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J Epidemiol Community Health 2004;58:700-704 doi:10.1136/jech.2003.014001
  • Research report

Sex differences in body fat distribution and carotid intima media thickness: cross sectional survey using data from the British regional heart study

  1. Debbie A Lawlor1,
  2. Shah Ebrahim1,
  3. Peter Whincup2,
  4. Jonathan Sterne1,
  5. Olia Papacosta3,
  6. Goya Wannamethee3,
  7. Surinder Dhanjil4,
  8. Maura Griffin4,
  9. Andrew N Nicolaides4,5,
  10. George Davey Smith1
  1. 1Department of Social Medicine, University of Bristol, Bristol, UK
  2. 2Department of Public Health Sciences, St George’s Hospital Medical School, London, UK
  3. 3Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, UK
  4. 4Division of Surgery, Anaesthetics and Intensive Care, Irvine Laboratory, Imperial College School of Medicine, St Mary’s Hospital, London, UK
  5. 5Department of Neurovascular Sciences, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
  1. Correspondence to:
 Dr D A Lawlor
 Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK; d.a.lawlorbristol.ac.uk
  • Accepted 3 December 2003

Abstract

Objective: To determine the role of central adiposity in explaining sex differences in carotid intima media thickness (IMT).

Design: Cross sectional survey.

Setting: Two British towns.

Participants: 800 men and women aged 56–75 years.

Main outcome measures: Carotid IMT.

Results: There was a continuous linear association between waist-hip ratio and IMT in both men and women. The magnitude of the association between waist to hip ratio and IMT was identical in both sexes. In age adjusted analyses IMT was 14% greater in men compared with women (age adjusted male to female ratio of geometric means 1.14; 95% confidence interval 1.07 to 1.21) with adjustment for waist to hip ratio this attenuated to no difference (1.00; 0.92 to 1.09). Adjustment for body mass index and for lifestyle risk factors had very little effect on the sex difference in mean intima media thickness.

Conclusions: Sex differences in body fat distribution may explain sex differences in arterial atherosclerosis.

Footnotes

  • Funding: this study was funded by the Stroke Association. The Department of Health and British Heart Foundation have provided funding for the British regional heart study. The CDER Trust provided funding for the ultrasound equipment used in this study. DAL was funded by a Medical Research Council/Department of Health (UK) research training fellowship at the time that this work was undertaken and is now funded by a Department of Health (UK) Career Scientist Award. The opinions expressed are those of the authors.

  • Conflicts of interest: none declared.

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