Carotid Intima‐Media Thickness but Not Carotid Artery Plaque in Healthy Individuals Is Linked to Lean Body Mass
Authors: Arnold Matthew , Linden Andrew , Clarke Robert , Guo Yu , Du Huaidong , Bian Zheng , Wan Eric , Yang Meng , Wang Liang , Chen Yuexin , Chen Jianwei , Long Huajun , Gu Qijun , Collins Rory , Li Liming , Chen Zhengming , Parish Sarah , Chen Junshi , Lv Jun , Peto Richard , Walters Robin , Bennett Derrick , Boxall Ruth , Bragg Fiona , Chang Yumei , Chen Yiping , Gilbert Simon , Hacker Alex , Holmes Michael , Kartsonaki Christiana , Kerosi Rene , Lancaster Garry , Lin Kuang , McDonnell John , Millwood Iona , Nie Qunhua , Yao Pang , Ryder Paul , Sansome Sam , Schmidt Dan , Sohoni Rajani , Turnbull Iain , Walters Robin , Wang Jenny , Wang Lin , Wright Neil , Yang Ling , Yang Xiaoming , Han Xiao , Hou Can , Jing Biao , Liu Chao , Lv Jun , Pei Pei , Tan Yunlong , Yu Canqing , Gao Ruqin , Li Shanpeng , Wang Shaojie , Liu Yongmei , Du Ranran , Zang Yajing , Cheng Liang , Tian Xiaocao , Zhang Hua , Zhai Yaoming , Ning Feng , Sun Xiaohui , Li Feifei , Lv Silu , Wang Junzheng , Hou Wei , Zeng Mingyuan , Jiang Ge , Yang Liqiu , He Hui , Yu Bo , Li Yanjie , Xu Qinai , Kang Quan , Wang Dan , Hu Ximin , Wang Hongmei , Chen Jinyan , Fu Yan , Fu Zhenwang , Wang Xiaohuan , Weng Min , Guo Zhendong , Wu Shukuan , Li Yilei , Li Huimei , Fu Zhifang , Wu Ming , Zhou Yonglin , Zhou Jinyi , Tao Ran , Yang Jie , Su Jian , Liu Fang , Zhang Jun , Hu Yihe , Lu Yan , Ma Liangcai , Tang Aiyu , Zhang Shuo , Jin Jianrong , Liu Jingchao , Tang Zhenzhu , Chen Naying , Huang Ying , Li Mingqiang , Meng Jinhuai , Pan Rong , Jiang Qilian , Lan Jian , Liu Yun , Wei Liuping , Zhou Liyuan , Chen Ningyu , Wang Ping , Meng Fanwen , Qin Yulu , Wang Sisi , Wu Xianping , Zhang Ningmei , Chen Xiaofang , Zhou Weiwei , Luo Guojin , Li Jianguo , Chen Xiaofang , Zhong Xunfu , Liu Jiaqiu , Sun Qiang , Ge Pengfei , Ren Xiaolan , Dong Caixia , Zhang Hui , Mao Enke , Wang Xiaoping , Wang Tao , Zhang Xi , Zhang Ding , Zhou Gang , Feng Shixian , Chang Liang , Fan Lei , Gao Yulian , He Tianyou , Sun Huarong , He Pan , Hu Chen , Zhang Xukui , Wu Huifang , He Pan , Yu Min , Hu Ruying , Wang Hao , Qian Yijian , Wang Chunmei , Xie Kaixu , Chen Lingli , Zhang Yidan , Pan Dongxia , Huang Yuelong , Chen Biyun , Yin Li , Liu Huilin , Fu Zhongxi , Xu Qiaohua , Xu Xin , Zhang Hao , Li Xianzhi , Zhang Libo , Qiu Zhe 
Published: July 2019

Background

Lean body mass has been identified as a key determinant of left ventricular mass and wall thickness. However, the importance of lean body mass or other body‐size measures as normative determinants of carotid intima‐media thickness (
cIMT
), a widely used early indicator of atherosclerosis, has not been well established.

Methods and Results

Carotid artery ultrasound measurements of
cIMT
and carotid artery plaque burden (derived from plaque number and maximum size) and measurements of body size, including height, body mass index, weight, body fat proportion, and lean body mass ([1−body fat proportion]×weight), were recorded in 25 020 participants from 10 regions of China. Analyses were restricted to a healthy younger subset (n=6617) defined as never or long‐term ex‐regular smokers aged <60 years (mean age, 50) without previous ischemic heart disease, stroke, diabetes mellitus, or hypertension and with plasma non‐high‐density lipoprotein cholesterol <4 mmol/L. Among these 6617 participants, 86% were women (because most men smoked) and 9% had carotid artery plaque. In both women and men separately, lean body mass was strongly positively associated with
cIMT
, but was not associated with plaque burden: overall, each 10 kg higher lean body mass was associated with a 0.03 (95%
CI
, 0.03–0.04) mm higher
cIMT
(
P
=5×10
−33
). Fat mass, height, and other body‐size measures were more weakly associated with
cIMT
.

Conclusions

The strong association of lean body mass with
cIMT,
but not with plaque burden, in healthy adults suggests a normative relationship rather than reflecting atherosclerotic pathology. Common mechanisms may underlie the associations of lean body mass with
cIMT
and with nonatherosclerotic vascular traits.