J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 18, Number 9, September 2026, pages 652-660

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

↓ Figure 1. Distribution of the IMT and the EMT of the carotid arteries. EMT: common carotid artery extra-media thickness; IMT: intima-media thickness.

↓ Figure 2. Correlation matrix (heat map) in the examined sample. *P < 0.05; **P < 0.01; ***P < 0.001. AO: abdominal obesity; BMI: body mass index; DBP: diastolic blood pressure; eGFR: estimated glomerular filtration rate; EMT: common carotid artery extra-media thickness; HC: hip circumference; HD: hypertension duration; HDL-C: high-density lipoprotein cholesterol; IMT: intima-media thickness; LDL-C: low-density lipoprotein cholesterol; NC: neck circumference; SBP: systolic blood pressure; TC: total cholesterol; TG: triglycerides; WC: waist circumference.

↓ Figure 3. Proportion of individuals with perivascular obesity, overweight, obesity by BMI, and abdominal obesity, by age group. BMI: body mass index.

↓ Figure 4. Frequency of individuals with perivascular obesity across groups with normal weight, overweight, obesity by BMI, and abdominal obesity in the examined sample. BMI: body mass index; PVO: perivascular obesity.

↓ **Table 1.** Clinical Characteristics of the Patients Included in the Study
Parameter	Value (n = 373)
Continuous variables are presented as median (25th; 75th percentile), and categorical variables as percentages. BMI: body mass index; DBP: diastolic blood pressure; EMT: carotid extra-media thickness; GFR: glomerular filtration rate; HDL-C: high-density lipoprotein cholesterol; IMT: carotid intima-media thickness; LDL-C: low-density lipoprotein cholesterol; SBP: systolic blood pressure; TG: triglycerides.
Sex, male/female (%)	38.9/61.1
Age (years)	23 (21; 32)
BMI (kg/m²)	23.0 (20.4; 26.3)
Obesity by BMI (%)	10.1
Waist circumference (cm)
Men	85 (79; 98)
Women	72 (67; 81)
Obesity by waist circumference (%)	14.6
Hip circumference (cm)
Men	102 (97; 108)
Women	97 (92; 103)
Neck circumference (cm)
Men	38 (35; 40)
Women	32.5 (31; 35)
Hypertension (%)	15.1
Hypertension duration (years)	1 (0.1; 3.5)
SBP (mm Hg)	126 (119; 135)
DBP (mm Hg)	78 (73; 83.3)
Smoking (%)	30.2
Dyslipidemia (%)	22.8
Total cholesterol (mmol/L)	4.32 (4; 4.9)
LDL-C (mmol/L)	2.3 (2.24; 2.4)
HDL-C (mmol/L)	1.3 (1; 1.5)
TG (mmol/L)	1.0 (0.9; 1.5)
Impaired fasting glycemia (%)	2.4
Glucose (mmol/L)	4.7 (4.3; 5.1)
GFR (mL/min/1.73 m²)	98.9 (87.5; 110)
Carotid EMT (mm)	0.43 (0.336; 0.535)
Carotid IMT (mm)	0.7 (0.63; 0.85)

↓ Table 1. Clinical Characteristics of the Patients Included in the Study

Parameter

Value (n = 373)

Continuous variables are presented as median (25th; 75th percentile), and categorical variables as percentages. BMI: body mass index; DBP: diastolic blood pressure; EMT: carotid extra-media thickness; GFR: glomerular filtration rate; HDL-C: high-density lipoprotein cholesterol; IMT: carotid intima-media thickness; LDL-C: low-density lipoprotein cholesterol; SBP: systolic blood pressure; TG: triglycerides.

