Abstract 18256: Inflammation Identifies a Non-Obese Phenotype With Subclinical Atherosclerosis
Introduction: Variations in atherosclerotic risk among individuals with similar adiposity are poorly understood, especially in African Americans (AA). high-sensitivity C-reactive protein (hsCRP) may be useful for discriminating between benign and high-risk obesity phenotypes for atherosclerosis in AAs.
Hypothesis: hsCRP will risk stratify adults for atherosclerosis severity beyond obesity alone.
Methods: Jackson Heart Study participants (n=4682) were stratified into four phenotypes based on the NHLBI definition of obesity (BMI ≥30 or BMI 25-30 with waist girth >102cm in men and >88cm in women) and inflammation by hsCRP ≥2 mg/L. Multivariable regression models were used to study the association between inflammatory obesity phenotypes and atherosclerosis determined by carotid intima-media thickness (cIMT) or coronary artery calcium scores (CAC).
Results: Prevalence of obesity was 65%, of which 30% did not have inflammation. Conversely, 37% of non-obese subjects had inflammation. The association between obesity, inflammation and atherosclerosis varied by vascular territory and by gender. hsCRP ≥2mg/dL identified a subset of non-obese men with higher cIMT (Adjusted-mean-difference= 0.05, 95% CI 0.02, 0.08 mm) but not CAC, compared to non-obese-non-inflammatory men, a finding not present in women (P=0.03 for interaction). hsCRP <2mg/dL identified a subset of obese men with lower CAC, but not cIMT. Associations between inflammation, obesity and CAC were not found in women.
Conclusions: In the largest AA population-based cohort to date, hsCRP was useful in identifying a subset of non-obese men with higher cIMT, but not in women. All phenotypes of obesity had higher carotid atherosclerotic burden in both men and women irrespective of inflammation; therefore, hsCRP did not identify a subset of obese AAs with less subclinical atherosclerosis.
Author Disclosures: A. Lin: None. M.E. Lacy: None. C. Eaton: None. A. Correa: None. W. Wu: None.
- © 2016 by American Heart Association, Inc.