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

PLoS One. 2016 Apr 11;11(4):e0153096. doi: 10.1371/journal.pone.0153096. eCollection 2016.

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Body Weight
  • Carotid Artery Diseases / etiology*
  • Carotid Intima-Media Thickness
  • Coronary Artery Disease / complications*
  • Female
  • Humans
  • Male
  • Metabolic Diseases / physiopathology*
  • Middle Aged
  • Obesity / physiopathology*
  • Overweight / physiopathology*
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT00924937

Grants and funding

The CORDIOPREV study is supported by the Fundacion Patrimonio Comunal Olivarero. Also received additional funding from CITOLIVA, CEAS, Junta de Andalucia (Consejeria de Salud, Consejeria de Agricultura y Pesca, Consejeria de Innovacion, Ciencia y Empresa), Diputaciones de Jaen y Cordoba, Centro de Excelencia en Investigacion sobre Aceite de Oliva y Salud and Ministerio de Medio Ambiente, Medio Rural y Marino, Gobierno de España. It was also partly supported by research grants from the Ministerio de Ciencia e Innovacion (AGL2009-122270 to JL-M, FIS PI10/01041 to PP-M, FIS PI13/00023 to JD-L); Ministerio de Economia y Competitividad (AGL2012/39615 to JL-M); Consejeria de Salud, Junta de Andalucia (PI0193/09 to JL-M, PI-0252/09 to JD-L, and PI-0058/10 to PP-M, PI-0206-2013 to AG-R); Proyecto de Excelencia, Consejería de Economía, Innovación, Ciencia y Empleo (CVI-7450 to JL-M). It was also partly supported by a research grant from the European Commission (NUTRITECH European Integrated Project-289511). Francisco Gomez-Delgado is supported by an ISCIII research contract (Programa Rio-Hortega). Also co-financiated by Fondo Europeo de Desarrollo Regional (FEDER). The CIBEROBN is an initiative of the Instituto de Salud Carlos III, Madrid, Spain. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.