Insulin resistance and not BMI is the major determinant of early vascular impairment in patients with morbid obesity

Abstract

Aim: Several factors contribute to the development of atherogenesis in patients with obesity. The aim of our study was to evaluate the different roles of insulin resistance, strictly correlated to visceral adiposity, and the body mass index (BMI), an estimate of overall adiposity, on early vascular impairment in patients with morbid obesity. Methods: We enrolled 65 morbidly obese subjects (BMI 44.6 ± 7 kg/m2) who were free of previous cardiovascular events and 28 nonobese subjects (control group) in a cross-sectional study. The presence of glycemia and insulinemia, the levels of lipids and liver parameter and the ultrasonographic assessment of the flow-mediated dilatation (FMD), carotid intima-media thickness (IMT) and visceral fat area (VFA) were evaluated in all subjects. Results: In the obese patients with a median HOMA value of > 3.5, the FMD was significantly lower (p