Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Lipids and Cardiovascular/Metabolic Health

Sex-specific relationships between adiposity and anthropometric measures and carotid intima-media thickness in Koreans: The Healthy Twin Study

European Journal of Clinical Nutrition volume 66, pages 39–46 (2012)Cite this article

Abstract

Background/Objectives:

Increased adiposity, shorter stature, shorter leg length and carotid intima-media thickening are associated with cardiovascular (CV) disease. This study aimed to evaluate the sex-specific phenotypic and genetic associations between adiposity and anthropometric measures and carotid intima-media thickness (IMT).

Subjects/Methods:

We measured IMT at common carotid artery (CCA-IMT), carotid bifurcation and internal carotid artery (ICA-IMT) using B-mode ultrasound, and adiposity and anthropometric measures, including body mass index (BMI), height, leg length, waist circumference (WC), waist-to-hip ratio and percentage of body fat; we also assessed conventional CV risk factors among 706 Korean adults from the Healthy Twin Study. The associations were analyzed using quantitative genetic and linear mixed analyses.

Results:

In linear mixed analyses, BMI and WC had independent associations with the IMT at CCA-IMT and ICA-IMT and CCA-IMT, respectively, after adjusting for age and conventional CV risk factors in men. By comparison, in women, adiposity and anthropometric measures were associated with carotid IMT only before adjusting for the covariates. In men, there were significant genetic correlations between BMI and CCA-IMT (ρG=0.32±0.11), BMI and ICA-IMT (ρG=0.35±0.11) and WC and ICA-IMT (ρG=0.32±0.13) after adjusting for covariates, whereas in women the cross-trait genetic correlations were no longer significant after adjusting for the covariates.

Conclusions:

In this Korean twins and families, we found sex-specific associations between adiposity and anthropometric measures and the IMT at each segment of the carotid artery, and BMI and WC in men can be indicators predicting carotid intima-media thickening regardless of age and CV risk factors.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • Batty GD, Shipley MJ, Gunnell D, Huxley R, Kivimaki M, Woodward M et al. (2009). Height, wealth, and health: an overview with new data from three longitudinal studies. Econ Hum Biol 7, 137–152.

    Article  Google Scholar 

  • Blangero J, Williams JT, Almasy L (2001). Variance component methods for detecting complex trait loci. Adv Genet 42, 151–181.

    Article  CAS  Google Scholar 

  • Canoy D (2008). Distribution of body fat and risk of coronary heart disease in men and women. Curr Opin Cardiol 23, 591–598.

    Article  Google Scholar 

  • Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S et al. (2007). Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. Circulation 116, 2933–2943.

    Article  Google Scholar 

  • Chiu YF, Chuang LM, Kao HY, Shih KC, Lin MW, Lee WJ et al. (2010). Sex-specific genetic architecture of human fatness in Chinese: the SAPPHIRe Study. Hum Genet 128, 501–513.

    Article  Google Scholar 

  • Czernichow S, Bertrais S, Oppert JM, Galan P, Blacher J, Ducimetiere P et al. (2005). Body composition and fat repartition in relation to structure and function of large arteries in middle-aged adults (the SU.VI.MAX study). Int J Obes (Lond) 29, 826–832.

    Article  CAS  Google Scholar 

  • De Michele M, Panico S, Iannuzzi A, Celentano E, Ciardullo AV, Galasso R et al. (2002). Association of obesity and central fat distribution with carotid artery wall thickening in middle-aged women. Stroke 33, 2923–2928.

    Article  Google Scholar 

  • Duggirala R, Gonzalez Villalpando C, O’Leary DH, Stern MP, Blangero J (1996). Genetic basis of variation in carotid artery wall thickness. Stroke 27, 833–837.

    Article  CAS  Google Scholar 

  • Ebrahim S, Papacosta O, Whincup P, Wannamethee G, Walker M, Nicolaides AN et al. (1999). Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women: the British Regional Heart Study. Stroke 30, 841–850.

    Article  CAS  Google Scholar 

  • Ferrie JE, Langenberg C, Shipley MJ, Marmot MG (2006). Birth weight, components of height and coronary heart disease: evidence from the Whitehall II study. Int J Epidemiol 35, 1532–1542.

    Article  Google Scholar 

  • Folsom AR, Eckfeldt JH, Weitzman S, Ma J, Chambless LE, Barnes RW et al. (1994). Relation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke 25, 66–73.

    Article  CAS  Google Scholar 

  • Fox CS, Polak JF, Chazaro I, Cupples A, Wolf PA, D’Agostino RA et al. (2003). Genetic and environmental contributions to atherosclerosis phenotypes in men and women: heritability of carotid intima-media thickness in the Framingham Heart Study. Stroke 34, 397–401.

    Article  Google Scholar 

  • Helfand M, Buckley DI, Freeman M, Fu R, Rogers K, Fleming C et al. (2009). Emerging risk factors for coronary heart disease: a summary of systematic reviews conducted for the U. Ann Intern Med 151, 496–507.

    Article  Google Scholar 

  • Herrera BM, Lindgren CM (2010). The genetics of obesity. Curr Diab Rep 10, 498–505.

    Article  CAS  Google Scholar 

  • Howard G, Sharrett AR, Heiss G, Evans GW, Chambless LE, Riley WA et al. (1993). Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 24, 1297–1304.

    Article  CAS  Google Scholar 

  • Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J (2010). Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk—a review of the literature. Eur J Clin Nutr 64, 16–22.

