6.6 WAIST CIRCUMFERENCE IS A BETTER PREDICTOR OF SUBCLINICAL ATHEROSCLEROSIS THAN ADIPONECTIN LEVEL

Abstract

Objective: Waist circumference is clinical marker of obesity and a well-established risk factor for cardiovascular disease. Adiponectin, an adipocyte-derived hormone and new biomarker of obesity, has recently been proposed to be the missing link between obesity and increased cardiovascular risk. We evaluated waist circumference and adiponectin level in a middle-aged population-based cohort to determine which marker of obesity was the best predictor of subclinical atherosclerosis. Methods and Results: Seven non-invasive measurements of atherosclerosis(NIMA), as surrogate markers of subclinical atherosclerosis, were determined in 1517 participants of the Nijmegen Biomedical Study, aged 50–70 years who were drawn from the Dutch community. Both men and women with a high waist(M>104cm;F>95cm) showed deteriorated outcomes of NIMA as reflected by increased pulse wave velocity(PWV)(M:+12.6%;F:+13.1%) and thicker intima-media thickness (IMT)(M:+9.0%;F:+6.6%) and in women an increased plaque thickness(+22.1%). However, participants with a low adiponectin level(M<2.2mg/L;F< 3.5mg/L) showed no changes in the outcomes of NIMA; in both sexes only after adjustment for age a decreased ankle-brachial index after exercise(M: −9%;F: −3.5%) and an increased IMT(M:3.7%;F:3.6%) and in women an increased PWV(+6.8%) was observed. Interaction between the effect of waist and adiponectin on NIMA was found only in women. Conclusions: Waist circumference was a better predictor of subclinical atherosclerosis than adiponectin level in our large population-based cohort. Measurement of waist circumference in clinical practice is a valuable tool in cardiovascular risk profiling, but our data does not support the measurement of adiponectin level.