title: The influence of obesity on the assessment of carotid intima-media thickness.
abstract: BACKGROUND
  The assessment of carotid intima-media thickness (CIMT) may improve cardiovascular risk prediction. The optimal protocol for CIMT measurement is unclear. CIMT may be measured in the common carotid artery (CCA), carotid bifurcation (CB), and internal carotid artery (ICA), but measurements from CB and ICA are more difficult to obtain. We studied the influence of body mass index (BMI) and atheroma plaques on the capacity to obtain CIMT measurements at different carotid sites.
  
  
  METHODS
  Using an automatic system, CIMT was measured in 700 subjects aged 45-75, in the near and far walls of CCA, CB, and ICA bilaterally. The presence of atheroma plaques, BMI and vascular risk factors were recorded.
  
  
  RESULTS
  CIMT measurements in CCA were possible in all except one subject. It was not possible to obtain CIMT measurements at CB or ICA in 24.1% of normal weight and 58.8% of obese subjects. The likelihood of obtaining CIMT measurement at all carotid sites decreased as the BMI increased. Atheroma plaques in a carotid segment did not preclude CIMT measurement at this site.
  
  
  CONCLUSIONS
  CIMT measurements in distal carotid segments are more challenging in obese subjects. Measuring CIMT at CCA remains feasible in obese subjects and should be the primary endpoint in these subjects. Nevertheless, CB and ICA measurements, when feasible, would improve risk classification.
authors.affiliation: Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Gállego Pérez-Larraya
authors.forename: Pablo
authors.initials: P
authors.lastname: Irimia
authors.forename: Eduardo
authors.initials: E
authors.lastname: Martínez-Vila
authors.forename: Joaquín
authors.initials: J
authors.lastname: Barba
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Guembe
authors.forename: Nerea
authors.initials: N
authors.lastname: Varo
authors.forename: José María
authors.initials: JM
authors.lastname: Castellano
authors.forename: José Javier
authors.initials: JJ
authors.lastname: Viñes
authors.forename: Javier
authors.initials: J
authors.lastname: Díez
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000473:pathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*