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Association Between Body Size Phenotypes and Subclinical Atherosclerosis.

Authors
  • Rossello, Xavier1, 2, 3
  • Fuster, Valentin1, 4
  • Oliva, Belén1
  • Sanz, Javier1, 4
  • Fernández Friera, Leticia A1, 5, 6
  • López-Melgar, Beatriz1, 5, 6
  • Mendiguren, José María7
  • Lara-Pezzi, Enrique1
  • Bueno, Héctor1, 8, 9
  • Fernández-Ortiz, Antonio1, 10
  • Ibanez, Borja1, 2, 11
  • Ordovás, José María12, 13
  • 1 Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. , (Spain)
  • 2 CIBER de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain. , (Spain)
  • 3 Cardiology Department, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain. , (Spain)
  • 4 Icahn School of Medicine at Mount Sinai, New York, New York.
  • 5 Hospital Universitario HM Montepríncipe-CIEC, Madrid, Spain. , (Spain)
  • 6 Universidad CEU San Pablo, Madrid, Spain. , (Spain)
  • 7 Banco de Santander, Madrid, Spain. , (Spain)
  • 8 Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 deOctubre (imas12), Madrid, Spain. , (Spain)
  • 9 Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain. , (Spain)
  • 10 Hospital Clínico San Carlos, Universidad Complutense, IdISSC, Madrid, Spain. , (Spain)
  • 11 IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain. , (Spain)
  • 12 U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
  • 13 IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain. , (Spain)
Type
Published Article
Journal
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Publication Date
Dec 01, 2020
Volume
105
Issue
12
Identifiers
DOI: 10.1210/clinem/dgaa620
PMID: 32879953
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The underlying relationship between body mass index (BMI), cardiometabolic disorders, and subclinical atherosclerosis is poorly understood. To evaluate the association between body size phenotypes and subclinical atherosclerosis. Cross-sectional. Cardiovascular disease-free cohort. Middle-aged asymptomatic subjects (n = 3909). A total of 6 cardiometabolic body size phenotypes were defined based on the presence of at least 1 cardiometabolic abnormality (blood pressure, fasting blood glucose, triglycerides, low high-density lipoprotein cholesterol, homeostasis model assessment-insulin resistance index, high-sensitivity C-reactive protein) and based on BMI: normal-weight (NW; BMI <25), overweight (OW; BMI = 25.0-29.9) or obese (OB; BMI >30.0). Subclinical atherosclerosis was evaluated by 2D vascular ultrasonography and noncontrast cardiac computed tomography. For metabolically healthy subjects, the presence of subclinical atherosclerosis increased across BMI categories (49.6%, 58.0%, and 67.7% for NW, OW, and OB, respectively), whereas fewer differences were observed for metabolically unhealthy subjects (61.1%, 69.7%, and 70.5%, respectively). When BMI and cardiometabolic abnormalities were assessed separately, the association of body size phenotypes with the extent of subclinical atherosclerosis was mostly driven by the coexistence of cardiometabolic risk factors: adjusted OR = 1.04 (95% confidence interval [CI], 0.90-1.19) for OW and OR = 1.07 (95% CI, 0.88-1.30) for OB in comparison with NW, whereas there was an increasing association between the extent of subclinical atherosclerosis and the number of cardiometabolic abnormalities: adjusted OR = 1.21 (95% CI, 1.05-1.40), 1.60 (95% CI, 1.33-1.93), 1.92 (95% CI, 1.48-2.50), and 2.27 (95% CI, 1.67-3.09) for 1, 2, 3, and >3, respectively, in comparison with noncardiometabolic abnormalities. The prevalence of subclinical atherosclerosis varies across body size phenotypes. Pharmacologic and lifestyle interventions might modify their cardiovascular risk by facilitating the transition from one phenotype to another. © Endocrine Society 2020.

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