Burden of subclinical cardiovascular disease in "metabolically benign" and "at-risk" overweight and obese women: The Study of Women's Health Across the Nation (SWAN)

被引:79
作者
Khan, Unab I. [2 ]
Wang, Dan [1 ]
Thurston, Rebecca C. [3 ]
Sowers, MaryFran [4 ]
Sutton-Tyrrell, Kim
Matthews, Karen A. [3 ]
Barinas-Mitchell, Emma
Wildman, Rachel P. [1 ]
机构
[1] Albert Einstein Coll Med, Dept Epidemiol & Publ Hlth, Bronx, NY 10461 USA
[2] Albert Einstein Coll Med, Dept Pediat, Bronx, NY 10461 USA
[3] Univ Pittsburgh, Dept Epidemiol, Sch Med, Pittsburgh, PA 15261 USA
[4] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
基金
美国国家卫生研究院;
关键词
Obesity phenotypes; Subclinical atherosclerosis; Carotid intima media thickness; Pulse wave velocity; Coronary calcification; Aortic calcification; VISCERAL ADIPOSE-TISSUE; BODY-MASS INDEX; INSULIN-RESISTANCE; HOT FLASHES; CALCIFICATION; PLASMA;
D O I
10.1016/j.atherosclerosis.2011.01.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Metabolically benign obese individuals have a 10-year cardiovascular disease (CVD) risk comparable to healthy normal weight individuals. However, the burden of subclinical CVD among metabolically benign obese is not well known. Methods: In cross-sectional analyses of 475 mid-life women, we compared common carotid artery intima media thickness (CCA-IMT), aortic pulse wave velocity (aPWV) and coronary (CAC) and aortic calcification (AC) among three groups: healthy normal weight, metabolically benign overweight/obese (<3 metabolic syndrome components/elevated CRP), and at-risk overweight/obese (>= 3 metabolic syndrome components/elevated CRP). Results: The mean (SD) CCA-IMT and aPWV were lowest in the normal weight group (n = 145), followed by the benign overweight/obese (n = 260) and at-risk overweight/obese (n = 70) groups[ CCA-IMT: 0.64 (0.08) vs. 0.68 (0.09) vs. 0.73 (0.13) mm, p < 0.001; aPWV: 731.0 (176.4) vs. 809.9 (182.3) vs. 875.7 (228.8) cm/s, p < 0.001]. Similar results were found for the frequency (%) of women with increased CAC and AC[ CAC: 13 (9%) vs. 53 (20%) vs. 28 (40%), p < 0.001; AC: 47 (32%) vs. 130 (50%) vs. 55 (79%), p < 0.001]. These differences remained significant after multivariable adjustment. Further adjustment for BMI attenuated the statistical significance of differences in aPWV and calcification between benign and at-risk overweight/obese women, but had little effect on the magnitude of these differences. Conclusions: Metabolically benign overweight/obese women have a significantly greater subclinical CVD burden than normal weight women, despite published data finding similar CVD event rates between the two groups. Prospective studies tracking the progression of sub clinical atherosclerosis to clinical CVD in these women are needed. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:179 / 186
页数:8
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