Subclinical atherosclerosis at peripheral arteries in obese individuals Subclinical atherosclerosis in obese

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Alberto Farinetti
Ivana Casteniere
Enrico Clini
Mario Migaldi
Roberta Gelmini
Flavia Scaringi Raspagliesi
Nicoletta Ara
Francesco Serra
Francesco Spatafora
Alessandro Genazzani
Anna Vittoria Mattioli


obesity; peripheral arterial disease; intima/media thickness


Evidence on relationship between obesity and peripheral arterial disease (PAD) are controversial. The aim of the present study is to evaluate the presence of subclinical atherosclerosis at all level of the explorable vascular segments with a systematic method in a selected population of young obese submitted to a comprehensive rehabilitation course. A group of 50 consecutive morbidly obese (BMI>30) was included. All patients underwent Doppler evaluation including intima media thickness (IMT) and presence/absence of plaques.

Results.We found that vessels in the upper segment of the body demonstrate the presence of thickening and/or plaques at the level of the carotid segments but not of the subclavian arteries. The IMT of the right Common Carotid Artery (CCA) (1.49 + 1.38 versus 0.62 + 0.23; p=0.037) and of the left CCA (1.66 + 1.89 versus 0.45 + 0.26; p=0.034) was greater in patients. Vessels of the lower segment demonstrate the presence of thickening and/or plaques at the iliac but not at femoral level. The control group did not present vessel thickening at any level. In conclusions asymptomatic vascular damage may be present in different segment of peripheral vessels, thus suggesting an early risk for developing an overt vascular disease over time in obese.


