Yume Imahori1, Ellisiv B Mathiesen2, David A Leon3, Laila A Hopstock4, Alun D Hughes5, Stein Harald Johnsen2, Lone Jørgensen6, Nina Emaus4, Katy E Morgan7. 1. London School of Hygiene & Tropical Medicine, Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, UK. Electronic address: yume.imahori@lshtm.ac.uk. 2. UiT the Arctic University of Norway, Department of Clinical Medicine, Department of Neurology, University Hospital of North Norway, Norway. 3. London School of Hygiene & Tropical Medicine, Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, UK; UiT the Arctic University of Norway, Department of Community Medicine, Faculty of Health Sciences, Norway. 4. UiT the Arctic University of Norway, Department of Health and Care Sciences, Faculty of Health Sciences, Norway. 5. University College London, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, Faculty of Population Health Sciences, UK. 6. UiT the Arctic University of Norway, Department of Health and Care Sciences, Faculty of Health Sciences, Norway; UiT the Arctic University of Norway, Department of Clinical Therapeutic Services, University Hospital of North Norway, Tromsø, Norway. 7. London School of Hygiene & Tropical Medicine, Department of Medical Statistics, Faculty of Epidemiology and Population Health, UK.
Abstract
BACKGROUND AND AIMS: Few studies have investigated the association of different measures of adiposity with carotid plaque. We aimed to investigate and compare the associations of four measures of adiposity: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) with the presence of carotid plaque and total plaque area (TPA) in the right carotid artery. METHODS: We included 4906 individuals aged 31-88 years who participated in a population-based study with ultrasonography of the right carotid artery. Adiposity measures were converted to sex-specific SD units to allow comparison of effect sizes. TPA was log transformed due to its skewed distribution. Logistic and linear regression models were used respectively to investigate the association of each adiposity measure with the presence of plaque and with log-transformed TPA. Estimates were adjusted for potential confounders and mediators such as blood pressure and lipids. RESULTS: After adjustment for age, sex, smoking, and education level, there was strong evidence of an association between all adiposity measures and log-transformed TPA, whereas only WHR was weakly associated with presence of plaque. WHR showed the largest adjusted effect size for both log-transformed TPA (beta 0.055, 95%CI 0.028-0.081) and the presence of plaque (OR 1.07, 95%CI 1.01-1.15). Adjustment for mediators led to appreciable attenuation of observed effects. CONCLUSIONS: Adiposity is more consistently associated with extent of plaque burden than with whether an individual does or does not have any plaque. There was evidence that established biomarkers mediate much of this association. Abdominal adiposity appears to show the strongest effect.
BACKGROUND AND AIMS: Few studies have investigated the association of different measures of adiposity with carotid plaque. We aimed to investigate and compare the associations of four measures of adiposity: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) with the presence of carotid plaque and total plaque area (TPA) in the right carotid artery. METHODS: We included 4906 individuals aged 31-88 years who participated in a population-based study with ultrasonography of the right carotid artery. Adiposity measures were converted to sex-specific SD units to allow comparison of effect sizes. TPA was log transformed due to its skewed distribution. Logistic and linear regression models were used respectively to investigate the association of each adiposity measure with the presence of plaque and with log-transformed TPA. Estimates were adjusted for potential confounders and mediators such as blood pressure and lipids. RESULTS: After adjustment for age, sex, smoking, and education level, there was strong evidence of an association between all adiposity measures and log-transformed TPA, whereas only WHR was weakly associated with presence of plaque. WHR showed the largest adjusted effect size for both log-transformed TPA (beta 0.055, 95%CI 0.028-0.081) and the presence of plaque (OR 1.07, 95%CI 1.01-1.15). Adjustment for mediators led to appreciable attenuation of observed effects. CONCLUSIONS: Adiposity is more consistently associated with extent of plaque burden than with whether an individual does or does not have any plaque. There was evidence that established biomarkers mediate much of this association. Abdominal adiposity appears to show the strongest effect.
Authors: Yume Imahori; Chris Frost; Ellisiv B Mathiesen; Andrey Ryabikov; Alexander V Kudryavtsev; Sofia Malyutina; Michael Kornev; Alun D Hughes; Laila A Hopstock; David A Leon Journal: BMJ Open Date: 2020-05-06 Impact factor: 2.692
Authors: Yume Imahori; Ellisiv B Mathiesen; Katy E Morgan; Chris Frost; Alun D Hughes; Laila A Hopstock; Stein Harald Johnsen; Nina Emaus; David A Leon Journal: BMC Cardiovasc Disord Date: 2020-03-17 Impact factor: 2.298