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Body Composition and Common Carotid Artery Remodeling in a Healthy Population

Department of Internal Medicine (M.K., C.P.), University of Pisa, 56126 Pisa, Italy; Department of Technosciences for Medical Application and Research (M.P.), Consiglio Nazionale delle Ricerche Institute of Clinical Physiology, 56124 Pisa, Italy; Division of Endocrinology and Metabolism (C.-H.A.), Department of Internal Medicine III, Medical University of Vienna, A-1090 Vienna, Austria; Institute fur Stoffwechselforschung (T.K.), D-60327 Frankfurt, Germany; St. James’s Hospital (M.-P.C.), Dublin, 8 Ireland; The Medical Research Laboratories (A.F.), Clinical Institute and Medical Department M (Diabetes and Endocrinology), Aarhus University Hospital, DK-8000 Aarhus, Denmark; and Institute for Research in Extramural Medicine Institute (J.D.), Vrije University, 1081 BT Amsterdam, The Netherlands

Address all correspondence and requests for reprints to: Michaela Kozakova, M.D., Ph.D., Department of Internal Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy. E-mail: m.kozakova{at}int.med.unipi.it.

Context: An independent association between obesity and preclinical carotid atherosclerosis has been demonstrated, however, the pathophysiological links were not clearly established. Body composition (BC) influences systemic hemodynamics and may participate in the remodeling of common carotid artery (CCA), independently of risk factors.

Objective: This study evaluated the association between CCA structure and BC in a large population of healthy subjects.

Design: This was a cross-sectional study.

Settings: The study was conducted at 19 European centers.

Subjects: The study included 627 healthy subjects (252 men, age 30–60 yr, body mass index 17–40 kg/m²).

Main Outcome Measures: CCA luminal diameter and intima-media thickness were measured on digitized ultrasound images. Acoustic properties of CCA wall were evaluated by digital densitometric analysis and described in terms of mean gray level. BC was assessed by electrical bioimpedance. Insulin sensitivity (euglycemic hyperinsulinemic clamp) and plasma adiponectin levels were measured. Associations between CCA structure, age, BC, and metabolic and atherosclerotic risk factors were analyzed by multivariate regression models.

Results: Independent factors affecting CCA diameter were fat-free mass and waist girth (standardized r = 0.44 and 0.12; P < 0.01 and < 0.0001; R² = 0.35); independent correlates of intima-media thickness were age, CCA diameter, systolic blood pressure, and low-density lipoprotein-cholesterol (standardized r = 0.39, 0.25, 0.10, and 0.14; P < 0.005–0.0001; R² = 0.40). The mean gray level of carotid wall was independently associated with age and waist girth (standardized r = 0.23 and 0.12; P < 0.0001 and = 0.001; R² = 0.30).

Conclusions: Findings of this cross-sectional study suggest that BC modulates CCA diameter, and may induce adaptive changes in carotid wall thickness, independently of metabolic and atherosclerotic factors. Central adiposity modifies the acoustic properties of carotid wall.

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