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Influence of Obesity and Metabolic Disease on Carotid Atherosclerosis in Patients with Coronary Artery Disease (CordioPrev Study)
Authors:Eva Talavera-Garcia  Javier Delgado-Lista  Antonio Garcia-Rios  Nieves Delgado-Casado  Purificacion Gomez-Luna  Angela Gomez-Gardu?o  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:BackgroundRecent 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.Methods1002 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.ResultsMetabolically 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).ConclusionsIn 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
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