Common Carotid Artery Extra-Media Thickness as a Marker of Perivascular Obesity and Cardiometabolic Risk in Individuals Without Cardiovascular Disease

Abstract

Background: Perivascular adipose tissue (PVAT) is increasingly recognized as a pathogenetic contributor to vascular dysfunction. Carotid extra-media thickness (EMT) measured by ultrasound is the simplest, noninvasive and clinically accessible marker of PVAT deposition. However, reference values in young individuals without cardiovascular disease (CVD) are lacking. The aim of this study was to analyze the relationship between carotid EMT and cardiovascular risk factors and to determine a tentative reference value of carotid EMT in individuals without CVD.

Methods: This cross-sectional study included 373 patients with a median age of 23 (21; 32) years and without CVD. All patients underwent anthropometric examination, lipid-profile assessment using the CardioChek PA (USA, 2020), and duplex ultrasound of the brachiocephalic arteries with measurement of common carotid artery EMT and intima-media thickness (IMT). A subgroup of apparently healthy individuals without cardiovascular risk factors was selected to define a threshold. EMT above the 90th percentile of this subgroup was regarded as perivascular obesity (PVO).

Results: Carotid EMT was significantly associated with age, blood pressure levels, anthropometric and laboratory metabolic markers, glycemia and smoking. On multivariable linear regression, age, obesity and smoking were independently associated with EMT. The 90th percentile threshold in the apparently healthy subgroup (n = 185) was 0.54 mm; EMT ≥ 0.54 mm (PVO) was identified in 24.2% of the sample and was most frequent in individuals aged 41–55 years. On multivariable logistic regression, age and waist circumference were independently associated with the presence of PVO.

Conclusions: Carotid EMT, reflecting the severity of PVAT deposition, may be associated with a wide range of cardiometabolic risk factors in individuals without CVD, with a tentative threshold value of 0.54 mm.