Influence of Obesity and Metabolic Disease on Carotid Atherosclerosis in Patients with Coronary Artery Disease (CordioPrev Study)

Eva Talavera-Garcia, Javier Delgado-Lista, Antonio Garcia-Rios, Nieves Delgado-Casado, Purificacion Gomez-Luna, Angela Gomez-Garduño, Francisco Gomez-Delgado, Juan F Alcala-Diaz, Elena Yubero-Serrano, Carmen Marin, Ana I Perez-Caballero, Francisco J Fuentes-Jimenez, Antonio Camargo, Fernando Rodriguez-Cantalejo, Francisco J Tinahones, Jose M Ordovas, Francisco Perez-Jimenez, Pablo Perez-Martinez, Jose Lopez-Miranda, Eva Talavera-Garcia, Javier Delgado-Lista, Antonio Garcia-Rios, Nieves Delgado-Casado, Purificacion Gomez-Luna, Angela Gomez-Garduño, Francisco Gomez-Delgado, Juan F Alcala-Diaz, Elena Yubero-Serrano, Carmen Marin, Ana I Perez-Caballero, Francisco J Fuentes-Jimenez, Antonio Camargo, Fernando Rodriguez-Cantalejo, Francisco J Tinahones, Jose M Ordovas, Francisco Perez-Jimenez, Pablo Perez-Martinez, Jose Lopez-Miranda

Abstract

Background: Recent data suggest that the presence of associated metabolic abnormalities may be important modifiers of the association of obesity with a poorer prognosis in coronary heart disease. We determined the influence of isolated overweight and obesity on carotid intima media thickness (IMT-CC), and also assessed whether this influence was determined by the presence of metabolic abnormalities.

Methods: 1002 participants from the CordioPrev study were studied at entry. We determined their metabolic phenotypes and performed carotid ultrasound assessment. We evaluated the influence of obesity, overweight and metabolic phenotypes on the IMT-CC.

Results: Metabolically sick participants (defined by the presence of two or more metabolic abnormalities) showed a greater IMT-CC than metabolically healthy individuals (p = 4 * 10(-6)). Overweight and normal weight patients who were metabolically healthy showed a lower IMT-CC than the metabolically abnormal groups (all p<0.05). When we evaluated only body weight (without considering metabolic phenotypes), overweight or obese patients did not differ significantly from normal-weight patients in their IMT-CC (p = 0.077). However, obesity was a determinant of IMT-CC when compared to the composite group of normal weight and overweight patients (all not obese).

Conclusions: In coronary patients, a metabolically abnormal phenotype is associated with a greater IMT-CC, and may be linked to a higher risk of suffering new cardiovascular events. The protection conferred in the IMT-CC by the absence of metabolic abnormality may be blunted by the presence of obesity.

Trial registration: ClinicalTrials.gov NCT00924937.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Influence of weight and metabolic…
Fig 1. Influence of weight and metabolic disease on IMT-CC of coronary patients in the CordioPrev study.
All data are Mean +/- SEM (mm). Panel A: IMT-CC of patients with and without metabolic disease (adjusted by age and gender). *p 1.7+10−6. Panel B: Influence of weight in three categories (normal, overweight and obese). Panel C: Influence of weight in two categories (not obese versus obese).** p 0.016.
Fig 2. Influence of metabolic phenotypes on…
Fig 2. Influence of metabolic phenotypes on IMT-CC of coronary patients in the CordioPrev study.
All data are Mean +/- SEM (mm). Columns which do not share at least one letter are different at p

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