Subclinical Atherosclerosis and Metabolic Risk: Role of Body Mass Index and Waist Circumference

Metabolic Syndrome and Related Disorders, 03/08/2011

Camhi SM et al. - Adults with elevated metabolic risk have greater intima-media thickness (IMT) than those with normal risk in normal-weight, overweight, low waist circumference (WC), and high WC, but not significant for overweight or moderate WC categories.


  • Adults from the Bogalusa Heart Study were considered.
  • They were 24-43 years of age (n=991)
  • They were classified as normal weight, overweight, or obese and into WC categories (men, low <94cm, moderate 94-101.9 cm, high >=102 cm; women, low <80 cm, moderate 80-87.9 cm, high >=88 cm).
  • Elevated metabolic risk was defined by cardiovascular risk factor clustering (>=2 abnormal risk factors or insulin resistance (upper quartile of homeostasis model of insulin resistance).
  • Carotid ultrasound measurements were obtained and mean IMT was calculated.
  • General linear models compared IMT between elevated versus normal metabolic risk groups, adjusting for sex, age, race/ethnicity, and either BMI or WC category.


  • 41% had elevated metabolic risk (42% male, 28% African American, and 38% obese).
  • IMT (mm) was greater in adults with elevated metabolic risk (0.83 ± 0.007) versus normal risk (0.80 ± 0.006) whether adjusted by BMI or WC (both P < 0.0005).
  • IMT was greater in adults with elevated compared to normal metabolic risk within normal-weight (0.84 ± 0.016 vs. 0.79 ± 0.008; P = 0.002), and obese adults (0.86 ± 0.009 vs. 0.80 ± 0.01; P = 0.03), but not significantly different between risk groups in overweight adults.
  • Similar results were found when stratified by WC category.

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