Independent Relevance of Different Measures of Adiposity for Carotid Intima‐Media Thickness in 40 000 Adults in UK Biobank

体质指数 腰围 医学 四分位间距 混淆 内膜中层厚度 腰高比 内科学 质量指数 肥胖 内分泌学 人口学 颈动脉 社会学
作者
Preyanka Pillay,Jennifer L. Carter,Hannah Taylor,Sarah Lewington,Robert Clarke
出处
期刊:Journal of the American Heart Association [Wiley]
卷期号:12 (2) 被引量:3
标识
DOI:10.1161/jaha.122.026694
摘要

Background Uncertainty persists about carotid intima–media thickness (CIMT) as a marker of subclinical atherosclerosis and the independent relevance of different measures of adiposity for CIMT. We assessed the independent relevance of general adiposity (body mass index), central adiposity (waist circumference), and body composition (fat mass index and fat‐free mass index) with CIMT among adults in the United Kingdom. Methods and Results Multivariable linear regression of cross‐sectional analyses of UK Biobank assessed the mean percentage difference in CIMT associated with equivalent differences in adiposity measures. To assess independent associations, body mass index and waist circumference were mutually adjusted, as were fat mass index and fat‐free mass index. Among 39 367 participants (mean [SD] age 64 [8] years, 52% female, 97% White), median (interquartile range) CIMT was 0.65 (0.14) mm in women and 0.69 (0.18) mm in men. All adiposity measures were linearly and positively associated with CIMT after adjusting for confounders. Fat‐free mass index was most strongly associated with CIMT after adjustment for fat mass index (% difference in CIMT: 1.23 [95% CI 0.93–1.53] women; 3.44 [3.01–3.86] men), while associations of fat mass index were attenuated after adjustment for fat‐free mass index (0.28 [−0.02, 0.58] women; −0.59 [−0.99, −0.18] men). After mutual adjustment, body mass index remained positively associated with CIMT, but waist circumference was completely attenuated. Conclusions Fat‐free mass index was the adiposity measure most strongly associated with CIMT, suggesting that CIMT may reflect vascular compensatory remodeling rather than atherosclerosis. Hence, screening for subclinical atherosclerosis should evaluate carotid plaques in addition to CIMT.
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