Comparison of predictive value of cardiometabolic indices for subclinical atherosclerosis in Chinese adults.

Objectives: Metabolic disturbances are well-known risk factors for atherosclerosis, but it remains unclear which cardiometabolic components are the predominant determinants. This study aimed to compare and identify the key determinants of carotid atherosclerosis in asymptomatic middle-aged and elderly Chinese.

Methods: A community-based cross-sectional study including 3,162 apparently healthy residents aged 37-75 years was performed from July 2008 to June 2010 in Guangzhou, China. Carotid artery intima-media thickness (IMT) was assessed by B-mode ultrasound, and increased IMT was defined as IMT>1.00 mm. Obesity indices, blood pressure, fasting blood lipids, glucose and uric acid levels were determined. Principal components factor analysis was used to extract common factors underlying 11 metabolic factors.

Results: Four common factors, defined as "adiposity," "blood lipids," "triglycerides/uric acid (TG/UA)" (in men) or "triglycerides/uric acid/glucose (TG/UA/Glu)" (in women), and "blood pressure," were retained for both sexes. After adjustment for potential covariates, the "adiposity" factor showed the strongest positive association with increased IMT in men. Comparing the extreme quartiles, ORs (95% CI) of increased IMT were 4.64 (2.04-10.59) at the CCA and 2.37 (1.54-3.64) at the BIF), followed by "blood pressure", the corresponding OR (95% CI) was 2.85 (1.37-5.90) at the CCA. Whereas, the four common factors showed comparable and weak relationship with increased IMTs, the ORs for quartile 4 vs. quartile 1 varied from 0.89 to 3.59 in women.

Conclusions: Among the metabolic factors, "adiposity" and "blood pressure" play predominant roles in the presence of carotid atherosclerosis in men, but no key factor is identified in women.