Endocrine Abstracts (2009) 20 P485

Carotid IMT values are related to insulin resistance and visceral disposition of adiposity in obese patients

Anca Sirbu1,2, Horia Nicolae1,2, Tudor Arbanas1,2, Serban Gologan1,2, Carmen Barbu1,2, Aura Reghina1,2, Claudia Lenghen2 & Simona Fica1,2

1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 2Elias University Hospital, Bucharest, Romania.

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.

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