The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors
Abstract Background In the last decade, several studies have reported an unexpected and seemingly paradoxical inverse correlation between BMI and incidence of cardiovascular diseases. This so called “obesity paradox effect” has been mainly investigated through imaging methods instead of histologic e...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-03-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-018-0685-0 |
| _version_ | 1818701143999512576 |
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| author | Valentina Rovella Lucia Anemona Marina Cardellini Manuel Scimeca Andrea Saggini Giuseppe Santeusanio Elena Bonanno Manuela Montanaro Iacopo Maria Legramante Arnaldo Ippoliti Nicola Di Daniele Massimo Federici Alessandro Mauriello |
| author_facet | Valentina Rovella Lucia Anemona Marina Cardellini Manuel Scimeca Andrea Saggini Giuseppe Santeusanio Elena Bonanno Manuela Montanaro Iacopo Maria Legramante Arnaldo Ippoliti Nicola Di Daniele Massimo Federici Alessandro Mauriello |
| author_sort | Valentina Rovella |
| collection | DOAJ |
| description | Abstract Background In the last decade, several studies have reported an unexpected and seemingly paradoxical inverse correlation between BMI and incidence of cardiovascular diseases. This so called “obesity paradox effect” has been mainly investigated through imaging methods instead of histologic evaluation, which is still the best method to study the instability of carotid plaque. Therefore, the purpose of our study was to evaluate by histology the role of obesity in destabilization of carotid plaques and the interaction with age, gender and other major cerebrovascular risk factors. Methods A total of 390 carotid plaques from symptomatic and asymptomatic patients submitted to endarterectomy, for whom complete clinical and laboratory assessment of major cardiovascular risk factors was available, were studied by histology. Patients with a BMI ≥ 30.0 kg/m2 were considered as obese. Data were analyzed by multivariate logistic regression and for each variable in the equation the estimated odds ratio (OR) was calculated. Results Unstable carotid plaque OR for obese patients with age < 70 years was 5.91 (95% CI 1.17–29.80), thus being the highest OR compared to that of other risk factors. Unstable carotid plaque OR decreased to 4.61 (95% CI 0.54–39.19) in males ≥ 70 years, being only 0.93 (95% CI 0.25–3.52) among women. When obesity featured among metabolic syndrome risk factors, the OR for plaque destabilization was 3.97 (95% CI 1.81–6.22), a significantly higher value compared to OR in non-obese individuals with metabolic syndrome (OR = 1.48; 95% CI 0.86–2.31). Similar results were obtained when assessing the occurrence of acute cerebrovascular symptoms. Conclusions Results from our study appear to do not confirm any paradoxical effect of obesity on the carotid artery district. Conversely, obesity is confirmed to be an independent risk factor for carotid plaque destabilization, particularly in males aged < 70 years, significantly increasing such risk among patients with metabolic syndrome. |
| first_indexed | 2024-12-17T15:16:10Z |
| format | Article |
| id | doaj.art-86738a2cbc684cdb8bbc520a08321cfa |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-17T15:16:10Z |
| publishDate | 2018-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-86738a2cbc684cdb8bbc520a08321cfa2022-12-21T21:43:32ZengBMCCardiovascular Diabetology1475-28402018-03-011711910.1186/s12933-018-0685-0The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factorsValentina Rovella0Lucia Anemona1Marina Cardellini2Manuel Scimeca3Andrea Saggini4Giuseppe Santeusanio5Elena Bonanno6Manuela Montanaro7Iacopo Maria Legramante8Arnaldo Ippoliti9Nicola Di Daniele10Massimo Federici11Alessandro Mauriello12Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor VergataAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Anatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”Anatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”Anatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”Anatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”Department of Systems Medicine, University of Rome Tor VergataVascular Surgery, Department of Biomedicine and Prevention, University of Rome Tor VergataHypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor VergataDepartment of Systems Medicine, University of Rome Tor VergataAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”Abstract Background In the last decade, several studies have reported an unexpected and seemingly paradoxical inverse correlation between BMI and incidence of cardiovascular diseases. This so called “obesity paradox effect” has been mainly investigated through imaging methods instead of histologic evaluation, which is still the best method to study the instability of carotid plaque. Therefore, the purpose of our study was to evaluate by histology the role of obesity in destabilization of carotid plaques and the interaction with age, gender and other major cerebrovascular risk factors. Methods A total of 390 carotid plaques from symptomatic and asymptomatic patients submitted to endarterectomy, for whom complete clinical and laboratory assessment of major cardiovascular risk factors was available, were studied by histology. Patients with a BMI ≥ 30.0 kg/m2 were considered as obese. Data were analyzed by multivariate logistic regression and for each variable in the equation the estimated odds ratio (OR) was calculated. Results Unstable carotid plaque OR for obese patients with age < 70 years was 5.91 (95% CI 1.17–29.80), thus being the highest OR compared to that of other risk factors. Unstable carotid plaque OR decreased to 4.61 (95% CI 0.54–39.19) in males ≥ 70 years, being only 0.93 (95% CI 0.25–3.52) among women. When obesity featured among metabolic syndrome risk factors, the OR for plaque destabilization was 3.97 (95% CI 1.81–6.22), a significantly higher value compared to OR in non-obese individuals with metabolic syndrome (OR = 1.48; 95% CI 0.86–2.31). Similar results were obtained when assessing the occurrence of acute cerebrovascular symptoms. Conclusions Results from our study appear to do not confirm any paradoxical effect of obesity on the carotid artery district. Conversely, obesity is confirmed to be an independent risk factor for carotid plaque destabilization, particularly in males aged < 70 years, significantly increasing such risk among patients with metabolic syndrome.http://link.springer.com/article/10.1186/s12933-018-0685-0ObesityStrokeCarotidHistologyMetabolic syndromeAge |
| spellingShingle | Valentina Rovella Lucia Anemona Marina Cardellini Manuel Scimeca Andrea Saggini Giuseppe Santeusanio Elena Bonanno Manuela Montanaro Iacopo Maria Legramante Arnaldo Ippoliti Nicola Di Daniele Massimo Federici Alessandro Mauriello The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors Cardiovascular Diabetology Obesity Stroke Carotid Histology Metabolic syndrome Age |
| title | The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors |
| title_full | The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors |
| title_fullStr | The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors |
| title_full_unstemmed | The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors |
| title_short | The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors |
| title_sort | role of obesity in carotid plaque instability interaction with age gender and cardiovascular risk factors |
| topic | Obesity Stroke Carotid Histology Metabolic syndrome Age |
| url | http://link.springer.com/article/10.1186/s12933-018-0685-0 |
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