TY - JOUR
T1 - Burden of subclinical cardiovascular disease in "metabolically benign" and "at-risk" overweight and obese women
T2 - The Study of Women's Health Across the Nation (SWAN)
AU - Khan, Unab I.
AU - Wang, Dan
AU - Thurston, Rebecca C.
AU - Sowers, Mary Fran
AU - Sutton-Tyrrell, Kim
AU - Matthews, Karen A.
AU - Barinas-Mitchell, Emma
AU - Wildman, Rachel P.
N1 - Funding Information:
The Study of Women's Health Across the Nation has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women's Health (ORWH) (grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495 ). The SWAN Heart Study is supported by the National Heart, Lung, and Blood Institute (grants HL065581 and HL065591 ). The Chicago site of the SWAN Heart Study is also supported by the Charles J. and Margaret Roberts Trust . The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH.
PY - 2011/7
Y1 - 2011/7
N2 - 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 subclinical atherosclerosis to clinical CVD in these women are needed.
AB - 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 subclinical atherosclerosis to clinical CVD in these women are needed.
KW - Aortic calcification
KW - Carotid intima media thickness
KW - Coronary calcification
KW - Obesity phenotypes
KW - Pulse wave velocity
KW - Subclinical atherosclerosis
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U2 - 10.1016/j.atherosclerosis.2011.01.007
DO - 10.1016/j.atherosclerosis.2011.01.007
M3 - Article
C2 - 21310415
AN - SCOPUS:79958819452
SN - 0021-9150
VL - 217
SP - 179
EP - 186
JO - Atherosclerosis
JF - Atherosclerosis
IS - 1
ER -
