The effect of the metabolically unhealthy obese phenotype on the vascular wall of the carotid arteries in patients with arterial hypertension who had acute cerebrovascular accident
https://doi.org/10.15829/1728-8800-2019-5-5-9
Abstract
Aim. To study the effect of the metabolically unhealthy obese phenotype on the vascular wall of the carotid arteries (CA) in patients with arterial hypertension (AH) who had acute cerebrovascular accident Material and methods. The study included 88 patients with AH who had acute cerebrovascular accident. The follow-up period was 12 months. All patients underwent anthropometry with the calculation of body mass index and body adiposity index. Visceral adiposity index (VAI), lipid spectrum parameters analysis and ultrasound duplex scanning of CA was performed.
Results. The atherogenic index has a direct correlation with the intima-media complex thickness (R=0,5, p=0,044), the resistance index of common CA (CCA) (R=0,6, p=0,045) and the diameter of the external CA (ECA) (R=0,55, p=0,042). VAI has strong inverse association with the OCA resistance index (R=-0,73, p=0,002), the diameter of the ECA and the left internal CA (ICA) (R=-0,6, p=0,018). The waist circumference has a direct association with the diameter of the ECA and ICA (R=0,38, p=0,02) and a negative association with the blood flow velocity of the ICA (R=-0,38, p=0,02). Regression analysis revealed the influence of VAI on the OCA resistance index (β=-0,72; p=0,008), the diameter of the left ICA (β=-0,71; p=0,004) and probability of cardiovascular complications (β=-0,64; p=0,0005).
Conclusion. VAI and waist circumference can be independent predictors of AH complications.
About the Authors
E. A. Lopina
Orenburg State Medical University
Russian Federation
Russian Federation
A. G. Dushina
Orenburg State Medical University
Russian Federation
Russian Federation
R. A. Libis
Orenburg State Medical University
Russian Federation
Russian Federation
References
1. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014;384(9945):766-81. doi:10.1016/S01406736(14)60460-8.
2. Wildman RP, Mauntner P, Reynols K, et al. The obese without cardiometabolic risk 7. factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Archives of internal medicine. 2008;168(15):1617-24. doi:10.1097/01.ogx.0000338100.83483.58.1.
3. Karelis AD, St-Pierre DH, Conus F. Metabolic and body composition factors in 8. subgroups of obesity: what do we know? The Journal of clinical endocrinology and metabolism. 2004;89:2569-75. doi:10.1210/jc.2004-0165.
4. Liu J, Fox CS, Hickson D, et al. Fatty liver, abdominal visceral fat and cardiometabolic 9. risk factors: the Jackson Heart Study. Arteriosclerosis, thrombosis, and vascular biology. 2011;31(11):2715-22. doi:10.1161/atvbaha.111.234062.
5. Chazova IE, Ratova LG, Boitsov SA, et al. Diagnostics and treatment of arterial 10. hypertension (Russian Medical Society of Arterial Hypertension and Society of Cardiology of the Russian Federation). Sistemnye gipertenzii. 2010;3:5-26. (In Russ.)
6. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final report. Circulation. 2002;106(25):3143-421. doi:10.1161/circ.106.25.3143.
7. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-219. doi:10.1093/euroheartj/eht151.
8. Ryoo JH, Park SK, Oh CM, et al. Evaluating the risk of hypertension according to the metabolic health status stratified by degree of obesity. J Am Soc Hyperten. 2017;11(1):20-7 doi:10.1016/j.jash.2016.10.006.
9. Cheng FW, Gao X, Mitchell DC. Metabolic Health Status and the Obesity Paradox in Older Adults. Journal of nutrition in gerontology and geriatrics. 2016;35(3):161-76. doi:10.1080/21551197.2016.1199004.
10. Baragetti A, Pisano G, Bertelli C, et al. Subclinical atherosclerosis is associated with Epicardial Fat Thickness and hepatic steatosis in the general population. Nutrition, Metabolism & Cardiovascular Diseases. 2016;26(2):141-53. doi:10.1016/j.numecd.2015.10.013.
Review
For citations:
Lopina E.A., Dushina A.G., Libis R.A. The effect of the metabolically unhealthy obese phenotype on the vascular wall of the carotid arteries in patients with arterial hypertension who had acute cerebrovascular accident. Cardiovascular Therapy and Prevention. 2019;18(5):5-9. (In Russ.) https://doi.org/10.15829/1728-8800-2019-5-5-9
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