An increased waist-to-hip ratio is a key determinant of atherosclerotic burden in overweight subjects
The association of overweight status and cardiovascular disease is not clear. In this study we aimed to investigate coronary atherosclerotic disease, evaluated as coronary artery calcium score (CACs), in overweight patients with or without abdominal obesity as defined by waist-to-hip ratio (WHR).
We enrolled 276 patients aged between 40 and 70 years, with a body mass index of 25–29.9 kg/m2 and at least one cardiovascular risk factor. Exclusion criteria were history of diabetes, cardiovascular or renal disease. Patients were stratified in high WHR (H-WHR) or low WHR (L-WHR) group according to WHR (≥ 0.85 for women and ≥ 0.90 for men) and underwent multi-detector computed tomography for CACs. Mean carotid intima-media thickness (IMT) and plaque presence were equally assessed.
CACs was higher in the H-WHR group compared to L-WHR (9.05 [0.0–83.48] vs 0.0 [0.0–64.7] AU, p < 0.01); the prevalence of CACs > 0 in the H-WHR group was significantly higher than subjects with L-WHR (59.6% vs 38.5%, p < 0.001). Moreover, H-WHR group had higher mean IMT (0.64 [0.56–0.72] vs 0.59 [0.55–0.67] mm, p < 0.05) and higher carotid plaque prevalence (63.7% vs 50.8%, p < 0.05) compared to subjects with L-WHR. Logistic regression showed that H-WHR was associated with presence of CACs and carotid plaque (p < 0.01). In a multiple linear regression, WHR was positively associated with CACs and IMT (p < 0.01).
H-WHR is a marker of coronary and peripheral atherosclerotic burden in overweight patients.
KeywordsCoronary artery calcium score WHR Cardiovascular risk assessment Overweight Intima-media thickness
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
DR declares having received honoraria from AMGEN, Sanofi, Novartis, Roche, Daiichi Sankyo, MSD. EB declares having received honoraria from AstraZeneca, AMGEN, Genfit, MSD, Sanofi and Regeneron, Unilever, Danone, Aegerion, Chiesi, Rottapharm-MEDA, Lilly, Ionis-pharmaceuticals. AG declares having received honoraria from AMGEN, Novartis, Unilever. The other authors have no conflicts of interest to disclose.
This study has been approved by the Ethics Committees of Pitié-Salpêtrière Hospital Group, in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
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