Evidence mapPaperPMID 29598820Full record

ArticleCardiovascular diabetology2018

The role of obesity in carotid plaque instability: interaction with age, gender, and cardiovascular risk factors.

Valentina Rovella, Lucia Anemona, Marina Cardellini, Manuel Scimeca, Andrea Saggini, Giuseppe Santeusanio, Elena Bonanno, Manuela Montanaro, Iacopo Maria Legramante, Arnaldo Ippoliti and 3 more

Open access · goldAbstract read
In one paragraph

Article in Cardiovascular diabetology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 61 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. The obesity pandemic and its impact on non-communicable disease burden.Pflugers Archiv : European journal of physiology · 2025
    Review
  6. Observational
  7. Article
  8. Review
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  11. Heliyon · 2023
    Article
  12. Article
  13. Body Mass Index and Late Adverse Outcomes after a Carotid Endarterectomy.International journal of environmental research and public health · 2023
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Is Obesity a Risk Factor for Carotid Atherosclerotic Disease?-Opportunistic Review.Journal of cardiovascular development and disease · 2022
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Valentina RovellaHypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Lucia AnemonaAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Marina CardelliniDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Manuel ScimecaDepartment of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Andrea SagginiAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Giuseppe SanteusanioAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Elena BonannoAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Manuela MontanaroAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Iacopo Maria LegramanteDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Arnaldo IppolitiVascular Surgery, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Nicola Di DanieleHypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Massimo FedericiDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Alessandro MaurielloAnatomic Pathology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy. alessandro.mauriello@uniroma2.it.
University of Rome Tor Vergata · ITVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the last decade, several studies have reported an unexpected and seemingly paradoxical inverse correlation between BMI and incidence of cardiovascular diseases. This so called "obesity paradox effect" has been mainly investigated through imaging methods instead of histologic evaluation, which is still the best method to study the instability of carotid plaque. Therefore, the purpose of our study was to evaluate by histology the role of obesity in destabilization of carotid plaques and the interaction with age, gender and other major cerebrovascular risk factors.

methodsA total of 390 carotid plaques from symptomatic and asymptomatic patients submitted to endarterectomy, for whom complete clinical and laboratory assessment of major cardiovascular risk factors was available, were studied by histology. Patients with a BMI ≥ 30.0 kg/m

resultsUnstable carotid plaque OR for obese patients with age < 70 years was 5.91 (95% CI 1.17-29.80), thus being the highest OR compared to that of other risk factors. Unstable carotid plaque OR decreased to 4.61 (95% CI 0.54-39.19) in males ≥ 70 years, being only 0.93 (95% CI 0.25-3.52) among women. When obesity featured among metabolic syndrome risk factors, the OR for plaque destabilization was 3.97 (95% CI 1.81-6.22), a significantly higher value compared to OR in non-obese individuals with metabolic syndrome (OR = 1.48; 95% CI 0.86-2.31). Similar results were obtained when assessing the occurrence of acute cerebrovascular symptoms.

conclusionsResults from our study appear to do not confirm any paradoxical effect of obesity on the carotid artery district. Conversely, obesity is confirmed to be an independent risk factor for carotid plaque destabilization, particularly in males aged < 70 years, significantly increasing such risk among patients with metabolic syndrome.

Indexed as

Plaque, AtheroscleroticAgedAge FactorsBody Mass IndexCarotid ArteriesCarotid StenosisCerebrovascular DisordersComorbidityFemaleHumansMaleMiddle AgedObesityPrognosisRisk AssessmentRisk FactorsAgeCarotidGenderHistologyMetabolic syndromeObesityStroke

Identifiers

PMID29598820
PMCPMC5874994
OpenAlexW2800255726

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.