Obesity with metabolic abnormality is associated with the presence of carotid atherosclerosis in Korean men: A cross-sectional study

Background: Obesity is a risk factor for cardiovascular disease, but metabolic disturbances can also lead to the development of this disease. Therefore, we investigated the associations between obesity subtype, considering both body weight and metabolic disturbances, and carotid atherosclerosis as a predictor of cardiovascular disease in Korean men. Methods: Data from a total of 980 men were analysed in this study. Obesity subtypes were classified as normal weight without metabolic syndrome (metabolically healthy normal weight; MHNW), obesity without metabolic syndrome (metabolically healthy, but obese; MHO), normal weight with metabolic syndrome (metabolically abnormal, but normal weight; MANW) and obesity with metabolic syndrome (metabolically abnormal obese; MAO). Carotid intima-media thickness (CIMT) and carotid plaque were assessed using a high-resolution B-mode ultrasound system. Carotid atherosclerosis was defined as a mean CIMT value >0.9 mm or the presence of carotid plaque. Results: Mean CIMT in the MAO subtype was significantly higher than that in the MHNW control group (0.790 ± 0.019 vs. 0.747 ± 0.013 mm; p < 0.001). The presence of carotid plaque was positively associated with MAO subtype [adjusted odds ratio (aOR) 1.49, 95 % confidence interval (CI) 1.02-2.16; p = 0.039], but not with MHO or MANW, compared to the MHNW control group. The MAO subtype showed a positive association with the presence of carotid atherosclerosis (aOR 1.68, 95 % CI 1.17-2.42; p = 0.006). Conclusions: Only the MAO subtype showed a higher CIMT value and positive associations with carotid plaque and carotid atherosclerosis, but not with MHO and MANW subtypes, compared to the MHNW control. Additional prospective studies are needed to evaluate preclinical carotid atherosclerosis according to the subtypes of obesity.