Rossello, XavierFuster, ValentinOliva, BelenSanz, JavierFernandez-Friera, LeticiaLopez-Melgar, BeatrizMendiguren, Jose MLara-Pezzi, EnriqueBueno, HectorFernandez-Ortiz, AntonioIbáñez, BorjaOrdovas, Jose M2020-10-212020-10-212020-12-01J Clin Endocrinol Metab. 2020; 105(12):dgaa620http://hdl.handle.net/20.500.13003/15219http://hdl.handle.net/20.500.12105/11189Context: The underlying relationship between body mass index (BMI), cardiometabolic disorders, and subclinical atherosclerosis is poorly understood. Objective: To evaluate the association between body size phenotypes and subclinical atherosclerosis. Design: Cross-sectional. Setting: Cardiovascular disease-free cohort. Participants: Middle-aged asymptomatic subjects (n = 3909). A total of 6 cardiometabolic body size phenotypes were defined based on the presence of at least 1 cardiometabolic abnormality (blood pressure, fasting blood glucose, triglycerides, low high-density lipoprotein cholesterol, homeostasis model assessment-insulin resistance index, high-sensitivity C-reactive protein) and based on BMI: normal-weight (NW; BMI <25), overweight (OW; BMI = 25.0-29.9) or obese (08; BMI >30.0). Main Outcome Measures: Subclinical atherosclerosis was evaluated by 2D vascular ultrasonography and noncontrast cardiac computed tomography. Results: For metabolically healthy subjects, the presence of subclinical atherosclerosis increased across BMI categories (49.6%, 58.0%, and 67.7% for NW, OW, and OB, respectively), whereas fewer differences were observed for metabolically unhealthy subjects (61.1%, 69.7%, and 70.5%, respectively). When BMI and cardiometabolic abnormalities were assessed separately, the association of body size phenotypes with the extent of subclinical atherosclerosis was mostly driven by the coexistence of cardiometabolic risk factors: adjusted OR = 1.04 (95% confidence interval [CI), 0.90-1.19) for OW and OR = 1.07 (95% CI, 0.88-1.30) for OB in comparison with NW, whereas there was an increasing association between the extent of subclinical atherosclerosis and the number of cardiometabolic abnormalities: adjusted OR = 1.21 (95% CI, 1.05-1.40),1.60 (95% Cl, 1.33-1.93), 1.92 (95% CI, 1.48-2.50), and 2.27 (95% Cl, 1.67-3.09) for 1, 2, 3, and >3, respectively, in comparison with noncardiometabolic abnormalities. Conclusions: The prevalence of subclinical atherosclerosis varies across body size phenotypes. Pharmacologic and lifestyle interventions might modify their cardiovascular risk by facilitating the transition from one phenotype to another.engVoRhttp://creativecommons.org/licenses/by-nc-nd/4.0/Body size phenotypesObesitySubclinical atherosclerosisSpainAdultHumansBody SizeMiddle AgedCross-Sectional StudiesAsymptomatic DiseasesPhenotypeMaleFemaleRisk FactorsAtherosclerosisCohort StudiesPrevalenceCardiovascular riskAttribution-NonCommercial-NoDerivatives 4.0 Internacional328799531051210.1210/clinem/dgaa6201945-7197The Journal of clinical endocrinology and metabolismopen accessEstudios de CohortesEnfermedades AsintomáticasPrevalenciaTamaño CorporalFemeninoMasculinoAterosclerosisEstudios TransversalesFactores de RiesgoHumanosPersona de Mediana EdadFenotipoAdultoEspaña2-s2.0-85092120313584547800050L2010072475