Sex, male/female (%)

38.9/61.1

Age (years)

23 (21; 32)

BMI (kg/m²)

23.0 (20.4; 26.3)

Obesity by BMI (%)

10.1

Waist circumference (cm)

Men

85 (79; 98)

Women

72 (67; 81)

Obesity by waist circumference (%)

14.6

Hip circumference (cm)

Men

102 (97; 108)

Women

97 (92; 103)

Neck circumference (cm)

Men

38 (35; 40)

Women

32.5 (31; 35)

Hypertension (%)

15.1

Hypertension duration (years)

1 (0.1; 3.5)

SBP (mm Hg)

126 (119; 135)

DBP (mm Hg)

78 (73; 83.3)

Smoking (%)

30.2

Dyslipidemia (%)

22.8

Total cholesterol (mmol/L)

4.32 (4; 4.9)

LDL-C (mmol/L)

2.3 (2.24; 2.4)

HDL-C (mmol/L)

1.3 (1; 1.5)

TG (mmol/L)

1.0 (0.9; 1.5)

Impaired fasting glycemia (%)

2.4

Glucose (mmol/L)

4.7 (4.3; 5.1)

GFR (mL/min/1.73 m²)

98.9 (87.5; 110)

Carotid EMT (mm)

0.43 (0.336; 0.535)

Carotid IMT (mm)

0.7 (0.63; 0.85)

↓ **Table 2.** Multivariable Linear Regression Analysis With Carotid EMT as the Dependent Variable, Adjusted for Age, Obesity, Hypertension, and Smoking
Parameter	Results of regression analysis
B: regression coefficient; EMT: extra-media thickness; SE: standard error.
Model significance	B = 0.248, SE of B = 0.033, P < 0.001
Age	B = 0.006, SE of B = 0.001, P < 0.001
Obesity	B = 0.219, SE of B = 0.05, P < 0.001
Hypertension	P > 0.05
Smoking	B = 0.053, SE of B = 0.03, P = 0.033

↓ Table 2. Multivariable Linear Regression Analysis With Carotid EMT as the Dependent Variable, Adjusted for Age, Obesity, Hypertension, and Smoking

Parameter

Results of regression analysis

B: regression coefficient; EMT: extra-media thickness; SE: standard error.

Model significance

B = 0.248, SE of B = 0.033, P < 0.001

Age

B = 0.006, SE of B = 0.001, P < 0.001

Obesity

B = 0.219, SE of B = 0.05, P < 0.001

Hypertension

P > 0.05

Smoking

B = 0.053, SE of B = 0.03, P = 0.033

↓ **Table 3.** Results of Multivariable Logistic Regression Analysis of the Association of Perivascular Obesity With Risk Factors Using Standardized Continuous Variables
Variable	B	SE of B	P	OR (95% CI)
B: regression coefficient; CI: confidence interval; IMT: intima-media thickness; OR: odds ratio; SE: standard error; TC: total cholesterol.
Age	1.652	0.406	< 0.001	5.22 (2.35–11.55)
Waist circumference	1.036	0.393	0.008	2.82 (1.31–6.09)
IMT	−0.396	0.402	0.324	0.67 (0.31–1.48)
Hypertension duration	−0.744	0.425	0.08	0.48 (0.21–1.09)
TC	−0.231	0.312	0.460	0.79 (0.43–1.46)
Glucose	−0.019	0.375	0.96	0.98 (0.47–2.05)

↓ Table 3. Results of Multivariable Logistic Regression Analysis of the Association of Perivascular Obesity With Risk Factors Using Standardized Continuous Variables

Variable

SE of B

OR (95% CI)

B: regression coefficient; CI: confidence interval; IMT: intima-media thickness; OR: odds ratio; SE: standard error; TC: total cholesterol.

Age

1.652

0.406

< 0.001

5.22 (2.35–11.55)

Waist circumference

1.036

0.393

0.008

2.82 (1.31–6.09)

IMT

−0.396

0.402

0.324

0.67 (0.31–1.48)

Hypertension duration

−0.744

0.425

0.08

0.48 (0.21–1.09)

−0.231

0.312

0.460

0.79 (0.43–1.46)

Glucose

−0.019

0.375

0.96

0.98 (0.47–2.05)