Predictors of subclinical atherosclerosis and microalbuminuria in middle-aged women: a cross-sectional study.

Abstract

BACKGROUND Cardiovascular disease is of increasing concern in women. The aim was to assess the role of clinical and anthropometric measures in the development of subclinical atherosclerosis. METHODS A cross-sectional study in 203 Europid females to determine the prevalence of abnormal carotid intima-media thickness (CIMT) and associated clinical parameters. RESULTS The study population had a mean age of the 38.3±5.4 years, a median body mass index of 29.25 (IQR 25.06-36.11) Kg/m2 and median waist index (WI) of 1.15 (IQR 1.06-1.34). Increased CIMT was present in 169 (83.25%) participants. Linear regression analysis revealed WI to be the sole predictor of increased CIMT (β=24.387, p<0.001). Post-hoc ROC analysis revealed a WI of 1.12 has 62% sensitivity and 53% specificity for predicting increased CIMT (AUC 0.63, 95% CI 0.55-0.72, p=0.016). The median urinary albumincreatinine ratio (ACR) was 4.4mg/g and the prevalence of microalbuminuria was 8.9%; serum triglycerides were the only independent predictor of ACR. CONCLUSIONS Atherosclerosis, as detected by abnormal CIMT, is very prevalent in middleaged women. Waist index is the major predictor of subclinical atherosclerosis in a contemporary premenopausal female population. A WI of 1.12 exhibits relatively good sensitivity & specificity in predicting the presence of atherosclerosis in this patient population.