Vascular wall status and its link with perivascular adipose tissue and other fat depots in young patients with abdominal obesity

Aim. To evaluate the common carotid artery (CCA) intima-media complex thickness (IMT) and the presence of atherosclerotic plaques (ASP) in young people with abdominal obesity who don’t have metabolic syndrome and those who have it, as well as a link between fat depots (perivascular, visceral, subcutaneous, epicardial) and CCA IMT. Materials and methods. The study included 145 people aged 18-45 years. They were divided into 3 groups: group 1 (n=18) - healthy volunteers (control group), group 2 (n=48) - patients with abdominal obesity and no more than one additional risk factor (metabolically healthy) and group 3 (n=79) - patients with metabolic syndrome. In persons included in the study the following parameters were measured: the height, weight, body mass index, waist circumference, fasting blood glucose, glucose tolerance, uric acid, lipid profile, insulin and the insulin resistance index (HOMA-IR). They also were given a 24-hour blood pressure monitoring, and an evaluation of CCA IMT, a presence of ASP in the carotid arteries and a maximum degree of internal carotid stenosis was performed using the duplex scan of brachiocephalic arteries. Computed tomography (Aquilion One Vision Edition, Toshiba, Japan) with determining subcutaneous, visceral, perivascular, epicardial fat was performed, and the ratio of subcutaneous to visceral fat was calculated. Results. Significant differences in mean CCA IMT were revealed only between persons of group 1 and group 3 (p=0.025), while the median of IMT were within normal ranges (group 1: 0.49 [0.46; 0.56]; group 2: 0.53 [0.49; 0.59]; group 3: 0.56 [0.52; 0.62]). Significant differences in a distribution of individuals with increased IMT between groups were also not revealed. However, the proportion of individuals with ASP was significantly higher in group 2 compared with group 1 (p<0.001) and in group 3 compared with group 2 (p<0.001), as well as the presence of maximum stenosis in the carotid artery. Direct correlation between CCA IMT and periaortic (r=0.440; p=0.000), epicardial (r=0.329; p<0.001) and visceral (r=0.326; p<0.001) fat depots, as well as the inverse correlation with a ratio subcutaneous fat/visceral fat (r=-0.241; p=0.005) were revealed. In addition, there were correlations between CCA IMT and body mass index, waist circumference, lipid profile and 24-hour blood pressure monitoring parameters, that once again confirms a close pathogenetic link between obesity, disorders of lipid metabolism and vascular wall status.