Abstract 16497: The Impact of Adiposity and Weight Loss on Intima Media Thickness in Adulthood
Background: Increased adiposity has been associated with adverse cardiovascular (CV) outcome. We examined whether exposure to adiposity has a cumulative effect on carotid intima media thickness (cIMT) and whether any such deleterious effect can be prevented by weight loss.
Methods: The study population consisted of 1147 participants from the MRC National Survey of Health and Development (1946 British birth cohort) who underwent cIMT measurements between 60-64years of age. Adiposity was characterized by body mass index (BMI) at 36, 43, 53 and 63 years. Participants with BMI between 25-29 kg/m2 were classified as overweight and those with BMI>30kg/m2 as obese at each age. Hypertension was defined as blood pressure≥140/90mmHg. cIMT was measured in right and left common carotid artery and mean cIMT was calculated.
Results: BMI at every age was positively associated with cIMT (p<0.001 for all). Exposure to adiposity and being hypertensive at all ages had an additive adverse impact on cIMT (p<0.001). At 60-64 years, overweight/obese (OW) participants had higher cIMT compared to their normal-weight (NW) peers (0.702 (0.13) vs 0.667 (0.11) mm; p<0.001). There was a graded cumulative effect of exposure to adiposity on cIMT at 60-64 years, with those who were OW for >20 years having higher cIMT (N=218, cIMT: 0.72(0.14) mm) than those with 10-20 year exposure (N=166, cIMT: 0.70(0.1) mm) and those who were NW across adulthood (N=256, cIMT: 0.67(0.1)), ANOVA: p<0.001). Weight reduction (a drop in category from obese to overweight or owerweight to normal) in any time period resulted in significant vascular benefit (-0.042 (-0.066, -0.017) in cIMT for those who lost weight (N=152) compared to those who never lost weight, (N=379; p=0.001 adjusted for CV risk factors) even if weight loss was not sustained. The vascular benefit of weight reduction was also observed in the OW female participants who were hypertensive.
Conclusion: Adiposity exposure from early adulthood has a cumulative adverse impact on cIMT in later life. Weight loss even if it is not sustained is associated with lower cIMT. These data suggest that interventions which can achieve weight loss, at any age in adulthood, are likely to result in long term vascular benefit.
- © 2013 by American Heart Association, Inc.