass index and waist circumference.
BACKGROUND
Carotid artery intima-media thickness (IMT) is greater in adults with elevated metabolic risk profiles. However, the influence of body mass index (BMI) or waist circumference (WC) on the relationship between IMT and metabolic risk is unclear.


METHODS
Adults from the Bogalusa Heart Study were classified as normal weight, overweight, or obese and into WC categories (men, low <94 cm, moderate 94-101.9 cm, high ≥102 cm; women, low <80 cm, moderate 80-87.9 cm, high ≥88 cm). Elevated metabolic risk was defined by cardiovascular risk factor clustering (≥2 abnormal risk factors or insulin resistance (upper quartile of homeostasis model of insulin resistance). Carotid ultrasound measurements were obtained and mean IMT was calculated. General linear models compared IMT between elevated versus normal metabolic risk groups, adjusting for sex, age, race/ethnicity, and either BMI or WC category.


RESULTS
Adults were 24-43 years of age (n = 991) and 41% had elevated metabolic risk (42% male, 28% African American, 38% obese). IMT (mm) was greater in adults with elevated metabolic risk (0.83 ± 0.007) versus normal risk (0.80 ± 0.006) whether adjusted by BMI or WC (both P < 0.0005). IMT was greater in adults with elevated compared to normal metabolic risk within normal-weight (0.84 ± 0.016 vs. 0.79 ± 0.008; P = 0.002), and obese adults (0.86 ± 0.009 vs. 0.80 ± 0.01; P = 0.03), but not significantly different between risk groups in overweight adults. Similar results were found when stratified by WC category.


CONCLUSIONS
Adults with elevated metabolic risk have greater IMT than those with normal risk in normal-weight, overweight, low WC, and high WC, but not significant for overweight or moderate WC categories.
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
Sarah M
SM
Camhi
Peter T
PT
Katzmarzyk
Stephanie T
ST
Broyles
Sathanur R
SR
Srinivasan
Wei
W
Chen
Claude
C
Bouchard
Gerald S
GS
Berenson
D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D012306:Risk; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D014463:Ultrasonography / Q000379:methods; D055105:Waist Circumference