The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors.

Cardiovasc Diabetol 2018 03 29;17(1):46. Epub 2018 Mar 29.

Anatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.

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: A total of 390 carotid plaques from symptomatic and asymptomatic patients submitted to endarterectomy, for whom complete clinical and laboratory assessment of major cardiovascular risk factors was available, were studied by histology. Patients with a BMI ≥ 30.0 kg/m 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.

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12933-018-0685-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874994PMC
March 2018
10 Reads

Publication Analysis

Top Keywords

carotid plaque
12
role obesity
8
cardiovascular risk
8
interaction age
8
age gender
8
carotid plaques
8
risk factors
8
carotid
5
factorsmethods total
4
cerebrovascular risk
4
major cerebrovascular
4
risk factorsmethods
4
390 carotid
4
patients submitted
4
submitted endarterectomy
4
endarterectomy complete
4
asymptomatic patients
4
symptomatic asymptomatic
4
gender major
4
plaques symptomatic
4

References

(Supplied by CrossRef)

SM Grundy et al.
Circulation 2005

CJ Lavie et al.
J Am Coll Cardiol 2009

FB Ortega et al.
Circ Res 2016

T Pischon et al.
N Engl J Med 2008

TR Wessel et al.
JAMA 2004

S Yusuf et al.
Lancet 2005

A Romero-Corral et al.
Lancet 2006

O Angeras et al.
Eur Heart J 2013

A Oreopoulos et al.
Am Heart J 2008

SV Brodsky et al.
Cardiovasc Pathol 2016

T Kurth et al.
Circulation 2005

Similar Publications