Neck Circumference Correlates to Coronary Calcification Better Than BMI and Waist Circumference in Insulin Resistance Obese Subjects
Abstract
The association of obesity, insulin resistance, and chronic low-grade inflammation has been evident for years. Neck circumference (NC), a parameter of subcutaneous fat, is a unique storage depot and allegedly has an additional role for cardiovascular risk beyond the effect of abdominal circumference.Vascular calfication is identified at early stage of atherosclerosis and associated with cardiovascular events. The degree of calcification associated with local vascular inflammation and progression of atherosclerosis, however, there is no study linking NC independently to coronary calcification, an established parameter of subclinical atherosclerosis. This study carried out 60 obese non-diabetes men, consisted of 30 insluin-resistant (IR) and 30 non insulin-resistant (NIR) subjects. In IR subjects, there was a significant positive correlation between CAC score with NC, but none between CAC score with body mass index (BMI) or waist circumference. A significant correlation was found between hs-CRP with CAC score or NC in IR subjects, but none in NIR subjects. Interestingly, the correlation between NC and CACA score in IR subjects remained significant after each of BMI, hs-CRP, HOMA-IR, leptin or adiponectin being adjusted, lead to suggestion of another mechanisms might invlolve in the patho-mechanisms of coronary calcification in upper body obesity subjects. We concluded, in non-diabetic beyond the effect of BMI, low-grade inflammation, the degree of insulin resistance and adipokines such as leptin and adipocnetin.
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References
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Barbarroja N, Lopez-Pedrera R, Mayas MD, Garcia-Fuentes E, Garrido-Sanchez L, Macias-Gonzalez M, El Bekay R, Vidal-Puig A, Tinahones FJ. The obese healthy paradox: is inflammation the answer? Biochem J.2010;430:141-149.
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Preis SR, Massaro JM, Hoffmann U, D’Agostino RB, Sr., Levy D, Robins SJ, Meigs JB, Vasan RS, O’Donnell CJ, Fox CS. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab. 2010;95:3701-3710.
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Davies RJ, Ali NJ, Stradling JR. Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax. 1992;47:101-105.
Vgontzas AN, Bixler EO, Chrousos GP. Metabolic disturbances in obesity versus sleep apnoea: the importance of visceral obesity and insulin resistance. J Intern Med.2003;254:32-44.
Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol.2010;7:677-685.
King CR, Knutson KL, Rathouz PJ, Sidney S, Liu K, Lauderdale DS. Short sleep duration and incident coronary artery calcifica-tion. JAMA.2008;300:2859-2866.
Hajer GR, van Haeften TW, Visseren FL. Adipose tissue dys-function in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29:2959-2971.
Mazzini MJ, Schulze PC. Proatherogenic pathways leading to vascular calcification. Eur J Radiol.2006;57:384-389.
Belovici MI, Pandele GI. [Arterial media calcification in patients with type 2 diabetes mellitus]. Rev Med Chir Soc Med Nat Iasi. 2008;112:21-34.
Reaven G. All obese individuals are not created equal: insulin resistance is the major determinant of cardiovascular disease in overweight/obese individuals. Diab Vasc Dis Res.2005;2:105-112.
Arita Y, Kihara S, Ouchi N, Maeda K, Kuriyama H, Okamoto Y, Kumada M, Hotta K, Nishida M, Takahashi M, Nakamura T, Shimomura I, Muraguchi M, Ohmoto Y, Funahashi T, Matsu-zawa Y. Adipocyte-derived plasma protein adiponectin acts as a platelet-derived growth factor-BB-binding protein and regulates growth factor-induced common postreceptor signal in vascular smooth muscle cell. Circulation.2002;105:2893-2898.
Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, Hotta K, Shimomura I, Nakamura T, Miyaoka K, Kuriyama H, Nishida M, Yamashita S, Okubo K, Matsubara K, Muraguchi M, Ohmoto Y, Funahashi T, Matsuzawa Y. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun.1999;257:79-83.
Raggi P, Gongora MC, Gopal A, Callister TQ, Budoff M, Shaw LJ. Coronary artery calcium to predict all-cause mortality in elderly men and women. J Am Coll Cardiol.2008;52:17-23.
Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ. Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology.2003;228:826-833.
Heilbronn LK, Campbell LV. Adipose tissue macrophages, low grade inflammation and insulin resistance in human obesity. Curr Pharm Des. 2008;14:1225-1230.
Olefsky JM, Glass CK. Macrophages, inflammation, and insulin resistance. Annu Rev Physiol.2010;72:219-246.
Barbarroja N, Lopez-Pedrera R, Mayas MD, Garcia-Fuentes E, Garrido-Sanchez L, Macias-Gonzalez M, El Bekay R, Vidal-Puig A, Tinahones FJ. The obese healthy paradox: is inflammation the answer? Biochem J.2010;430:141-149.
Zeyda M, Stulnig TM. Obesity, inflammation, and insulin resistance--a mini-review. Gerontology.2009;55:379-386.
Preis SR, Massaro JM, Hoffmann U, D’Agostino RB, Sr., Levy D, Robins SJ, Meigs JB, Vasan RS, O’Donnell CJ, Fox CS. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab. 2010;95:3701-3710.
Winer S, Winer DA. The adaptive immune system as a fun-damental regulator of adipose tissue inflammation and insulin resistance. Immunol Cell Biol. 2012.
Davies RJ, Ali NJ, Stradling JR. Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax. 1992;47:101-105.
Vgontzas AN, Bixler EO, Chrousos GP. Metabolic disturbances in obesity versus sleep apnoea: the importance of visceral obesity and insulin resistance. J Intern Med.2003;254:32-44.
Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol.2010;7:677-685.
King CR, Knutson KL, Rathouz PJ, Sidney S, Liu K, Lauderdale DS. Short sleep duration and incident coronary artery calcifica-tion. JAMA.2008;300:2859-2866.
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How to Cite
Lukito, A., Wijaya, A., Kabo, P., & Bakri, S. (1). Neck Circumference Correlates to Coronary Calcification Better Than BMI and Waist Circumference in Insulin Resistance Obese Subjects. Indonesian Journal of Cardiology, 33(2), 65-72. https://doi.org/10.30701/ijc.v33i2.46
Section
Clinical Research
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