Carotid plaque burden in the adult Polish urban population and its association with body fat distribution.

INTRODUCTION Carotid plaques (CP) reflect systemic atherosclerotic burden and may predict cardiovascular (CV) events.

Objectives

The aim of the study was to assess CP burden in a general adult urban population and its associations with fat distribution with adjustment for known CV risk factors. PATIENTS AND

Methods

Overall, 3321 participants from the Bialystok PLUS study (Poland) with a complete carotid ultrasound examination and clinical dataset were included, with a median (IQR) age of 49.0 (37.0-62.0) years. Plaques were assessed on ultrasound of 8 extracranial carotid segments. CP presence was defined as at least one plaque-positive segment, and CP burden was quantified as the number of plaque-positive segments across both sides (range, 0-8). Dual-energy X-ray absorptiometry was used to assess body composition.

Results

Most participants had no CP (60.1%), whereas CP in 1, 2, 3, 4, and ≥5 segments were observed in 14.1%, 14.8%, 6.0%, 3.3%, and 1.6% of participants, respectively. Plaques were unevenly distributed across carotid segments, clustering at the bifurcation (right 30.1%, left 30.0%). A more central fat pattern was associated with a higher CP burden in women, whereas a more peripheral gynoid fat distribution was associated with a lower burden in men. After adjustment for selected CV risk factors, fat-distribution measures showed modest associations with CP burden in sex-stratified analyses. However, formal interaction tests did not provide statistically significant evidence of heterogeneity by sex.

Conclusions

Age and established CV risk factors were the primary determinants of CP burden; however, selected fat-distribution measures showed additional but modest covariate-adjusted associations.