Objective The association between obesity and atherosclerotic disease is controversial. We examined whether common carotid intima-media thickness (IMT), a precursor to preclinical atherosclerosis, was associated with total body fatness or the accumulation of fat mass in the abdominal region in middle-aged and older persons.
Methods Participants were consecutively enrolled from patients aged ≥50 years, and were 623 men aged 73±10 (mean±standard deviation) years and 835 women aged 76±10 years. Demographic data were collected and maximal preperitoneal fat thickness (PFT_max) and carotid intima-media thickness (IMT) were evaluated on B-mode ultrasonography. Subjects were divided into 3 groups on the basis of body mass index (BMI), a marker of general obesity.
Results It was shown by multiple regression analysis for IMT that age, smoking status, hypertension and uric acid were significantly associated with IMT in subjects in the lowest BMI group (<20 kg/m²), and age, hypertension, dyslipidemia and uric acid in middle BMI group (20-22.9 kg/m²). Moreover, man sex, age, BMI, PFT_max, smoking status, hypertension and uric acid were significantly associated with IMT in subjects with highest BMI group (≥23 kg/m²). Analysis of covariance showed that interaction between BMI and visceral obesity (f=7.202, p=0.007) was significantly associated with IMT, in addition to age, visceral obesity, smoking status, hypertension, dyslipidemia and uric acid.
Conclusion The present study indicates a graded and independent association between general and visceral obesity and preclinical carotid artery changes in patients aged ≥50 years with a BMI ≥23 kg/m².