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1. NCD Risk Factor Collaboration, Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants, Lancet 387 (10026) (2016) 1377e1396.
2. World Health Organization, Obesity and Overweight, 2016 [cited 2017].
Available from:
3. Murabito JM, Evans JC, Nieto K, Larson MG, Levy D, Wilson PW. Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study. Am Heart J 2002; 143: 961–5.
4. O’Hare AM, Katz R, Shlipak MG, Cushman M, Newman AB. Mortality and cardiovascular risk across the ankle-arm index spectrum results from the cardiovascular health study. Circulation 2006; 113: 388–93.
5. Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the united states results from the national health and nutrition examination survey, 1999–2000. Circulation 2004; 110: 738–43.
6. Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly the Rotterdam study. Arterioscler Thromb Vasc Biol 1998; 18: 185–92.
7. Sumner AD, Khalil YK, Reed JF. The relationship of peripheral arterial disease and metabolic syndrome prevalence in asymptomatic US adults 40 years and older: results from the National Health and Nutrition Examination Survey. (1999–2004). J Clin Hypertens 2012; 14: 144.
8. Katsiki N, Athyros G, Karagiannis A, Mikhailidis P. Metabolic syndrome and non-cardiac vascular diseases: an update from human studies. Curr Pharm Des 2014; 20: 4944–52.
9. Ostchega Y, Paulose-Ram R, Dillon CF, Gu Q, Hughes JP. Prevalence of
peripheral arterial disease and risk factors in persons aged 60 and older: data from the National Health and Nutrition Examination Survey 1999–2004. J Am Geriatrics Soc 2007; 55: 583.
10. Hirsch AT, Criqui MH, Treat-Jacobson D, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001; 286: 1317–24
11. Mattioli AV, Miloro C, Pennella S, Pedrazzi P, Farinetti A. Adherence to Mediterranean diet and intake of antioxidants influence spontaneous conversion of atrial fibrillation. Nutr Metab Cardiovasc Dis. 2013 Feb;23(2):115-21. doi: 10.1016/j.numecd.2011.03.005. Epub 2011 Jul 27.
12. Touboul PJ, Hennerici MG, Meairs S, et al. Mannheim Carotid Intima-Media Thickness and Plaque Consensus (2004–2006–2011): An Update on Behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis. 2012; 34(4): 290–296.
13. Nambi V, Chambless L, Folsom AR, et al. Carotid Intima-Media Thickness and Presence or Absence of Plaque Improves Prediction of Coronary Heart Disease Risk. The ARIC (Atherosclerosis Risk in Communities) Study. J Am Coll Cardiol 2010;55: 1600-7.
14. Paul TK, Srinivasan SR, Chen W, et al. Impact of multiple cardiovascular risk factors on femoral artery intima-media thickness in asymptomatic young adults (the Bogalusa Heart Study). Am J Cardiol 2005;95: 469-73.
15. Mattioli AV, Coppi F, Migaldi M, Scicchitano P, Ciccone MM, Farinetti A. Relationship between Mediterranean diet and asymptomatic peripheral arterial disease in a population of pre-menopausal women. Nutr Metab Cardiovasc Dis. 2017 Nov;27(11): 985-990. doi: 10.1016/j.numecd.2017.09.011
16. Herder M, Johnsen SH, Arntzen KA, Mathiesen EB. Risk factors for progression of carotid intima-media thickness and total plaque area: a 13-year follow-up study: the Tromso Study, Stroke 43 (7) (2012) 1818e1823 [13].
17. Selwaness M, Hameeteman R, Van 't Klooster R, et al. Determinants of carotid atherosclerotic plaque burden in a stroke-free population, Atherosclerosis 255 (2016) 186e192
18. Zeymer U, Parhofer KG, Pittrow D, et al. Risk factor profile, management and prognosis of patients with peripheral arterial disease with or without coronary artery disease: results of the prospective German REACH registry cohort. Clin Res Cardiol 2009; 98: 249–56
19. Fox CS, Massaro JM, Schlett CL, et al. Periaortic fat deposition is associated with peripheral arterial disease the framingham heart study. Circ Cardiovasc Imaging 2010; 3:515–9.
20. McDermott MM, Liu K, Criqui MH, et al. Ankle-brachial index and subclinical cardiac and carotid disease the multi-ethnic study of atherosclerosis. Am J Eepidemiol 2005; 162: 33–41.
21. Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly the Rotterdam study. Arterioscler Thromb Vasc Biol 1998; 18: 185–92.
22. Mattioli AV, Coppi F, Migaldi M, Farinetti A. Physical activity in premenopausal women with asymptomatic peripheral arterial disease. J Cardiovasc Med 2018;19(11):677-680. doi: 10.2459/JCM.0000000000000714
23. Kypreos KE, Bitzur R, Karavia EA, Xepapadaki E, Panayiotakopoulos G, Constantinou C. Pharmacological Management of Dyslipidemia in Atherosclerosis: Limitations, Challenges, and New Therapeutic Opportunities. Angiology. 2018 Jan 1:3319718779533. doi: 10.1177/0003319718779533
24. Garvey WT, Mechanick JI, Brett EM, et al., American association of clinical endocrinologists and american college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity, Endocr. Pract. 22 (Suppl 3) (2016) 1e203.
25. Nasi M, Patrizi G, Pizzi C et al. The role of physical activity in individuals with cardiovascular risk factors: An opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport. J Cardiov Med 2019; in press
26. Farb MG, Gokce N. Visceral adiposopathy: a vascular perspective, Horm. Mol. Biol. Clin. Invest. 21 (2) (2015) 125e136.
27. Addison O, Yang R, Serra MC. Body-weight goals, trends, and weight-loss techniques among patients with peripheral arterial disease. Nutr Health. 2019 Mar;25(1):47-52. doi: 10.1177/0260106018817190
28. Tanaka A, Perlick A, Miller CC 3rd, et al. Metabolic Syndrome but not Obesity Adversely Affects Outcomes after Open Aortoiliac Bypass Surgery. Ann Vasc Surg. 2018 Jan; 46: 155-161. doi: 10.1016/j.avsg.2017.08.011. Epub 2017 Sep 6
29. Haberka M, Skilton M, Biedro M, et al. Obesity, visceral adiposity and carotid atherosclerosis. J Diabetes Complications. 2019; 33(4):302-306. doi: 10.1016/j.jdiacomp.2019.01.002. Epub 2019 Jan 17.

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