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Relation of body mass index with carotid intima-media thickness and diameter is independent of metabolic syndrome in postmenopausal Mediterranean women

Gentile, Marco PhD1; Iannuzzi, Arcangelo MD2; Iannuzzo, Gabriella MD1; Covetti, Giuseppe MD2; Panico, Salvatore MD1; Mattiello, Amalia MD1; De Michele, Mario MD, FESC, FAHA3; Rubba, Paolo MD1

doi: 10.1097/gme.0b013e31825ad66c
Original Articles

Objective The aim of this study was to evaluate whether overweight and obesity are associated with arterial abnormalities in postmenopausal women and the contribution of the metabolic syndrome.

Methods A total of 390 postmenopausal women (mean age, 63.1 ± 7.7 y) living in the metropolitan area of Naples, Southern Italy, and participating in a population-based cohort study (Progetto Atena) were offered an ultrasound examination of the carotid arteries; 370 women accepted. Blood pressure, serum high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting glucose, insulin, apolipoprotein B, and high-sensitivity C-reactive protein were measured in all participants.

Results Women in the second and third tertiles of body mass index showed a greater common carotid intima-media thickness compared with those in the first tertile (tertile II vs I, odds ratio, 2.15; P = 0.013; tertile III vs I, odds ratio, 2.24; P = 0.018), adjusted for age and metabolic syndrome. Obese and overweight postmenopausal women showed greater common carotid lumen diameters as compared with lean postmenopausal women (mean ± SD, 6.36 ± 0.86, 6.16 ± 0.65, and 5.96 ± 0.59 mm, respectively; P < 0.001 [obese vs lean] and P = 0.04 [overweight vs lean]); no statistical difference in carotid lumen diameter was found between obese and overweight postmenopausal women. The statistical significance between obese and lean postmenopausal women was retained even after adding the components of the metabolic syndrome as covariates.

Conclusions These findings indicate an association between overweight, obesity, and preclinical carotid artery abnormalities, independently of the metabolic syndrome, in a population of postmenopausal women.

From the 1Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy; 2Division of Internal Medicine 5, A. Cardarelli Hospital, Naples, Italy; and 3Division of Cardiology, Moscati Hospital, Aversa, Italy.

Received October 18, 2011; revised and accepted February 14, 2012.

Funding/support: The Progetto Atena study was supported by funds from (1) Consiglio Nazionale delle Ricerche (Rome, Italy), “Progetto finalizzato Biotecnologie” and “Progetto finalizzato FATMA”; (2) Ministero dell’Università e della Ricerca Scientifica e Tecnologica-MURST 1998, grant no. 9806174392-008; and (3) Fondazione Banco di Napoli.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Mario De Michele, MD, FESC, FAHA, Via De Amicis 50, 80145 Naples, Italy. E-mail:

©2012The North American Menopause Society