The aim of our study was to assess the relation between common carotid intima-media thickness, a marker of subclinical atherosclerosis and other metabolic risk factors, in a group of obese patients.
Patients and methods: Of 142 obese patients (47 male, 95 female, mean age 39.74±11.41 years, and mean BMI 46.88±8.85 kg/m2) were clinically and biologically evaluated. BMI and waist circumference were measured and a complete patient history regarding cardiovascular and metabolic disease was recorded. Biological tests included insulin resistance assessment (HOMA-IR). The degree of hepatic steatosis and liver right lobe diameter were measured by abdominal ultrasound, while common carotid intima-media thickness (IMT) was evaluated by Doppler ultrasound (UF 850XTD Tellus) and was expressed as the mean value of the bilateral measurements
Results: We found a significant correlation between IMT values and waist circumference, independent of BMI level (r=.307, P<0.001). IMT values were higher in previously known hypertensive (0.64±0.16 vs 0.53±0.13 cm, P<0.01) and in diabetic patients (0.66±0.13 vs 0.57±0.15 cm, P<0.05), despite non-significant differences in BMI level. In non-diabetic patients, IMT positively correlated with HOMA-IR (r=0.234, P< 0.05) and with liver right lobe diameter (r=0.299, P=0.01). Obese patients with severe steatosis (diagnosed by the ultrasonographic aspect bright liver- assessed by the same independent investigator) had higher mean IMT values compared to those with apparently normal structure or lesser degrees of steatosis (0.63±0.16 vs 0.55±0.14 cm, P<0.05).
Conclusions: High IMT values, a feature of subclinical atherosclerosis, correlate with markers of visceral obesity (waist circumference) and ectopic adiposity (right liver lobe diameter and steatosis). The positive relation between all these parameters and HOMA-IR suggest a possible common pathological pathway, with insulin resistance playing a central role.
25 - 29 Apr 2009
European Society of Endocrinology