title: Subclinical atherosclerosis and obesity phenotypes among Mexican Americans.
abstract: BACKGROUND
  Data on the influence of obesity on atherosclerosis in Hispanics are inconsistent, possibly related to varying cardiometabolic risk among obese individuals. We aimed to determine the association of obesity and cardiometabolic risk with subclinical atherosclerosis in Mexican-Americans.
  
  
  RESULTS
  Participants (n=503) were drawn from the Cameron County Hispanic Cohort. Metabolic health was defined as <2 of the following: blood pressure ≥130/85; triglyceride ≥150 mg/dL; high-density lipoprotein cholesterol <40 mg/dL (men) or <50 mg/dL (women); fasting glucose ≥100 mg/dL; homeostasis model assessment of insulin resistance value >5.13; or high-sensitivity C-reactive protein >3 mg/L. Carotid intima media thickness (cIMT) was measured. A high proportion of participants (77.8%) were metabolically unhealthy; they were more likely to be male, older, with fewer years of education, and less likely to meet daily recommendations regarding fruit and vegetable servings. One-third (31.8%) had abnormal carotid ultrasound findings. After adjusting for covariates, mean cIMT varied across the obesity phenotypes (P=0.0001); there was no difference among the metabolically unhealthy regardless of whether they were obese or not. In multivariable analysis, after adjusting for covariates, cardiometabolic risk (P=0.0159), but not obesity (P=0.1446), was significantly associated with subclinical atherosclerosis.
  
  
  CONCLUSIONS
  In Mexican-Americans, cardiometabolic risk has a greater effect on early atherosclerosis development than body mass index. Non-obese but metabolically unhealthy participants had similar development of subclinical atherosclerosis as their obese counterparts. Interventions to maintain metabolic health among obese and non-obese patients may be a more important goal than weight loss alone.
authors: Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center-Houston, Houston, TX (S.T.L., B.S., D.D.M.P.).
authors: Susan T
authors: ST
authors: Laing
authors: Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center-Houston, Houston, TX (S.T.L., B.S., D.D.M.P.).
authors: Beverly
authors: B
authors: Smulevitz
authors: Division of Epidemiology, School of Public Health, University of Texas Health Science Center-Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.).
authors: Kristina P
authors: KP
authors: Vatcheva
authors: Division of Clinical and Translational Sciences, Department of Internal Medicine, University of Texas Health Science Center-Houston, Houston, TX (M.H.R.).
authors: Mohammad H
authors: MH
authors: Rahbar
authors: Division of Epidemiology, School of Public Health, University of Texas Health Science Center-Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.).
authors: Belinda
authors: B
authors: Reininger
authors: Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center-Houston, Houston, TX (S.T.L., B.S., D.D.M.P.).
authors: David D
authors: DD
authors: McPherson
authors: Division of Epidemiology, School of Public Health, University of Texas Health Science Center-Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.).
authors: Joseph B
authors: JB
authors: McCormick
authors: Division of Epidemiology, School of Public Health, University of Texas Health Science Center-Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.).
authors: Susan P
authors: SP
authors: Fisher-Hoch
mesh_terms: D000328:Adult; D000367:Age Factors; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D004522:Educational Status; D005260:Female; D006801:Humans; D008019:Life Style / Q000208:ethnology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D017058:Mexican Americans; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D010641:Phenotype; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D013781:Texas / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: atherosclerosis; carotid intima‐media thickness; obesity; population; risk factors