Higher waist-to-hip ratio (IRR 1.22; 95% CI 1.12-1.33) and android-to-gynoid fat ratio were associated with increased carotid plaque burden, whereas excess body weight itself was not.
Cohort (n=3,527)
Does adipose tissue distribution associate with increased carotid plaque burden in unselected adults?
Adipose tissue distribution, rather than excess body weight itself, plays a key role in the burden of carotid atherosclerotic plaques beyond known risk factors.
IRR: 1.22 (95% CI 1.12–1.33)
Abstract Abstract Carotid atherosclerotic plaques reflect systemic atherosclerotic burden and predict future cardiovascular events. However, data on segment-specific plaque distribution and clinical determinants of plaque burden in unselected adults are still limited. Purpose To characterise the distribution of carotid plaques across arterial segments and age groups, and to identify age and sex adjusted risk factors for the number of carotid artery segments with atherosclerotic plaques in a population. Methods We analysed 3527 adults (age 20–80 years; 55.7% women) from the Bialystok PLUS (Poland) study who underwent bilateral ultrasound of the common carotid artery (CCA), bifurcation, internal (ICA) and external carotid (ECA) segments. Plaque presence was assessed in 8 locations and plaque burden was defined as the number of segments with plaque (0–8). Hypertension, hypercholesterolemia and diabetes were defined based on self-reported history in a structured interview and/or identification during the study visit. Baseline risk profile included anthropometry (BMI, waist-to-hip ratio WHR, android-to-gynoid fat ratio), HDL cholesterol, NT-proBNP, high-sensitivity troponin T, uric acid, lipoprotein(a), vitamin D, smoking status (ever/current). Negative binomial regression with log link was used to model carotid artery segments with plaque count. First, a base model with age and sex was fitted. Then, each risk factor was entered separately into age and sex adjusted models. Incidence rate ratios (IRR) and 95% CI were reported, with false discovery rate control. Results Mean age was 49.2±15.3 years. Overall, 40.0% of participants had at least one plaque in one segment; 14.3% had 1, 14.9% had 2 and 10.8% had ≥3segments with plaque. Plaques occurred predominantly at the bifurcation, especially in older adults (65–69% prevalence in age 60–80 years vs 25% in age 40–59 and 5% in age 20–39). In the base model, plaque count increased with age (IRR per 10 years 2.28; 95% CI 2.18–2.39; p0.001), while women had fewer plaques than men (IRR 0.64; 95% CI 0.57–0.71; p0.001). In age and sex adjusted analyses, current smoking (IRR 1.60; 95% CI 1.37–1.87), ever smoking (1.42; 1.26–1.60), hypercholesterolemia (1.54; 1.34–1.76), hypertension (1.27; 1.12–1.44), higher WHR (1.22; 1.12–1.33 per 1 SD) and a higher android-to-gynoid fat ratio (1.13; 1.04–1.22 per 1 SD) were associated with a higher plaque count. Higher HDL cholesterol (IRR 0.90; 0.83–0.97 per 1 SD) and vitamin D (0.92; 0.87–0.97 per 1 SD) showed inverse associations. Lipoprotein(a) showed a borderline positive association with plaque burden, whereas diabetes, BMI, NT-proBNP, troponin T, uric acid and overweight were not significantly associated after multiple-testing correction. Conclusions This findings suggest that it is not excess body weight itself, but rather the distribution of adipose tissue, that plays a key role in the burden of atherosclerotic plaques in the carotid arteries, beyond known risk factors.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
Chlabicz et al. (Mon,) conducted a cohort in Carotid plaque burden (n=3,527). Adipose tissue distribution (waist-to-hip ratio and android-to-gynoid fat ratio) was evaluated on Number of carotid artery segments with atherosclerotic plaques (IRR 1.22, 95% CI 1.12-1.33). Higher waist-to-hip ratio (IRR 1.22; 95% CI 1.12-1.33) and android-to-gynoid fat ratio were associated with increased carotid plaque burden, whereas excess body weight itself was not.