    Article  CAS  Google Scholar 

  • Jee SH, Sull JW, Park J, Lee SY, Ohrr H, Guallar E et al. (2006). Body-mass index and mortality in Korean men and women. N Engl J Med 355, 779–787.

    Article  CAS  Google Scholar 

  • Juo SH, Lin HF, Rundek T, Sabala EA, Boden-Albala B, Park N et al. (2004). Genetic and environmental contributions to carotid intima-media thickness and obesity phenotypes in the Northern Manhattan Family Study. Stroke 35, 2243–2247.

    Article  Google Scholar 

  • Lawlor DA, Taylor M, Davey Smith G, Gunnell D, Ebrahim S (2004). Associations of components of adult height with coronary heart disease in postmenopausal women: the British women's heart and health study. Heart 90, 745–749.

    Article  CAS  Google Scholar 

  • Lewis CE, North KE, Arnett D, Borecki IB, Coon H, Ellison RC et al. (2005). Sex-specific findings from a genome-wide linkage analysis of human fatness in non-Hispanic whites and African Americans: the HyperGEN study. Int J Obes (Lond) 29, 639–649.

    Article  CAS  Google Scholar 

  • Liao YC, Lin HF, Rundek T, Cheng R, Guo YC, Sacco RL et al. (2008). Segment-specific genetic effects on carotid intima-media thickness: the Northern Manhattan study. Stroke 39, 3159–3165.

    Article  Google Scholar 

  • Schousboe K, Willemsen G, Kyvik KO, Mortensen J, Boomsma DI, Cornes BK et al. (2003). Sex differences in heritability of BMI: a comparative study of results from twin studies in eight countries. Twin Res 6, 409–421.

    Article  Google Scholar 

  • Song YM, Lee D, Lee MK, Lee K, Lee HJ, Hong EJ et al. (2010). Validity of the zygosity questionnaire and characteristics of zygosity-misdiagnosed twin pairs in the healthy twin study of Korea. Twin Res Hum Genet 13, 223–230.

    Article  Google Scholar 

  • Song YM, Sung J, Davey Smith G, Ebrahim S (2004). Body mass index and ischemic and hemorrhagic stroke: a prospective study in Korean men. Stroke 35, 831–836.

    Article  Google Scholar 

  • Stensland-Bugge E, Bonaa KH, Joakimsen O, Njolstad I (2000). Sex differences in the relationship of risk factors to subclinical carotid atherosclerosis measured 15 years later: the Tromso study. Stroke 31, 574–581.

    Article  CAS  Google Scholar 

  • Strazzullo P, D’Elia L, Cairella G, Garbagnati F, Cappuccio FP, Scalfi L (2010). Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants. Stroke 41, e418–e426.

    Article  Google Scholar 

  • Sung J, Cho SI, Lee K, Ha M, Choi EY, Choi JS et al. (2006). Healthy Twin: a twin-family study of Korea—protocols and current status. Twin Res Hum Genet 9, 844–848.

    Article  Google Scholar 

  • Takami R, Takeda N, Hayashi M, Sasaki A, Kawachi S, Yoshino K et al. (2001). Body fatness and fat distribution as predictors of metabolic abnormalities and early carotid atherosclerosis. Diabetes Care 24, 1248–1252.

    Article  CAS  Google Scholar 

  • Terry JG, Tang R, Espeland MA, Davis DH, Vieira JL, Mercuri MF et al. (2003). Carotid arterial structure in patients with documented coronary artery disease and disease-free control subjects. Circulation 107, 1146–1151.

    Article  Google Scholar 

  • Underhill HR, Yuan C, Terry JG, Chen H, Espeland MA, Hatsukami TS et al. (2008). Differences in carotid arterial morphology and composition between individuals with and without obstructive coronary artery disease: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 10, 31.

    Article  Google Scholar 

  • Weiss LA, Pan L, Abney M, Ober C (2006). The sex-specific genetic architecture of quantitative traits in humans. Nat Genet 38, 218–222.

    Article  CAS  Google Scholar 

  • Yan RT, Yan AT, Anderson TJ, Buithieu J, Charbonneau F, Title L et al. (2009). The differential association between various anthropometric indices of obesity and subclinical atherosclerosis. Atherosclerosis 207, 232–238.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by a grant from Inje University in 2009, and the Korean Centers for Disease Control Research Program contract (budget numbers 2005-347-2400-2440-215, 2006-347-2400-2440-215, 2007-347-2400-2440-215, 2008- E00255-00 and 2009-E00500-00), the Korean Ministry of Knowledge Economy (budget number 10033321), the Korean Ministry of Education, Science and Technology (Grant number M10305030005), and the National Research Foundation of Korea (Grant number 2010-0025814).

Author information

Authors and Affiliations

  1. Department of Family Medicine, Samsung Medical Center and Center for Clinical Research, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea

    Y-M Song

  2. Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

    K Lee

  3. Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea

    J Sung, Y S Kim & J Y Lee

Authors
  1. Y-M Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Sung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y S Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J Y Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K Lee.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Song, YM., Lee, K., Sung, J. et al. Sex-specific relationships between adiposity and anthropometric measures and carotid intima-media thickness in Koreans: The Healthy Twin Study. Eur J Clin Nutr 66, 39–46 (2012). https://doi.org/10.1038/ejcn.2011.150

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2011.150

Keywords

Search

Advanced search

Quick links