The relationship between Carotid Intima Media Thickness (CIMT) and abdominal waist circumference in Metabolic Syndrome compared to BMI

Abstract

Metabolic syndrome is a cluster of cardiovascular risk factors which can predicts cardiovascular disease (CVD). Carotid intima-media thickness (CIMT) is known as a surrogate measure of subclinical atherosclerosis and predictor of CVD. And, it has shown association between metabolic syndrome and CIMT. Carotid intima-media thickness (CIMT) is a simple and inexpensive tool to assess the cumulative effect of atherosclerotic risk factors and is an independent predictor of future cardiovascular (CV) risk. CIMT is a measure of the thickness of the intima and media layer of the carotid artery most commonly assessed by B-mode ultrasound. CIMT is commonly used as a surrogate end point in research trials as a marker of atherosclerosis. More important from a clinical perspective, CIMT has been shown to correlate with cardiac risk factors. Abdominal obesity, due to intra-abdominal adiposity, drives the progression of multiple cardio-metabolic risk factors independently of body mass index. The prevalence of abdominal obesity is increasing in populations, due to a combination of low physical activity and high-energy diets. The measurement of waist circumference, will give an idea about CIMT and thus predicting subclinical atherosclerosis which identifies the presence of increased cardio-metabolic risk associated with abdominal obesity. Accordingly, measurement of waist circumference should become a standard component of cardiovascular risk evaluation in routine clinical practice. Lifestyle modification remains the initial intervention of choice for this population, with pharmacological modulation of risk factors where this is insufficiently effective. This study was conducted on 100 patients with metabolic syndrome, 50 patients with abdominal obesity and 50 patients with no abdominal obesity. The aim of this study was to measure CIMT in two groups of patients. Group A (with no abdominal obesity), group B (with abdominal obesity) in patients less than 55 years old to determine subclinical atherosclerosis and to examine its correlation with increasing abdominal waist circumference. Our result showed that CIMT significally increased among patients in group (B) compared to group (A). There is significant correlation between CIMT and abdominal waist circumference and no significant correlation between CIMT and BMI. In multiple regression analysis for the multiple component of metabolic syndrome that predict increase CIMT, this study showed that there was significant association with waist circumference and LDL with the best cut - off value of waist circumference for detection of increase CIMT is 90 mm with sensitivity 68.6% and specificity 65.4%.