The effect of sex and menopause on carotid intima‐media thickness and pulse wave velocity in morbid obesity

Abstract

Background Women are relatively protected from cardiovascular disease compared with men. Since morbid obesity is an independent risk factor for cardiovascular disease, the current study investigated whether the association between sex and cardiovascular risk factors and outcomes can be demonstrated in subjects suffering from morbid obesity. Materials and methods Two hundred subjects enrolled in a study on cardiovascular risk factors in morbid obesity underwent extensive laboratory screening, carotid intima‐media thickness (cIMT) and pulse wave velocity (PWV) measurements. Gender differences were analysed using univariate and multivariable linear regression models. In addition, the effect of menopause on cIMT and PWV was analysed. Results of these models were reported as B coefficients with 95% confidence intervals. Results The group consisted of 52 men and 148 women, with a mean age of 41 (±11.8) years and a mean body mass index (BMI) of 42.7 (±5.2) kg/m 2 . Both, cIMT and PWV were significantly higher in men than in women, although the difference in cIMT disappeared after adjustment for covariables such as waist circumference, age, high‐density lipoprotein cholesterol and mean arterial pressure. PWV was associated with sex after adjustments for covariables in morbidly obese patients. Postmenopausal women had significantly increased cIMT and PWV when compared with premenopausal women. Conclusion Sex differences in PWV persist in subjects suffering from morbid obesity. However, no difference was found in cIMT between morbidly obese men and women after adjustment for classic cardiovascular risk factors. Premenopausal morbidly obese women are protected for cardiovascular disease when compared with postmenopausal morbidly obese women.

Coronary circulatory function with increasing obesity: A complex U‐turn

“…7,23 The observed paradoxical normalization or U-turn of coronary circulatory dysfunction in obesity to a normalization in morbid obesity is also supported by previously described assessment of flow-mediated vasomotor function of the brachial artery, 22 or ultrasound measured carotid-femoral pulse-wave velocity, as a reflection of arterial stiffness. 19,24,25 In the current study population, gender, age, total cholesterol, LDL cholesterol, and HDL cholesterol were predictive of alterations in hyperaemic MBF. By multivariate analysis, however, only age and HDL cholesterol remained independent predictors of the hyperaemic MBF.…”

“…These marked alterations in lipid profile, inflammatory‐metabolic environment, and adipocytokine pattern may indeed have shifted the pendulum to a positive dysbalance favouring a normalization of coronary circulatory dysfunction in morbid obesity 7,23 22 or ultrasound measured carotid‐femoral pulse‐wave velocity, as a reflection of arterial stiffness 19,24,25 …”

Sex‐dependent correlates of arterial stiffness in Tanzanian adults

“…This notion is supported by evidence that women who undergo menopause earlier and women who have a greater post‐menopausal androgen profile have poorer cardiovascular outcomes [28,29]. However, this protection diminishes after menopause, with dramatic increases in arterial stiffening in the years following menopause onset [30–32]. Importantly, more severe symptoms in menopause are associated with greater arterial stiffness, and the association between mortality and arterial stiffness in females is double that in males [32,33].…”

Peran Ketebalan Tunika Intima Media Karotis Terhadap Fungsi Kognitif Pada Wanita Menopause

“…[27][28][29] Penelitian yang dilakukan oleh Mil, dkk pada kelompok wanita dengan obesitas morbid, juga menunjukkan peningkatan signifikan CIMT pada wanita pascamenopause dibandingkan dengan wanita pramenopause. [30] Pada hasil penelitian Early versus Late Intervention Trial with Estradiol (ELITE), didapatkan penurunan penebalan CIMT pada wanita yang memulai terapi hormon kurang dari 6 tahun setelah menopause. [31] Hubungan Ketebalan CIMT dengan Fungsi Kognitif Dari hasil beberapa penelitian potong lintang, ditemukan adanya hubungan antara ketebalan CIMT dan fungsi kognitif.…”