Association between thigh circumference and carotid intima-media thickening

Abstract

Objective: Currently, studies have reported relationships between the different anthropometric indices of obesity and risk for atherosclerosis. Specifically, there are few studies of the relationship between lower-body composition parameters such as thigh circumference and atherosclerosis. Therefore, this study aims to assess the association between thigh circumference and carotid intima-media thickness (IMT) as a marker of atherosclerosis. Methods: This study used data from the Korean Genome and Epidemiology Study (KoGES)？Kangwha, a community-based prospective cohort study with 779 men, 393 premenopausal, and 839 postmenopausal women, without history of stroke, angina, and cancer. Maxima of carotid IMT (CIMT) measured by ultrasonography were used as continuous variables. CIMT thickening was defined when CIMT ≥ 1.0 mm. Independent association between thigh, waist circumference, and waist-to-thigh ratio (WTR) and CIMT by sex and menopause status was assessed by cross-sectional and prospective analysis. Results: Thigh circumference at baseline was inversely associated with change of CIMT even after adjustment for potential confounders such as baseline age, body mass index, waist circumference, systolic blood pressure, ratio of total cholesterol to high-density lipoprotein, alcohol intake, regular exercise, and follow-up period in premenopausal women (standardized ？ for CIMT = ？0.154, p = 0.013) and postmenopausal women (standardized ？ for CIMT = ？0.153, p < 0.001). But there is no significant association between thigh circumference and change of CIMT in men (standardized ？ for CIMT = ？0.070, p = 0.166). The odds ratio (OR) for having CIMT thickening among baseline without CIMT thickening that decreased per 5 cm of thigh circumference at baseline was 1.74 (95% CI = 1.28？2.35) in postmenopausal women when adjusted for potential confounds, but not significant in men (OR = 0.95, 95% CI = 0.69？1.32) and premenopausal women (OR = 1.22, 95% CI = 0.82？1.82). Also, the OR for having CIMT thickening (OR = 1.58, 2.44, and 2.80, respectively; p for trend = 0.012) increased with decreasing quartile of thigh circumference. This trend was not shown in men or premenopausal women. Conclusion: In postmenopausal women, a low thigh circumference seems to be associated with an increased risk of CIMT thickening. These results suggest that measure of thigh circumference might be a new anthropometric marker of early identification of individuals at an increased risk of atherosclerosis.