Its unknown if obesity or its associated risk factors influence early vascular change.

Methods: We investigated if anthropometric measurements, body mass index [BMI], waist/hip ratio [WHR], waist circumference [Wc] and Waist/height ratio WHTR, or metabolic parameters (glucose, insulin, lipid, uric acid and blood pressure {BP}) correlated more with Carotid intima-media thickness (IMT), vascular stiffness [Augmentation Index] and brachial artery reactivity). 100 Subjects (71F, 29M) without vascular events, BP <140/90, LDL < 4 mmol/l, glucose < 6.2 mmol/l participated.

Results: BMI, WHR, WC, WHTR correlated significantly with triglyceride, HDL, LDL, insulin, glucose, uric acid and BP levels (p< 0.001). IMT correlated with WHTR, BMI, WC, Glucose (p<0.001), Homeostasis Index (HOMA) and Cholesterol levels (p<0.05). Only Age, WHTR or BMI were significant correlates of IMT in a multivariate analysis (MVA) (p<0.01) including WHTR or BMI, with age, sex, SBP, HDLc and HOMA. Augmentation Index correlated with age (p<0.0001), WHTR and WC (p<0.0005) but with age only in a MVA. Vascular reactivity did not correlate with any anthropometric or metabolic parameters. Anthropometric cut off points, (BMI <25, WC <102cm M, <88cm F, WHR <0.9 M, <0.8 F, and WHTR < 0.5) significantly differenciated normal from abnormal metabolic and vascular measurements. The WHTR ratio < 0.5 was as reliable as the BMI cut-off < 25 in determining metabolic and vascular abnormalities. BMI and WHTR were strongly associated with 89% agreement (p<0.0001). These results demonstrated that anthropometric and metabolic parameters correlated, but anthropometric parameters were the significant correlates of vascular change. A waist/height ratio > 0.5 predicts both early vascular and metabolic changes. These data support a risk factor independent vasculotrophic effect of obesity.