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Intern Med. 2007;46(21):1771-7. Epub 2007 Nov 1.

Carotid atherosclerosis in normal-weight metabolic syndrome.

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Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.



To examine whether or not individuals with a normal body mass index (BMI) (18.5 kg/m(2)-24.9 kg/m(2)), but who also fulfill the criteria for the metabolic syndrome (MetS) class, can be associated with carotid atherosclerosis.


The subjects were consecutive in-patients with a normal BMI (18.5 kg/m(2)-24.9 kg/m(2)) in the Medical Department of Seiyo Municipal Nomura Hospital enrolled between September 1996 and February 2006. The subjects were 452 men aged 69+/-15 (mean+/-standard deviation) years and 542 women aged 74+/-13 years. Carotid atherosclerosis was assessed by carotid intima-media thickness (IMT) on B-mode ultrasonography.


Compared with men with BMI 18.5 kg/m(2) to 20.9 kg/m(2), the odds ratios of the MetS were 2.83 (95% confidence interval [CI], 1.69-4.76) for men with BMI 21 kg/m(2) to 22.9 kg/m(2) and 6.13 (95% CI, 3.57-10.5) for men with BMI 23.0 kg/m(2) to 24.9 kg/m(2) after controlling for age, smoking status, high low-density lipoprotein cholesterol, and uric acid. Using the same regression model and BMI categories in women, the odds ratios were 2.52 (95% CI, 1.42-2.83) and 4.38 (95% CI, 2.42-7.92), respectively. Multivariate-adjusted carotid IMT was significantly greater in men with than without MetS, especially in patients with BMI 23.0 kg/m(2) to 24.9 kg/m(2). Although in women, there were no inter-group differences in categories of normal BMI and MetS.


Individuals in the upper normal BMI range have a relatively high prevalence and are at increased risk of having metabolic syndrome. Therefore, screening of individuals with normal or slightly elevated BMI is important in preventing atherosclerosis.

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