Department of Cardiology, Sahlgrenska University Hospital, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
J Intern Med. 2014 May;275(5):534-43. doi: 10.1111/joim.12171. Epub 2014 Apr 7.
Obesity is known to be associated with carotid artery remodelling, but less is known about how body fat distribution, inflammation and weight loss may affect this relation.
Ultrasonography, dual-energy X-ray absorptiometry and computed tomography were performed to evaluate carotid artery intima-media thickness (IMT), body composition and fat distribution, respectively. Participants were divided into three matched study groups (n = 44 per group): obese patients with sustained weight loss 10 years after bariatric surgery [surgery group, body mass index (BMI) 31.5 kg m(-2)]; obese patients who maintained stable weight during the same time period (obese group, BMI 42.5 kg m(-2)); and normal weight subjects (lean group, BMI 24.4 kg m(-2)).
Patients in the surgery group, compared with those in the obese group, had slightly lower common carotid artery (CCA) IMT (0.75 ± 0.18 vs. 0.78 ± 0.17 mm) and common carotid bulb (CCB) IMT (0.92 ± 0.32 vs. 0.97 ± 0.32 mm); however, these differences were not statistically significant. Lean individuals, compared with those in the surgery group, had significantly lower CCA and CCB IMT values (P < 0.001). In forward stepwise multiple regression analyses including all subjects (n = 132), CCA IMT was predicted mainly by visceral adipose tissue, but was also related to blood pressure and levels of triglycerides and high-sensitivity C-reactive protein. Carotid lumen diameter was primarily influenced by lean body mass.
Visceral adiposity was the main determinant of premature carotid artery atherosclerosis, possibly through elevated blood pressure, dyslipidaemia and inflammation. Lean body mass predicted carotid artery lumen diameter. Obese patients with long-term sustained weight loss did not have thinner carotid artery walls compared with their weight-stable obese counterparts.
已知肥胖与颈动脉重塑有关，但对于体脂分布、炎症和体重减轻如何影响这种关系知之甚少。
超声、双能 X 射线吸收法和计算机断层扫描分别用于评估颈动脉内膜中层厚度（IMT）、身体成分和脂肪分布。将参与者分为三组进行匹配研究（每组 44 人）：肥胖患者，10 年前接受减肥手术后体重持续减轻[手术组，体重指数（BMI）为 31.5 kg/m2]；在同一时期保持稳定体重的肥胖患者（肥胖组，BMI 为 42.5 kg/m2）；和正常体重受试者（瘦组，BMI 为 24.4 kg/m2）。
与肥胖组相比，手术组患者的颈总动脉（CCA）IMT（0.75±0.18 毫米比 0.78±0.17 毫米）和颈总动脉球部（CCB）IMT（0.92±0.32 毫米比 0.97±0.32 毫米）略低，但这些差异无统计学意义。与手术组相比，瘦组的 CCA 和 CCB IMT 值明显较低（P<0.001）。在包括所有受试者（n=132）的向前逐步多元回归分析中，CCA IMT 主要由内脏脂肪组织预测，但也与血压、甘油三酯和高敏 C 反应蛋白水平有关。颈动脉管腔直径主要受瘦体重影响。
内脏肥胖是颈动脉粥样硬化早期发生的主要决定因素，可能通过升高血压、血脂异常和炎症来实现。瘦体重预测颈动脉管腔直径。与体重稳定的肥胖患者相比，长期持续减肥的肥胖患者的颈动脉壁并没有变薄。
