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Effects of Obesity, Body Composition, and Adiponectin on Carotid Intima-Media Thickness in Healthy Women

Program in Nutritional Metabolism (J.L., S.E.D., J.R.K., S.K.G.), Massachusetts General Hospital, and Boston Heart Foundation (L.C.H., J.M.C., R.S.L.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114

Address all correspondence and requests for reprints to: Steven K. Grinspoon, M.D., Program in Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit Street, LON207, Boston, Massachusetts 02114. E-mail: sgrinspoon{at}partners.org.

Context: Increased common carotid intima-media thickness (IMT) is predictive of coronary artery disease and stroke.

Objective: In this study, we investigated common carotid IMT by obesity category in a cohort of healthy women without previously known cardiovascular disease.

Design, Setting, Participants, and Main Outcome Measures: One hundred healthy women (aged 24–59 yr) from the general community enrolled in an observational study conducted at an academic medical center participated in the study. B-mode ultrasound imaging of the common carotid arteries was used to measure common carotid IMT in 99 subjects. Fat distribution was determined by computed tomography. Hormonal and inflammatory parameters related to cardiovascular disease and obesity were measured.

Results: IMT was higher in obese [body mass index (BMI) 30 kg/m²], compared with overweight women (BMI 25 and < 30 kg/m²) [0.69 mm, interquartile range (IQR) 0.60–0.75 mm] vs. 0.62 mm [IQR 0.56–0.68 mm), P = 0.044] and in comparison with lean women (BMI < 25 kg/m²) [0.69 mm (IQR 0.60–0.75 mm) vs. 0.59 mm (IQR 0.54–0.67 mm), P = 0.016]. In multivariate modeling, age (beta = 0.0050 mm change in IMT per year of age, P = 0.003), smoking (beta = 0.0044 mm change in IMT per pack-year, P = 0.046), and sc abdominal adiposity (beta = 0.00026 mm change in IMT per square centimeter, P = 0.010) were positively associated with IMT, whereas adiponectin (beta = –0.0042 mm change in IMT per milligram per liter, P = 0.045) was negatively associated with IMT. Visceral adiposity (beta = 0.00048 mm change in IMT per square centimeter, P = 0.092) was not significantly associated with IMT after adjusting for age, race, smoking, sc abdominal adiposity, and adiponectin.

Conclusions: Obesity is associated with increased common carotid IMT in young and middle-aged women. Adiponectin and sc abdominal adiposity are associated with carotid IMT in this population.

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