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. 2020 Apr 22;20(1):151.
doi: 10.1186/s12877-020-01544-5.

Age-dependent effect of metabolic phenotypes on carotid atherosclerotic disease in coronary heart disease patients (CORDIOPREV study)

Francisco M Gutierrez-Mariscal  1   2 , Antonio García-Ríos  1   2 , Purificación Gómez-Luna  1   2 , Carolina Fernández-Gandara  1   2 , Magdalena P Cardelo  1   2 , Silvia de la Cruz-Ares  1   2 , Fernando Rodriguez-Cantalejo  3 , Raul M Luque  2   4 , Ana León-Acuña  1   2 , Javier Delgado-Lista  1   2 , Pablo Perez-Martinez  1   2 , Elena M Yubero-Serrano  1   2 , Jose Lopez-Miranda  5   6
Affiliations

Age-dependent effect of metabolic phenotypes on carotid atherosclerotic disease in coronary heart disease patients (CORDIOPREV study)

Francisco M Gutierrez-Mariscal et al. BMC Geriatr. .

Abstract

Background: Aging is associated with a high risk for cardiovascular disease. The relation of obesity and risk of cardiovascular events appears to be more closely linked to certain clinical or metabolic phenotypes than to obesity itself. Our aim was to establish whether aging influenced the metabolic phenotypes regarding to cardiovascular risk, evaluated by changes in the intima media thickness-common carotid (IMT-CC), in coronary heart disease (CHD) patients.

Methods: In this cross-sectional study, 1002 CHD patients were studied at entry from the CORDIOPREV study. We performed carotid ultrasound assessment to obtain their IMT-CC values. Carotid atherosclerosis was considered to exist if IMT-CC > 0.7 mm.

Results: Age determined a higher IMT-CC, regardless metabolic phenotype (all p < 0.05). Metabolically healthy non-obese (MHNO) aged< 60 showed a lesser prevalence for carotid atherosclerotic disease than metabolically sick non-obese (MSNO) and obese (MSO), while MHNO aged≥60 only showed less prevalence for the disease than the MSO. Carotid atherosclerosis associated with age, sex, impaired fasting glucose (IFG), hypertension and high sensitivity C-reactive protein (hsCRP). However, in patients aged< 60, it associated with sex and IFG and in the age ≥ 60 group, with hypertension and hsCRP.

Conclusions: Our results suggest that CHD patients aged≥60 are less metabolic flexible compared to patients aged< 60. Thus, MHO patients aged≥60 show the same risk of suffering carotid atherosclerosis as those with metabolic disease, while MHO patients aged< 60 show lower risk than MSO. This fact indicates the need to focus on therapeutic strategies in order to modify those parameters related to obesity and metabolic inflexibility in patients with CHD before entering old age.

Keywords: Cardiovascular risk factors; Carotid atherosclerosis; Metabolic flexibility; Metabolically healthy obese.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Influence of metabolic phenotypes and age on IMT-CC. All data are mean +/− SE. p < .05, Continuous variables were compared using the analysis of variance (ANOVA). #p < .05 aged< 60 years vs aged≥60 years. Bars with different letters a and b mean differences between metabolic phenotypes. IMT-CC: Intima media thickness-common carotid
See this image and copyright information in PMC

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