Obesity independently increased the risk of carotid plaque destabilization compared to non-obese patients (OR 2.58), with the highest risk observed in males aged under 70 years.
Cross-Sectional (n=390)
No
Does obesity increase the risk of carotid plaque instability in patients with carotid disease?
Obesity is an independent risk factor for histologic carotid plaque destabilization, particularly in younger males and those with metabolic syndrome, challenging the concept of an 'obesity paradox' in cerebrovascular disease.
Effect estimate: OR 2.58 (95% CI 1.08-6.19)
p-value: p=0.03
BACKGROUND: In the last decade, several studies have reported an unexpected and seemingly paradoxical inverse correlation between BMI and incidence of cardiovascular diseases. This so called "obesity paradox effect" has been mainly investigated through imaging methods instead of histologic evaluation, which is still the best method to study the instability of carotid plaque. Therefore, the purpose of our study was to evaluate by histology the role of obesity in destabilization of carotid plaques and the interaction with age, gender and other major cerebrovascular risk factors. METHODS: were considered as obese. Data were analyzed by multivariate logistic regression and for each variable in the equation the estimated odds ratio (OR) was calculated. RESULTS: Unstable carotid plaque OR for obese patients with age < 70 years was 5.91 (95% CI 1.17-29.80), thus being the highest OR compared to that of other risk factors. Unstable carotid plaque OR decreased to 4.61 (95% CI 0.54-39.19) in males ≥ 70 years, being only 0.93 (95% CI 0.25-3.52) among women. When obesity featured among metabolic syndrome risk factors, the OR for plaque destabilization was 3.97 (95% CI 1.81-6.22), a significantly higher value compared to OR in non-obese individuals with metabolic syndrome (OR = 1.48; 95% CI 0.86-2.31). Similar results were obtained when assessing the occurrence of acute cerebrovascular symptoms. CONCLUSIONS: Results from our study appear to do not confirm any paradoxical effect of obesity on the carotid artery district. Conversely, obesity is confirmed to be an independent risk factor for carotid plaque destabilization, particularly in males aged < 70 years, significantly increasing such risk among patients with metabolic syndrome.
Rovella et al. (Thu,) conducted a cross-sectional in Carotid atherosclerosis (n=390). Obesity (BMI ≥ 30.0 kg/m2) vs. Non-obese (BMI < 30.0 kg/m2) was evaluated on Unstable carotid plaque (histological evaluation) (OR 2.58, 95% CI 1.08-6.19, p=0.03). Obesity independently increased the risk of carotid plaque destabilization compared to non-obese patients (OR 2.58), with the highest risk observed in males aged under 70 years.