Acta Diabetologica

, Volume 55, Issue 7, pp 741–749 | Cite as

An increased waist-to-hip ratio is a key determinant of atherosclerotic burden in overweight subjects

  • Roberto Scicali
  • David Rosenbaum
  • Antonino Di Pino
  • Philippe Giral
  • Philippe Cluzel
  • Alban Redheuil
  • Salvatore Piro
  • Agata Maria Rabuazzo
  • Francesco Purrello
  • Eric Bruckert
  • Antonio Gallo
Original Article



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.


Coronary 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.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.

Supplementary material

592_2018_1144_MOESM1_ESM.doc (56 kb)
Supplementary material 1 (DOC 56 kb)


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Roberto Scicali
    • 1
  • David Rosenbaum
    • 2
    • 3
  • Antonino Di Pino
    • 1
  • Philippe Giral
    • 2
    • 4
  • Philippe Cluzel
    • 3
    • 5
  • Alban Redheuil
    • 3
    • 5
  • Salvatore Piro
    • 1
  • Agata Maria Rabuazzo
    • 1
  • Francesco Purrello
    • 1
  • Eric Bruckert
    • 2
    • 4
  • Antonio Gallo
    • 2
    • 3
  1. 1.Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi HospitalUniversity of CataniaCataniaItaly
  2. 2.Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public AssistancePitié-Salpêtrière Hospital Group – Pierre et Marie Curie UniversityParisFrance
  3. 3.UPMC Univ Paris 06, INSERM 1146, - CNRS 7371, Laboratoire d’imagerie BiomédicaleSorbonne UniversitésParisFrance
  4. 4.Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC – Paris VI)ParisFrance
  5. 5.Département d’imagerie cardiovasculaire et de radiologie interventionnelle, Pôle Imagerie-Groupe Hospitalier Pitié-SalpêtrièreAssistance Publique-Hôpitaux de ParisParisFrance

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