title: Association between carotid intima-media thickness and index of central fat distribution in middle-aged and elderly Chinese.
abstract: BACKGROUND
  Evidence has demonstrated that central fat distribution produces the most profound metabolic abnormalities and is associated with an increased risk of atherosclerotic cardiovascular diseases. We aimed to investigate whether the indexes of central fat distribution, including waist-to-height ratio (WHtR) and visceral fat area (VFA), were stronger risk factors of subclinical atherosclerosis than body mass index (BMI) in Chinese adults.
  
  
  METHODS
  A total of 3381 participants aged 40 years or older without history of cardiovascular diseases (CVD) were enrolled in the present cross-sectional study from the Songnan community, Shanghai, China. Height, weight and waist circumference (WC) were measured by experienced physicians. High-resolution B-mode ultrasonography was performed to measure carotid intima-media thickness (CIMT). Regional adiposity was measured by a dual-source computed tomography (CT) scanner.
  
  
  RESULTS
  Normal weight but central obesity group (BMI < 23 kg/m2 and WHtR > 0.5) had higher levels of systolic blood pressure (SBP), fasting plasma glucose (FPG), 2 h post-load glucose (2 h PG), Hemoglobin A1c (HbA1c), and CIMT, as well as an elevated prevalence of hypertension and diabetes compared with overweight/obesity but not central obesity group (BMI ≥ 23 kg/m2 and WHtR ≤ 0.5). In logistic regression analysis, WHtR > 0.5 was significantly and independently associated with elevated CIMT (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.01-1.68, p value = 0.044). Similar association was noted for each standard deviation (SD) increase of WHtR (OR 1.25, 95% CI 1.07-1.47, p value = 0.006). Stepwise multiple linear regression analysis revealed that both WHtR and VFA were important determinants of CIMT, independent of other well-recognized risk factors (both p values < 0.01).
  
  
  CONCLUSIONS
  WHtR and VFA were associated with CIMT, independent of BMI and conventional CVD risk factors. Given the relatively high cost and complexness of VFA measurement, WHtR could be a more convenient and appropriate measure of abdominal obesity in clinical practice.
authors.forename: Chenxi
authors.initials: C
authors.lastname: Ren
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Yu
authors.initials: Y
authors.lastname: Xu
authors.forename: Baihui
authors.initials: B
authors.lastname: Xu
authors.forename: Wanwan
authors.initials: W
authors.lastname: Sun
authors.forename: Jichao
authors.initials: J
authors.lastname: Sun
authors.forename: Tiange
authors.initials: T
authors.lastname: Wang
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.forename: Jieli
authors.initials: J
authors.lastname: Lu
authors.forename: Weiqing
authors.initials: W
authors.lastname: Wang
authors.forename: Yufang
authors.initials: Y
authors.lastname: Bi
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology*