Stroke, Vol 25, 66-73, Copyright © 1994 by American Heart Association
AR Folsom, JH Eckfeldt, S Weitzman, J Ma, LE Chambless, RW Barnes, KB Cram and RG Hutchinson
BACKGROUND AND PURPOSE--We tested the hypothesis that body mass, waist-
to-hip circumference ratio, physical inactivity, diabetes, hyperglycemia,
and fasting insulin are each positively associated with asymptomatic
carotid artery wall thickness. METHODS--Average intimal- medial carotid
wall thickness (an indicator of atherosclerosis) was measured noninvasively
by B-mode ultrasonography in cross-sectional samples of 45- to 64-year-old
adults, both blacks and whites, free of symptomatic cardiovascular disease,
in four US communities. RESULTS-- Sample mean carotid wall thickness was
approximately 0.7 mm in women (n = 7956) and 0.8 mm in men (n = 6474). Body
mass, waist-to-hip ratio, work physical activity, diabetes, and fasting
insulin were associated (P < .05) with carotid wall thickness in the
hypothesized direction. Adjusted for age, race, smoking, body mass index,
artery depth, and Atherosclerosis Risk in Communities field center, mean
wall thickness was greater by 0.02 mm in women and 0.03 mm in men for a
0.07-unit (one SD) larger waist-to-hip ratio. Adjusted mean wall thickness
was about 0.07 mm thicker in participants with diabetes mellitus and 0.02
mm thicker in participants with hyperglycemia (fasting glucose 6.4 to 7.7
mmol/L) than in subjects with fasting glucose < 6.4 mmol/L. Adjusted
mean wall thickness increased by about 0.02 mm with an increase of 100
mmol/L in fasting serum insulin. CONCLUSIONS--Abdominal adiposity, physical
inactivity, and abnormal glucose metabolism are associated positively with
carotid intimal-medial wall thickness, suggesting these factors contribute
to atherogenesis.
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Relation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity. Atherosclerosis Risk in Communities (ARIC) Study Investigators
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454.
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P. H. Davis, J. D. Dawson, L. T. Mahoney, and R. M. Lauer Increased Carotid Intimal-Medial Thickness and Coronary Calcification Are Related in Young and Middle-Aged Adults : The Muscatine Study Circulation, August 24, 1999; 100(8): 838 - 842. [Abstract] [Full Text] [PDF]
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Y. Nagai, E J. Metter, and J. L Fleg Increased carotid artery intimal-medial thickness: risk factor for exercise-induced myocardial ischemia in asymptomatic older individuals Vascular Medicine, August 1, 1999; 4(3): 181 - 186. [Abstract] [PDF]
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K. Jensen-Urstad, M. Jensen-Urstad, and J. Johansson Carotid Artery Diameter Correlates With Risk Factors for Cardiovascular Disease in a Population of 55-Year-Old Subjects Stroke, August 1, 1999; 30(8): 1572 - 1576. [Abstract] [Full Text] [PDF]
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C. Thalhammer, B. Balzuweit, A. Busjahn, C. Walter, F. C. Luft, and H. Haller Endothelial Cell Dysfunction and Arterial Wall Hypertrophy Are Associated With Disturbed Carbohydrate Metabolism in Patients at Risk for Cardiovascular Disease Arterioscler. Thromb. Vasc. Biol., May 1, 1999; 19(5): 1173 - 1179. [Abstract] [Full Text] [PDF]
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M. A. Espeland, R. Tang, J. G. Terry, D. H. Davis, M. Mercuri, and J. R. Crouse III Associations of Risk Factors With Segment-Specific Intimal-Medial Thickness of the Extracranial Carotid Artery Stroke, May 1, 1999; 30(5): 1047 - 1055. [Abstract] [Full Text] [PDF]
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